Epidemiological Features of Central Nervous System (CNS) Infections in Taiwan and Molecular Investigation of CNS Infections of Unknown Cause

In this thesis, I explore the epidemiological features of CNS infections using a population-based dataset and analyze CSF samples from patients with meningitis or encephalitis of unknown cause using molecular methods. In the second chapter, I review the literature on the epidemiology of meningitis and encephalitis, and current diagnostic approaches, focusing on the strengths and limitations of various diagnostic methods. In the third chapter, I investigate the causes of meningitis and encephalitis using a population-based dataset from the National Health Insurance Research Dataset (NHIRD) from Taiwan, representing the interval from 1996 to 2008. The analysis assesses differences in the disease between known and unknown cause groups in terms of incidence, demographic features, seasonal and geographic distribution. In the fourth chapter, I analyze CSF samples from patients with meningitis or encephalitis of unknown cause using a tiered molecular approach to discover the undetected or novel pathogens; techniques used include MassTag PCR, DNA microarrays and high-throughput pyrosequencing. I conclude the thesis in the fifth chapter, summarizing and highlighting the main results of these studies

IS HEALTH LITERACY EQUAL WITH E-HEALTH LITERACY AMONG LEPROSY STAFF AT PUBLIC HEALTH CENTER PEKALONGAN DISTRICT, INDONESIA

1,2), Ming-Chin Lin1), 3), 1), Anis Fuad1

Prediction model for high glycated hemoglobin concentration among ethnic Chinese in Taiwan

<p>Abstract</p> <p>Background</p> <p>This study aimed to construct a prediction model to identify subjects with high glycated hemoglobin (HbA1c) levels by incorporating anthropometric, lifestyle, clinical, and biochemical information in a large cross-sectional ethnic Chinese population in Taiwan from a health checkup center.</p> <p>Methods</p> <p>The prediction model was derived from multivariate logistic regression, and we evaluated the performance of the model in identifying the cases with high HbA1c levels (> = 7.0%). In total 17,773 participants (age > = 30 years) were recruited and 323 participants (1.8%) had high HbA1c levels. The study population was divided randomly into two parts, with 80% as the derivation data and 20% as the validation data.</p> <p>Results</p> <p>The point-based clinical model, including age (maximal 8 points), sex (1 point), family history (3 points), body mass index (2 points), waist circumference (4 points), and systolic blood pressure (3 points) reached an area under the receiver operating characteristic curve (AUC) of 0.723 (95% confidence interval, 0.677- 0.769) in the validation data. Adding biochemical measures such as triglycerides and HDL cholesterol improved the prediction power (AUC, 0.770 [0.723 - 0.817], <it>P </it>= < 0.001 compared with the clinical model). A cutoff point of 7 had a sensitivity of 0.76 to 0.96 and a specificity of 0.39 to 0.63 for the prediction model.</p> <p>Conclusions</p> <p>A prediction model was constructed for the prevalent risk of high HbA1c, which could be useful in identifying high risk subjects for diabetes among ethnic Chinese in Taiwan.</p

An Envelope Disrupted by a Quadrupolar Outflow in the Pre-Planetary Nebula IRAS19475+3119

IRAS 19475+3119 is a quadrupolar pre-planetary nebula (PPN), with two bipolar lobes, one in the east-west (E-W) direction and one in the southeast-northwest (SE-NW) direction. We have observed it in CO J=2-1 with the Submillimeter Array at ~ 1" resolution. The E-W bipolar lobe is known to trace a bipolar outflow and it is detected at high velocity. The SE-NW bipolar lobe appears at low velocity, and could trace a bipolar outflow moving in the plane of the sky. Two compact clumps are seen at low velocity around the common waist of the two bipolar lobes, spatially coincident with the two emission peaks in the NIR, tracing dense envelope material. They are found to trace the two limb-brightened edges of a slowly expanding torus-like circumstellar envelope produced in the late AGB phase. This torus-like envelope originally could be either a torus or a spherical shell, and it appears as it is now because of the two pairs of cavities along the two bipolar lobes. Thus, the envelope appears to be disrupted by the two bipolar outflows in the PPN phase.Comment: 23 pages, 8 figure

Overexpression of Nuclear Protein Kinase CK2 α Catalytic Subunit (CK2α) as a Poor Prognosticator in Human Colorectal Cancer

BACKGROUND: Colorectal cancer (CRC) is one of the most common malignancies but the current therapeutic approaches for advanced CRC are less efficient. Thus, novel therapeutic approaches are badly needed. The purpose of this study is to investigate the involvement of nuclear protein kinase CK2 α subunit (CK2α) in tumor progression, and in the prognosis of human CRC. METHODOLOGY/PRINCIPAL FINDINGS: Expression levels of nuclear CK2α were analyzed in 245 colorectal tissues from patients with CRC by immunohistochemistry, quantitative real-time PCR and Western blot. We correlated the expression levels with clinicopathologic parameters and prognosis in human CRC patients. Overexpression of nuclear CK2α was significantly correlated with depth of invasion, nodal status, American Joint Committee on Cancer (AJCC) staging, degree of differentiation, and perineural invasion. Patients with high expression levels of nuclear CK2α had a significantly poorer overall survival rate compared with patients with low expression levels of nuclear CK2α. In multi-variate Cox regression analysis, overexpression of nuclear CK2α was proven to be an independent prognostic marker for CRC. In addition, DLD-1 human colon cancer cells were employed as a cellular model to study the role of CK2α on cell growth, and the expression of CK2α in DLD-1 cells was inhibited by using siRNA technology. The data indicated that CK2α-specific siRNA treatment resulted in growth inhibition. CONCLUSIONS/SIGNIFICANCE: Taken together, overexpression of nuclear CK2α can be a useful marker for predicting the outcome of patients with CRC

Antidiabetic effect and mode of action of cytopiloyne

Cytopiloyne was identified as a novel polyacetylenic compound. However, its antidiabetic properties are poorly understood. The aim of the present study was to investigate the anti-diabetic effect and mode of action of cytopiloyne on type 2 diabetes (T2D). We first evaluated the therapeutic effect of cytopiloyne on T2D in db/db mice. We found that one dose of cytopiloyne reduced postprandial glucose levels while increasing blood insulin levels. Accordingly, long-term treatment with cytopiloyne reduced postprandial blood glucose levels, increased blood insulin, improved glucose tolerance, suppressed the level of glycosylated hemoglobin A1c (HbA1c), and protected pancreatic islets in db/db mice. Next, we studied the anti-diabetic mechanism of action of cytopiloyne. We showed that cytopiloyne failed to decrease blood glucose in streptozocin- (STZ-)treated mice whose β cells were already destroyed. Additionally, cytopiloyne dose dependently increased insulin secretion and expression in β cells. The increase of insulin secretion/expression of cytopiloyne was regulated by protein kinase C α (PKC α ) and its activators, calcium, and diacylglycerol (DAG). Overall, our data suggest that cytopiloyne treats T2D via regulation of insulin production involving the calcium/DAG/PKC α cascade in β cells. These data thus identify the molecular mechanism of action of cytopiloyne and prove its therapeutic potential in T2D