Publications (105)296.81 Total impact
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Article: Reduced Sleep Duration and Daytime Naps in Pregnant Women in Taiwan.
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ABSTRACT: BACKGROUND:: Napping is highly prevalent in pregnant women, but the relation between nighttime sleep and daytime naps in pregnant women is poorly understood. OBJECTIVES:: The aim of this study was to examine the temporal association of nighttime sleep quality and quantity with subsequent daytime naps and the temporal association of daytime naps with sleep quality and quantity the following night in women during the third trimester of pregnancy in Taiwan. METHODS:: Sleep was assessed in 80 Taiwanese nulliparous women aged 31.70 years (SD = 4.58 years) using actigraphy and diaries for 7 consecutive days. Subjective sleep quality was examined using the Pittsburgh Sleep Quality Index. Multiple linear regressions with generalized estimating equations were used to examine the temporal associations of nighttime sleep and daytime naps. RESULTS:: All women napped sometime during the study week, and mean Pittsburgh Sleep Quality Index global score was 6.6, indicating poor sleep quality. Fewer weekly work hours and shorter sleep duration the preceding night were associated with longer nap duration the next day. More work hours, longer nap duration, and more intense fatigue were associated with shorter sleep duration the following night. DISCUSSION:: Naps during pregnancy might indicate insufficient nighttime sleep, and longer daytime naps could compromise subsequent nighttime sleep. Further research is needed to determine if short sleep duration and longer daytime naps are associated with negative pregnancy outcomes.Nursing research 03/2013; 62(2):99-105. · 1.80 Impact Factor -
Article: The safety and immunogenicity of trivalent inactivated influenza vaccination: a study of maternal-cord blood pairs in taiwan.
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ABSTRACT: There are little data about adverse effects and immunogenicity of flu vaccine in Asian pregnant women. This prospective trial (NCT01514708) enrolled 46 pregnant women who received a single intramuscular dose of trivalent flu vaccine (AdimFlu-S®) containing 15 mcg of hemagglutinin for each strain/0.5 mL from influenza A (H1N1), influenza A (H3N2), and influenza B after the first trimester. Blood samples were collected at day 0 and 28 after vaccination, and at delivery. Cord blood was also collected. Hemagglutination inhibition (HAI) assays were performed to determine seroprotection and seroconversion rates and fold increase in the HAI geometric mean titer (GMT). Twenty-eight days after vaccination the seroprotection rate against H1N1, H3N2, and influenza B was 91.3%, 84.8% and 56.5%, respectively. The GMT fold increase was 12.8, 8.4, and 4.6 for H1N1, H3N2, and influenza B, respectively. At delivery, both the seroprotection rate (86.4%, 68.2%, and 47.7%) and GMT fold increase (9.4, 5.7 and 3.8) were slightly lower than day 28. The seroprotection rate and GMT fold increase in maternal and cord blood samples were comparable. No significant adverse effects were detected. Trivalent flu vaccine induces a strong immune response in pregnant women and their infants without adverse effects. Clinical Trials. gov NCT01514708.PLoS ONE 01/2013; 8(6):e62983. · 4.09 Impact Factor -
Article: Maternal ascites after thoracoamniotic shunting.
Prenatal Diagnosis 08/2012; 32(8):815. · 2.11 Impact Factor -
Article: Should array CGH be applied to all routine prenatal care?
Prenatal Diagnosis 07/2012; 32(7):710; author reply 711-2. · 2.11 Impact Factor -
Article: Intraperitoneal and intracardiac transfusion of recurrent fetal erythroblastosis due to anti-M alloimmunization with unfavorable outcome.
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ABSTRACT: To present intensive intrauterine treatment of recurrent early onset fetal erythroblastosis due to anti-M alloimmunization. A 33-year-old woman, gravid 3, para 1, had anti-M IgG antibody, which caused alloimmunization of her previous pregnancies. This time she visited our hospital for intensive intervention. No evidence of fetal hydrops was found during ultrasound examination at 12 weeks of gestation. Plasmapheresis was given from 17 weeks of gestation but fetal erythroblastosis still developed 1 week later. Two intraperitoneal transfusions and one intracardiac transfusion were given within three days but fetal erythroblastosis still progressed to fetal bradycardia and occasional asystole. Epinephrine resuscitation could only temporarily improve the fetal heart rate and fetal death was inevitable. Serial measurements of fetal middle cerebral artery peak systolic velocities, advanced plasmapheresis, intrauterine blood transfusion, and, if needed, intravenous immunoglobulin supplement, may be the appropriate treatment for early onset fetal erythroblastosis resulting from alloimmunization.Taiwanese journal of obstetrics & gynecology 06/2012; 51(2):253-5. -
Article: HELLP syndrome with postpartum hepatic infarction and subcapsular bleeding.
Acta Obstetricia Et Gynecologica Scandinavica 05/2012; 91(5):637-8. · 1.77 Impact Factor -
Article: Prenatal diagnosis of a fetus with a de novo trisomy 12p by array-comparative genomic hybridization (array-CGH).
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ABSTRACT: Trisomy 12p syndrome is a rare chromosomal abnormality, which presents with facial dysmorphism, moderate to severe psychomotor retardation and generalized hypotonia. Here we present the prenatal sonographic findings investigated of a fetus in prenatal diagnosis with a de novo trisomy of 12p identified by array-comparative genomic hybridization (aCGH).Gene 03/2012; 495(2):178-82. · 2.34 Impact Factor -
Article: Resolution of high uterine artery pulsatility index and notching following sildenafil citrate treatment in a growth-restricted pregnancy.
Ultrasound in Obstetrics and Gynecology 02/2012; · 3.01 Impact Factor -
Article: AdimFlu-S(®) influenza A (H1N1) vaccine during pregnancy: the Taiwanese Pharmacovigilance Survey.
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ABSTRACT: This study evaluated the incidence, nature, and seriousness of adverse drug reactions (ADRs) occurring after AdimFlu-S(®) influenza A (H1N1) vaccination in pregnant women was administered. This is a retrospective cohort study. Between October 2009 and February 2010, 198 pregnant women who had received the AdimFlu-S(®) influenza A (H1N1) vaccine during pregnancy and 198 age-matched pregnant women who had not received influenza vaccine were included and recorded. The pregnancy outcome and maternal adverse effects were extracted from chart reviews. Infant health status data were followed up until 8 weeks post-partum. During the observation period of each cohort, four subjects (2.0%) in the exposed group experienced vaccine-related adverse events that were mild in severity. A total of 17 women (8.6%) in the vaccine exposed group and 40 women (20.2%) in the unexposed group underwent at least one adverse effect during their pregnancy. A total of 72 infants (35.6%) in the exposed group and 101 infants (49%) in the unexposed group had at least one adverse event within 8 weeks after they were born (p<0.05). The adverse events experienced by the women and their infants were not increased when the vaccine was administered during the first trimester. There were no significant differences between these two groups with regard to preterm delivery rate and stillbirth rate. AdimFlu-S (®) influenza A (H1N1) vaccine is safe for pregnant women and their infants.Vaccine 02/2012; 30(16):2671-5. · 3.77 Impact Factor -
Article: Cord blood stem-cell-derived dendritic cells generate potent antigen-specific immune responses and anti-tumour effects.
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ABSTRACT: The aim of the present study was to investigate whether CBSCs [(umbilical) cord blood stem cells] can be a new source of DCs (dendritic cells), which can generate more potent antigen-specific immune responses and anti-tumour effects. CBSCs and PBMCs (peripheral blood mononuclear cells) were collected, cultured and differentiated into DCs. Surface markers, secreting cytokines, antigen-presentation activity, antigen-specific cell-mediated immunity and cytotoxic killing effects induced by these two DC origins were evaluated and compared. CBSCs were expanded ~17-fold by ex vivo culture. The expression of surface markers in CBSC-derived DCs were higher than those in PBMC-derived DCs treated with LPS (lipopolysaccharide). The CBSC-derived DCs mainly secreted IL (interleukin)-6, IL-10 and TNF (tumour necrosis factor)-α, whereas PBMC-derived DCs mainly secreted IL-5 and IFN (interferon)-γ. The CBSC-derived DCs had better antigen-presentation abilities when stimulated with LPS or TNF-α, induced higher numbers of IFN-γ-secreting antigen-specific CD8+ T-cells, as assessed using an ELISpot (enzyme-linked immunosorbent spot) assay, and stimulated more potent antigen-specific CTL (cytotoxic T-cell) activities (P<0.01, one-way ANOVA). CBSC-derived DCs had quicker and greater ERK (extracellular-signal-regulated kinase) and Akt phosphorylation, and weaker p38 phosphorylation, than PBMC-derived DCs when stimulated with LPS. In conclusion, CBSC-derived DCs have the ability to induce stronger antigen-specific immunity and more potent anti-tumour effects and therefore could be a good source of DCs for use in DC-based cancer vaccines and immunotherapy.Clinical Science 01/2012; 123(6):347-60. · 4.61 Impact Factor -
Article: HELLP syndrome with postpartum hepatic infarction and subcapsular bleeding.
Acta Obstetricia Et Gynecologica Scandinavica 01/2012; · 1.77 Impact Factor -
Article: Risk factors of pregnancy-related lumbopelvic pain: a biopsychosocial approach.
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ABSTRACT: To examine the associations between pain-related psychological and social factors and pregnancy-related lumbopelvic pain intensity and interference after controlling biological factors. Pregnancy-related lumbopelvic pain is prevalent and has been shown to interfere with women's quality of life. Although pain is a multidimensional phenomenon known to be influenced by psychosocial factors, the majority of previous research on this pregnancy-related lumbopelvic pain has focused on biological factors. Cross-sectional correlational research. A sample of 183 pregnant women with lumbopelvic pain was recruited from a medical center in northern Taiwan. Study participants provided demographic information and were administered the Brief Pain Inventory and a modified Catastrophising subscale of the Coping Strategies Questionnaire. Multiple regressions were used to examine the associations among the study variables. Analyses indicated that lower education level was associated with higher pain intensity. Higher pain intensity during pregnancy and catastrophising cognitions were associated significantly with higher pain interference. Moreover, age moderated the strength of the association between pain intensity and pain interference. This association was stronger for older than for younger women. This study identified the psychosocial factors associated with pregnancy-related lumbopelvic pain intensity (educational level) and interference (pain intensity and catastrophising) and also a variable (age) that moderated the association between pain intensity and pain interference. The findings support a biopsychosocial approach in understanding the experience and impact of pregnancy-related lumbopelvic pain. Nurses should assess pregnant clients' age, educational level, pain intensity and pain catastrophising thoughts to help identify women who are more at risk for higher lumbopelvic pain intensity or interference. Women endorsing catastrophising cognitions should be referred to or provided with treatment to reduce the frequency of these cognitions that are known to have a negative impact on quality of life in other pain populations.Journal of Clinical Nursing 11/2011; 21(9-10):1274-83. · 1.12 Impact Factor -
Article: Factors associated with sleep quality in pregnant women: a prospective observational study.
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ABSTRACT: : Sleep disturbance is a significant health issue in pregnant women. Although previous studies contribute to an understanding of the multifactorial nature of pregnancy-related sleep disturbance, objective measures of sleep were not included, and so data may be subject to recall and potential participant self-report bias. : The aim of this study was to identify sociodemographic, lifestyle, and health-related factors associated with poor sleep quality in women during their third trimester of pregnancy. : This prospective study included 30 nulliparous women who wore a wrist actigraph to objectively monitor sleep for 7 consecutive days and completed the Pittsburgh Sleep Quality Index. : Fifteen women (50%) had a Pittsburgh Sleep Quality Index global score of >5, indicating poor sleep quality. Mean actigraphic sleep efficiency was only 80.05% ± 6.27%. There were significant differences (p < .01) in sleep offset time and total nocturnal sleep time between weekdays and weekends. Later sleep onset time was associated with poorer sleep, including longer sleep latency, and reduced total nocturnal sleep time and sleep efficiency. : Nulliparous women experience both objective and subjective sleep disturbances, and their sleep patterns differ between weekdays and weekends during their third trimester of pregnancy. Results suggest that maternal sleep pattern may be improved by maintaining a regular and earlier bedtime so women have more opportunity to obtain sufficient nocturnal sleep and improved sleep quality.Nursing research 11/2011; 60(6):405-12. · 1.80 Impact Factor -
Article: MUC1 expression is elevated in severe preeclamptic placentas and suppresses trophoblast cell invasion via β1-integrin signaling.
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ABSTRACT: Preeclampsia is a pregnancy-specific disorder that features insufficient extravillous trophoblast (EVT) invasion. We have previously shown that MUC1 expression in human placenta increases with gestational age and inhibits choriocarcinoma cell invasion. Here, we studied whether MUC1 expression in preeclamptic placentas is dysregulated and the mechanism of EVT invasion regulated by MUC1. MUC1 expression in severe preeclamptic placentas and gestational age-matched control placentas was analyzed by real-time RT-PCR, Western blot analysis, and immunohistochemistry. The effects of MUC1 expression on cell-matrix adhesion, invasion, and cell signaling were studied in HTR8/SVneo EVT cells. We found that MUC1 mRNA and MUC1 protein were significantly up-regulated in severe preeclamptic placentas when compared with the gestational age-matched control placentas. Immunohistochemical analyses showed increased expression of MUC1 in the syncytiotrophoblast and EVT of severe preeclamptic placentas. In addition, MUC1 overexpression suppressed cell-matrix adhesion and invasion of EVT cells. Importantly, our data showed that MUC1 overexpression inhibited β1-integrin activity and phosphorylation of focal adhesion kinase, whereas the surface expression of β1-integrin was not significantly changed. Our findings suggest that MUC1 is overexpressed in severe preeclamptic placentas and that MUC1 overexpression suppresses EVT invasion mainly via modulating β1-integrin signaling.The Journal of clinical endocrinology and metabolism 09/2011; 96(12):3759-67. · 6.50 Impact Factor -
Article: Quantitative and qualitative analyses of the SNRPN gene using real-time PCR with melting curve analysis.
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ABSTRACT: Prader-Willi syndrome and Angelman syndrome are distinct neurodevelopmental disorders that are associated with the deletion of the chromosomal 15q11-13 region or uniparental disomy of chromosome 15. In this article, we applied SYBR Green I-based real-time PCR and melting curve analysis assay for rapid genotyping of the small nuclear ribonucleoprotein polypeptide N (SNRPN) gene methylation status and for detecting aberrations in copy number in a single tube. A single pair of primers was designed to create a 357 bp fragment containing the cytosine phosphodiester guanine islands in the SNRPN promoter and to amplify both unmethylated and methylated sequences. Genotypes were identified based on the TC value for copy number changes and the characteristic melting temperature of methylated cytosine phosphodiester guanine. Genotyping of SNRPN was performed on blood samples of 20 individuals with Prader-Willi syndrome, 3 individuals with Angelman syndrome, and 20 unaffected individuals. The promoter methylation status and the copy number changes were successfully determined and compared with standard methylation-specific PCR, and were validated by multiplex ligation-dependent probe amplification. This single-tube, SYBR Green I, real-time PCR with melting curve assay is rapid, reliable, sensitive, and easy to perform. It is suitable for high-throughput analysis as an alternative technique for quantitative and qualitative analysis of target genes.The Journal of molecular diagnostics: JMD 08/2011; 13(6):609-13. · 3.48 Impact Factor -
Article: Recombinant activated factor VII as a promising adjuvant therapy for postpartum hemorrhage in the practice of obstetric anesthesia: experience from a university hospital in Taiwan.
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ABSTRACT: Massive postpartum hemorrhage is one of the major complications in the peripartum period. In some critical cases, hemostasis is hard to achieve even after a hysterectomy has been performed. Recombinant activated factor VII has been reported as a promising adjuvant therapy for obstetric hemorrhage, although it remains unlicensed for this indication. Eight cases receiving recombinant activated factor VII in postpartum hemorrhage refractory to the conventional therapy in a Taiwanese hospital were analyzed retrospectively. A good response, defined as bleeding control in 15 min, was achieved in six patients (75%) with a single dose ranging from 55 to 105 µg/kg. The two patients with a poor response were later discovered to have had unsolved birth canal injuries. No drug-related adverse effects were noted. We recommend that any surgical bleeding should first be controlled, as well as the correction of metabolic and hematological abnormalities; however, in the situation of intractable postpartum hemorrhage, recombinant activated factor VII offers a salvage therapy and should be considered early, even before hysterectomy.Journal of Obstetrics and Gynaecology Research 07/2011; 37(7):901-7. · 0.94 Impact Factor -
Article: Two cases of Lowe syndrome presenting as increased fetal nuchal translucency.
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ABSTRACT: No abstract available.Journal of Perinatal Medicine 06/2011; 39(4):483-5. · 1.70 Impact Factor -
Article: The experience of and coping with lumbopelvic pain among pregnant women in Taiwan.
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ABSTRACT: 1) To replicate and extend previous research on the prevalence and characteristics of pregnancy-related lumbopelvic pain, and 2) to examine the associations between pain intensity, pain interference, and pain coping strategies in a sample of women with pregnancy-related lumbopelvic pain. Cross-sectional design. An academic public and urban medical center in Taiwan. Pregnant women without gestational or psychiatric diseases in the 35th to 41st gestational week. N/A. Questionnaires were used to collect data on demographics, pain intensity, pain interference, and pain coping responses. Of 230 consecutive cases scheduled for an outpatient obstetrics-gynecology clinic appointment, 187 agreed to participate in this study. One hundred and forty (74.9%) of these reported pregnancy-related lumbopelvic pain. Most participants with pain reported it as mild to moderate in severity and that the pain interfered with a number of daily activities. The coping responses used most often for pain management included rest (94.3%), task persistence (87.9%), and asking for assistance (87.1%). The results confirmed that pregnancy-related lumbopelvic pain is a common problem that interferes with important activities. Pregnant women use a number of coping strategies to manage lumbopelvic pain. A common use of passive coping responses such as rest and asking for assistance suggest the possibility of a helplessness phenomenon in response to pain among some of the study participants. Education and interventions targeting this may be warranted to minimize the chances that the lumbopelvic pain experienced during pregnancy will develop into a chronic pain problem over time.Pain Medicine 06/2011; 12(6):846-53. · 2.35 Impact Factor -
Article: Successful application of the strategy of blastocyst biopsy, vitrification, whole genome amplification, and thawed embryo transfer for preimplantation genetic diagnosis of neurofibromatosis type 1.
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ABSTRACT: Preimplantation genetic diagnosis (PGD) offers an alternative for women to carry an unaffected fetus risk of hereditary diseases. Trophectoderm biopsy may provide more cells for accurate diagnosis. However, the time allowed for transportation of the specimens to the laboratory and performance of molecular diagnosis is limited. We designed a PGD program of trophectoderm biopsy, vitrification of blastocysts, whole genome amplification (WGA), double confirmatory genotypings, and thawed embryo transfer. We conducted this strategy for a woman of familial neurofibromatosis type I (NF-1). She had a genotype of heterozygous c.6709C>T mutation of NF1 gene. Trophectoderm biopsies were performed on 13 blastocysts. Then, individual blastocyst was vitrified. WGA was performed for the samples, followed by genotypings with both real-time polymerase chain reaction and sequencing. Eight embryos were diagnosed as unaffected, four were affected, and one was inconclusive because of allele drop-out. In the next cycle, two unaffected blastocysts were thawed and transferred, that resulted in a singleton pregnancy. The pregnancy was confirmed as unaffected by means of chorionic villi sampling. We first demonstrate successful application of blastocyst biopsy, vitrification, WGA, and thawed embryo transfer for PGD of a monogenic disease. Vitrification of blastocysts after biopsy permits sufficient time for shipment of samples and operation of molecular diagnosis.Taiwanese journal of obstetrics & gynecology 03/2011; 50(1):74-8. -
Article: Carrier screening for spinal muscular atrophy (SMA) in 107,611 pregnant women during the period 2005-2009: a prospective population-based cohort study.
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ABSTRACT: Spinal muscular atrophy (SMA) is the most common neuromuscular autosomal recessive disorder. The American College of Medical Genetics has recently recommended routine carrier screening for SMA because of the high carrier frequency (1 in 25-50) as well as the severity of that genetic disease. Large studies are needed to determine the feasibility, benefits, and costs of such a program. This is a prospective population-based cohort study of 107,611 pregnant women from 25 counties in Taiwan conducted during the period January 2005 to June 2009. A three-stage screening program was used: (1) pregnant women were tested for SMA heterozygosity; (2) if the mother was determined to be heterozygous for SMA (carrier status), the paternal partner was then tested; (3) if both partners were SMA carriers, prenatal diagnostic testing was performed. During the study period, a total of 2,262 SMA carriers with one copy of the SMN1 gene were identified among the 107,611 pregnant women that were screened. The carrier rate was approximately 1 in 48 (2.10%). The negative predictive value of DHPLC coupled with MLPA was 99.87%. The combined method could detect approximately 94% of carriers because most of the cases resulted from a common single deletion event. In addition, 2,038 spouses were determined to be SMA carriers. Among those individuals, 47 couples were determined to be at high risk for having offspring with SMA. Prenatal diagnostic testing was performed in 43 pregnant women (91.49%) and SMA was diagnosed in 12 (27.91%) fetuses. The prevalence of SMA in our population was 1 in 8,968. The main benefit of SMA carrier screening is to reduce the burden associated with giving birth to an affected child. In this study, we determined the carrier frequency and genetic risk and provided carrier couples with genetic services, knowledge, and genetic counseling.PLoS ONE 01/2011; 6(2):e17067. · 4.09 Impact Factor
Top co-authors
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Institutions
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2004–2012
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National Taiwan University
- • College of Medicine
- • Institute of Biomedical Engineering
Taipei, Taipei, Taiwan
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1997–2012
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National Taiwan University Hospital
Taipei, Taipei, Taiwan
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2007–2010
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Chang Gung Memorial Hospital
- Department of Obstetrics and Gynecology
Taipei, Taipei, Taiwan
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2005
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Animal technology institute Taiwan
Taipei, Taipei, Taiwan
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1996
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Taiwan Adventist Hospital
Taipei, Taipei, Taiwan
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