Wen-Lin Su

• Doctor of Philosophy
• Managing Director at Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

Background Aspiration pneumonia is a critical concern, particularly in older adults with comorbidities. Micro-aspiration is often underdiagnosed due to the lack of precise diagnostic tools. This study evaluated the utility of anaerobic PCR for Veillonella parvula compared with traditional diagnostic methods for predicting aspiration pneumonia. Met...

Sepsis remains a leading cause of morbidity and mortality worldwide, representing a substantial burden on healthcare systems [...]

Background/Objectives: The rapid viral spread observed in coronavirus disease 2019 (COVID-19) is capable of inducing the secretion of excessive inflammatory cytokines. The resulting multi-organ damage is a severe complication that can be attenuated through adequate nutrition. Formulae enhanced with either glutamine or arginine are conditionally ess...

Chronic Obstructive Pulmonary Disease (COPD) is one of the world's most significant causes of illness and mortality. It is vital to identify modifiable risk factors for COPD prevention and therapy, and the scientific community has started to focus closely on nutrition as a crucial component of COPD management, from prevention to treatment. For the...

Background: Sepsis is a leading cause of mortality in intensive care units (ICUs). Cell-free hemoglobin (CFH) released during sepsis interacts with lysosomal enzymes from neutrophils and macrophages. This study aims to examine the association of LVV-hemorphin-7 (LVV-H7), cathepsin D, and cathepsin G with sepsis and shock in ICU patients. Methods: A...

Background The coronavirus disease 2019 (COVID-19) has a considerable impact on the global healthcare system. Individuals who have recovered from COVID often experience chronic respiratory symptoms that affect their daily lives. This study aimed to assess respiratory dynamics such as airway hyperresponsiveness (AHR) and bronchodilator response in p...

A BSTRACT Objectives Endotracheal tube (ETT) intubation is a life-saving procedure in patients with respiratory failure. However, the presence of an ETT can cause significant discomfort. A tracheostomy tube is used to administer a mechanical ventilator, resulting in a more stable airway and fewer serious injuries. Noninvasive ventilators (NIPPVs)...

Objectives Asthma is a chronic respiratory disease that affects millions of people worldwide and causes severe symptoms such as wheezing, coughing, and breathing difficulty. Despite modern treatments, 3%–10% of patients develop severe asthma, which requires high-dose medications, and they may still experience frequent and severe symptoms, exacerbat...

A BSTRACT Uremic toxins play a crucial role in the development of low bone turnover disease in chronic kidney disease (CKD) through the induction of oxidative stress. This oxidative stress disrupts the delicate balance between bone formation and resorption, resulting in a decline in both bone quantity and quality. Reactive oxygen species (ROS) acti...

Background and objective: This study evaluated the predictive roles of hematologic inflammatory biomarkers including neutrophil-percentage-to-albumin ratio (NPAR), neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR) for mortality in community-dwelling individuals with chronic obstructive pulmonary disease (COPD). Methods...

Background: Chronic obstructive pulmonary disease (COPD) often causes cardiopulmonary dysfunction, which deteriorates exercise capacity. Cardiopulmonary exercise testing (CPET) and echocardiography are common tools for evaluating cardiovascular function. No studies have analyzed the correlation between echocardiography-derived parameters and cardi...

Background Patients with chronic obstructive pulmonary disease (COPD) often have exercise intolerance. The prevalence of hypertension in COPD patients ranges from 39–51%, and β-blockers and amlodipine are commonly used drugs for these patients. Objectives We aimed to study the impact of β-blockers and amlodipine on cardiopulmonary responses during...

Because it is an accessible and routine image test, medical personnel commonly use a chest X-ray for COVID-19 infections. Artificial intelligence (AI) is now widely applied to improve the precision of routine image tests. Hence, we investigated the clinical merit of the chest X-ray to detect COVID-19 when assisted by AI. We used PubMed, Cochrane Li...

Background: Immunothrombosis, a process of inflammation and coagulation, is involved in sepsis-induced acute respiratory distress syndrome formation (ARDS). However, the clinical correlation between immunothrombosis biomarkers (including tissue factor [TF] and von Willebrand factor [vWF]) and coronavirus disease 2019 (COVID-19)-related ARDS is unk...

Aging processes, including immunosenescence, inflammation, inflammasome formation, genomic instability, telomeric attrition, and altered autophagy, are involved in viral infections and they may contribute to increased pathophysiological responses to the SARS-CoV-2 infection in the elderly; this poses additional risks of accelerated aging, which cou...

Background Heme oxygenase one (HO-1) is considered a poor prognostic factor for survival in patients with severe-to-critical coronavirus disease (COVID-19), but the clinical correlation between heme catabolism biomarkers and COVID-19-related sepsis is unknown. The etiopathogenetic hypothesis of HO-1 response during sepsis in patients with poor prog...

Nuss surgery is effective in correcting pectus excavatum (PE), with a recurrence rate of 1.2–27%. Re-do surgery is successful but still has a 6% failure rate. Patients with obstructive sleep apnea (OSA) experience repetitive PE-associated sternal depression during sleep. As the prevalence of OSA among PE patients is higher than the average, co-exis...

A BSTRACT When patient with coronavirus disease 2019 (COVID-19) are hospitalized, the limited space for activity, disease itself causes fever, muscle aches, fatigue, respiratory failure with mechanical ventilation, or medications such as steroids or neuromuscular blocking can cause muscle dysfunction. Pulmonary rehabilitation (PR) should be arrange...

Acute lung injury (ALI) is characterized by diffuse pulmonary infiltrates and causes great mortality. ALI presents with overproduction of proinflammatory cytokines, cell death, destruction of alveoli-endothelial barriers, and neutrophil infiltration in lung tissues. Damage-associated molecular patterns (DAMPs) are molecules released from damaged ce...

Background The decision guild for non-invasive positive pressure ventilation (NPPV) application in acute respiratory failure (ARF) patients still needs to work out. Methods Adult patients with acute hypoxemic or hypercapnic respiratory failure were recruited and treated with NPPV or primary invasive mechanical ventilation (IMV). Patients’ characte...

Background: Traditional Chinese medicine (TCM) theories assert that body constitution and meridian energy lay the foundation for disease prevention. TCM-based health concepts have not yet been incorporated into mobile health (mHealth) apps for individuals with prediabetes. Objective: The aim of this study was to examine the effectiveness of a TC...

Non-small-cell lung cancer (NSCLC) causes significant mortality worldwide. Patients with chronic renal failure have an increased risk of developing lung cancer. NSCLC Patients with chronic renal failure undergoing hemodialysis (HD) often exhibit poor performance, and chemotherapy is generally contraindicated. Oral epidermal growth factor receptor (...

Melatonin, an endogenous indoleamine, is an antioxidant and anti-inflammatory molecule widely distributed in the body. It efficiently regulates pro-inflammatory and anti-inflammatory cytokines under various pathophysiological conditions. The melatonin rhythm, which is strongly associated with oxidative lesions and mitochondrial dysfunction, is also...

Background: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease with an increased mortality rate in recent years, mainly caused by exposure to tobacco smoke. Regular physical activity is thought to diminish the risk of COPD exacerbation, while very few studies investigate the interaction between smoking and physical...

The first wave of the coronavirus disease 2019 (COVID-19) outbreak in Taiwan occurred in May 2021. The risk for and severity of this disease vary and are highly dependent on personal habits and comorbidities. Moreover, the gut microbiome, which may be affected by diet, is highly susceptible with regard to the risk and severity of infectious disease...

Purpose: Patients with septicemia caused by vancomycin-resistant Enterococcus (VRE) bacteremia have higher mortality rates than patients infected by VSE. Vancomycin or teicoplanin is selected as the antibiotic stewardship intervention to cover methicillin-resistant Staphylococcus aureus infections before blood culture reveals VRE bacteremia in cri...

Continuous positive airway pressure (CPAP) therapy can spread infections if the equipment is not cleaned properly. We report a case of Pneumocystis jirovecii pneumonia likely spread by unclean CPAP equipment and accessories. A 48-year-old man with severe obstructive sleep apnea was using CPAP equipment that had never been cleaned for 5 years. He ex...

This was a preliminary study on ultraviolet C (UVC) irradiation for SARS-CoV-2-contaminated hospital environments. Forty-eight locations were tested for SARS-CoV-2 using RT-PCR (33.3% contamination rate). After series dosages of 222-nm UVC irradiation, samples from the surfaces were negative at 15 s irradiation at 2 cm length (fluence: 81 mJ/cm²).

To overcome the ongoing coronavirus disease 2019 (COVID-19) pandemic, transmission routes, such as healthcare worker infection, must be effectively prevented. Ultraviolet C (UVC) (254 nm) has recently been demonstrated to prevent environmental contamination by infected patients; however, studies on its application in contaminated hospital settings...

Sepsis is a health issue that affects millions of people worldwide. It was assumed that erythrocytes were affected by sepsis. However, in recent years, a number of studies have shown that erythrocytes affect sepsis as well. When a pathogen invades the human body, it infects the blood and organs, causing infection and sepsis-related symptoms. Pathog...

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) attacks pulmonary alveolar cells via angiotensin-converting enzyme 2 (ACE2) receptors and causes pulmonary infections that result in coronavirus disease (COVID-19), inducing immune responses that can result in severe pneumonia. We reviewed the clinical experiences of lung diseases during...

Background Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease with exacerbations causing hospitalizations, morbidity, and mortality. COPD exacerbation causes a substantial health impact, and its subtypes might differ in prognosis and treatment response. Methods This study evaluated the factors of COPD exacerbations and...

Introduction Sepsis is a severe disease with a high morbidity and mortality. Baicalin, an active compound of Chinese medicine, Scutellaria baicalensis Georgi (Huang Qui), exhibits several beneficial effects. In this study, we examined whether administration of baicalin increases the survival in mice with endotoxemia and investigated its anti-inflam...

Increased heme levels, anemia, and desaturation occur during infection. We aimed to compare the levels of heme, heme oxygenase-1 (HO-1), ferritin, and bilirubin in coronavirus disease 2019 (COVID-19) patients at different saturation levels. Heme and HO-1 enzyme levels significantly increased in the low SpO2 group, but further studies are required.

Background: Emergency room (ER) physicians need to face clinically suspected pneumonia patients in the front line of medical care and must do to give major medical interventions if patients show severity in pneumonia. Methods: The data of pneumonia-related ER visit rates were categorized based on the International Classification of Disease (ICD)...

Objectives: Pneumonia is the fourth leading cause of death globally, with rapid progression during sepsis. Multidrug-resistant organisms (MDROs) are becoming more common with some healthcare-associated pneumonia events. Early detection of MDRO risk improves the outcomes; however, MDROs risk in pneumonia with sepsis is unknown. This study investiga...

Herein, we report that nosocomial infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be mitigated by using surgical masks and closed looped ventilation for both non-critical and critical patients. These preventive measures resulted in no viral contamination of surfaces in negative pressure environments.

Objectives Families are a transmission route for severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) because of the close contact. Monitoring of the viral load will be a valuable method to reduce the optimal number of quarantine days, especially in presymptomatic and symptomatic carriers of their households. The traditional three-generatio...

Background Pneumonia is the fourth leading cause of death globally, with rapid progression during septic shock. Multidrug-resistant organisms (MDROs) are becoming more common with some healthcare-associated pneumonia events. Early detection of MDRO risk may improve the outcomes; however, the risk of MDROs in patients with pneumonia and septic shock...

Objectives: Appropriate initial antibiotic therapy is critical for successfully treating sepsis. In the emergency department (ED), clinicians often rely on septic symptoms to guide empirical therapy. The aim of this study was to investigate whether history of contacting pre-ED healthcare setting is easy to be neglected and whether the patients rec...

Objective: In the present study, we investigated the effects of dextromethorphan (DM) and its metabolites, including dextrorphan (LK2), 3-methoxymorphinan (LK3), and 3-hydroxymorphinan (LK4), on platelet aggregation in vitro and the inflammatory pain caused by carrageenan in rats, and their underlying mechanisms. Materials and methods: Rabbit pl...

Tuberculosis (TB) is the leading cause of death by a single infectious agent worldwide. One factor that contributes to the success of the microbe is the deficiency in immunomodulatory nutrients, such as vitamin A (retinol), which are prevalent in areas where TB is endemic. Clinical trials show that restoration of systemic retinol levels in active T...

Some patients with chronic obstructive pulmonary disease (COPD) have eosinophilic inflammation which may be evaluated via the measurement of fractional exhaled nitric oxide (FeNO) like asthma. The aim of this prospective study was to assess whether FeNO levels can be used to identify patients with COPD with eosinophilic inflammation who may respond...

Background and objectives: Patients with chronic obstructive pulmonary disease (COPD) often have poor health-related quality of life (HRQL), exercise capacity and cardiopulmonary function. Pulmonary rehabilitation (PR) is beneficial to improve exercise capacity and HRQL. However, series changes of these parameters remain unclear. Methods: Forty-...

Objectives: Patients with pectus excavatum have a poorer quality of life than the general population. Sleep quality is a critical component of quality of life. This pilot study compared the sleep quality of adult patients with pectus excavatum with that of the general population in Taiwan. Methods: Participants comprised 30 healthy adults, 21 ad...

Background: Troponin I is better than other troponin isoforms for monitoring cardiocyte damage, and correlates with sepsis-related mortality. However, hemodynamic factors possibly interact with cardiac function to affect mortality in sepsis. Thus, this study used parameters from pulse-induced contour cardiac output (PiCCO) to investigate the possi...

Hypersensitivity pneumonitis is a potentially fatal immunological lung disease caused by occupational or environmental exposure to specific antigens. Here, we report on an obstructive sleep apnea patient whose hypersensitivity pneumonitis was aggravated because of the use of unclean continuous positive airway pressure equipment. This report shows t...

In our previous study, we observed younger OSAS patients had higher CPAP acceptance but similar compliance as older OSAS patients, suggesting gender factor might play an important role on CPAP acceptance. Hence, we aimed to evaluate the influences of both gender and age on CPAP acceptance and compliance in Taiwanese OSAS patients. This retrospectiv...

Macrophages are the primary effector cells responsible for killing Mycobacterium tuberculosis (MTB) through various mechanisms, including apoptosis. However, MTB can evade host immunity to create a favorable environment for intracellular replication. MTB-infected human macrophages produce interleukin-32 (IL-32). IL-32 is a pro-inflammatory cytokine...

Pulmonary oil embolism (POE) is a rare fatal complication after transcatheter arterial embolization (TAE) and transcatheter arterial chemoembolization (TACE). As risk factors have not been clearly delineated, the aim of the present study was to identify the risk factors for development of POE after TACE. A retrospective analysis was carried out on...

Nuclear factor-kappa B (NFkB) is a ubiquitous transcription factor that mediates pro-inflammatory responses required for host control of many microbial pathogens; on the other hand, NFkB has been implicated in the pathogenesis of other inflammatory and infectious diseases. Mice with genetic disruption of the p50 subunit of NFkB are more likely to s...

Cytotoxicity of MTB-infected THP-1 cells with and without BAY treatment. The percentages of dead cells were determined by trypan blue dye exclusion after 5 days of infection. Data are the means ± SEM from two independent experiments performed in duplicates. **p<0.01. (TIF)

BAY 11-7082 (BAY) does not affect MTB H37Rv growth in Middlebrook 7H9 medium. MTB H37Rv (2.4×105 bacilli/mL) was incubated in 7H9 liquid medium containing 0.1% (v/v) DMSO vehicle (control) or 5 µM or 10 µM BAY for 4 and 8 days, and CFU determined. Data shown are the mean ± SEM of two independent experiments performed in duplicates. (TIF)

Good's syndrome is an acquired immunodeficiency state associated with thymoma and characterized by recurrent pulmonary infections. We describe a 67-year-old woman who presented with respiratory symptoms caused by concomitant disseminated cytomegalovirus infection and Pneumocystis jiroveci pneumonia 38 months after thymectomy for a thymoma. Immunolo...

To report a case of invasive pulmonary aspergillosis mimicking lung cancer with lung to lung metastases in ectopic adrenocorticotropic hormone syndrome (EAS). A 60-year-old man suffering from hypokalemic alkalosis, hypertension and limbs paralysis was referred to our hospital. EAS caused by malignancy of lung was highly suspected due to multiple pu...

Limited evidence is available on the use of budesonide inhalation suspension (BIS) for the treatment of mild to severe acute asthma exacerbations (AAE) in adults in an inpatient setting. This study was conducted to evaluate the efficacy of a five-day course of BIS compared with oral prednisolone (OP) in the management of adults with AAE. A retrospe...

Adaptive support ventilation (ASV) facilitates ventilator liberation in postoperative patients in surgical intensive care units (ICU). Whether ASV has similar benefits in patients with acute respiratory failure is unclear. We conducted a pilot study in a medical ICU that manages approximately 600 mechanically ventilated patients a year. The ICU has...

Removing the artificial airway is the last step in the mechanical ventilation withdrawal process. In order to assess cough effectiveness, a critical component of this process, we evaluated the involuntary cough peak flow (CPFi) to predict the extubation outcome for patients weaned from mechanical ventilation in ICUs. One hundred fifty patients were...

Differentiating tuberculosis (TB) from pneumonia remains a challenge. We evaluated the cytokine profiles of whole blood cells from patients with TB (n = 38) or pneumonia (n = 30) and from healthy individuals (n = 30) before and after stimulating cells with ESAT-6 or lipopolysaccharide (LPS). When the percent change in the levels of gamma interferon...

A 55-year-old man developed progressive cough and dyspnoea after regular attendance at a public steam bath. Hypoxaemia, diffuse pulmonary infiltrates and a predominance of lymphocytes with an increased percentage of CD8+ T cells in his bronchoalveolar lavage fluid suggested hypersensitivity pneumonitis. Microbial cultures from the steam bath room a...

Mycobacterium tuberculosis infection is a major world health issue. The early identification of patients at risk for a poor response to anti-M. tuberculosis therapy would help elucidate the key players in the anti-M. tuberculosis response. The objective of the present study was to correlate the modulation of cytokine expression (interleukin-1 [IL-1...

Acute respiratory distress syndrome (ARDS) associated with pulmonary lipiodol embolism is a rare complication of transcatheter arterial chemoembolization (TACE). We performed a survey of ARDS associated with pulmonary lipiodol embolism after TACE. A retrospective analysis of the cases of all patients with hepatic tumors who received transcatheter a...

No standard protocol exists for the treatment of acute respiratory distress syndrome induced by inhalation of smoke from a smoke bomb. In this case, a 23-year-old man was exposed to smoke from a smoke grenade for approximately 10 to 15 minutes without protective breathing apparatus. Acute respiratory distress syndrome developed subsequently, compli...

Small-cell lung cancer accounts for 15-20% of all lung cancers, and it is the cell type most commonly associated with paraneoplastic syndrome. Small-cell lung cancer presenting as ectopic adrenocorticotropic hormone (ACTH) syndrome associated with hypothyroidism and hypogonadotropic hypogonadism is clinically very rare. A 43-year-old man who presen...

Fatty tumors in the posterior mediastinum are uncommon. We report the case of a 15-year-old male with chest pain in whom was found, with computed tomography, a fat-containing mass in the posterior mediastinum. From characteristic computed tomography features, a diagnosis of mature cystic teratoma was suggested, which was consistent with the patholo...

Bilateral vocal fold immobility (BVFI) due to prolonged endotracheal intubation resulted in aphonia without any airway morbidity and was treated by several reconstructive procedures. Laryngeal reinnervation and silicone implantation failed to medialize one of those two fixed cords. Arytenoid adduction (AA) eventually achieved this goal. To select a...

Because of the continuing rise in pneumococcal vaccine costs and limits on funding of such costs, vaccination priorities in Taiwan were assessed. Data of a randomly selected sample of 200,448 people were analyzed to identify the highest risk groups. Patients were subgrouped on the basis of age and gender, and estimates were made of cumulative admis...

Open lung biopsy (OLB) is the standard procedure for the diagnosis of specific parenchymal lung diseases. The purpose of this study was to investigate the influence of OLB on subsequent treatment strategy and outcome in patients with diffuse lung infiltrates and acute respiratory failure. This retrospective review included 32 patients (aged 50.6 +/...

Background and Purpose: Open lung biopsy (OLB) is the standard procedure for the diagnosis of specific parenchymal lung disease. The purpose of this study was to investigate the influence of OLB on subsequent treatment strategy and outcome in patients with diffuse lung infiltrates and acute respiratory failure. Methods: This retrospective review in...

Chest ultrasonography is a useful diagnostic tool for the detection of pleural effusions of different etiologies. Our purpose was to determine whether the echogenic swirling pattern identifiable on real-time chest ultrasonographic images is a predictor of malignant pleural effusions in patients with malignancies. Medical records of patients undergo...

In 1998, Taiwan became the first country in Asia to provide free influenza vaccination to high-risk groups, mainly the elderly. The purpose of this study is to determine: (1) the annual mortality rate from influenza and pneumococcal-related illnesses such as pneumonia, chronic bronchitis, pulmonary emphysema and asthma and (2) the effectiveness of...

Pulmonary function tests may reveal obstructive lung disease with altered forced expiratory volume in 1 s (FEV1) in cotton textile workers. Since 1930, many cohort studies have been performed to assess the disease mortality rate in cotton textile workers. The authors performed a meta-analysis of the SMR results of these studies. From the meta-analy...

Since leukocystosis and anemia are common findings in pregnancy, pathological alterations in hematopoesis, such as leukemias, can sometimes proceed undetected. Chemotherapy during pregnancy carries the risk of teratogenic effects on the fetus, and there is little data to guide chemotherapeutic regimens for leukemia during pregnancy. The following p...

Hydrofluoric acid (HF) is one of the strongest inorganic acids and is used widely in industry. It differs from other acids in the mechanism of injury. The hydrogen ion readily penetrates the skin and causes destruction of deep tissue layers and even bone. If HF burns to the digital skin, keep washing with large amounts of tap water for a minimum of...

During the late 19th century, it was found that continuous exposure to benzene can lead to aplastic anemia and leukemia. There were also cases of acute myeloblastic leukemia reported during this period.3 This association brought attention to the toxicity of benzene to the bone marrow. Additional studies in Italy and Turkey showed that the stan- dar...

Back ground. Hy dro flu oric acid (HF) is one of the stron gest in or ganic ac - ids and is used widely in in dus try. It dif fers from other ac ids in the mech a - nism of in jury. The hy dro gen ion readily pen e trates the skin and causes de - struc tion of deep tis sue lay ers and even bone. Methods. If HF burns to the dig i tal skin, keep wash...

Emergency use of extracorporeal membrane oxygenation (ECMO) for cardiopulmonary failure is well documented. However, the use of ECMO for carbon monoxide (CO) poisoning is rare. We report a case of a patient with severe CO poisoning that initially manifested as stunned myocardium-induced acute pulmonary edema. The patient was severely hy-poxemic and...