Boron Isotopic Analysis of Representative Atmospheric Aerosols Derived From Long-Range Transported/Local Emission on an Islet Offshore NE Taiwan

To identify pollutant origins and their potential sources from either long-range transported (LRT) or local emissions, the Boron (B) concentrations and the B isotopic compositions (δ11B) in the water-soluble fraction of aerosols were determined. These aerosols were collected from an islet offshore in northeastern Taiwan, Peng Chia Yu (PCY), a non-residential islet, from January 1998 to March 2000. This islet may be influenced by various pollutants or chemical transport during monsoon periods, but suffers minimal human perturbation locally. The B in the specimens falls to 0.3–1.63 ng m−3 during the SW monsoon seasons when compared to 0.46–2.56 ng m−3 in the NE monsoon. However, the δ11B results show no clear variations in both monsoon seasons (10.7–24.3‰), regardless of differences in air mass origin. A two end-member mixing scenario is proposed to explain our observations using the obtained δ11B and 1/[B] results. The ocean endmember is characterized by high 1/[B] and high δ11B; while other endmember is from continental endmember or anthropogenic contributions that are characterized by of 1/[B] and lowδ11B (δ11B < 10‰). Based on these chemical and isotopic results, we found aerosol emissions in northern Taiwan are characterized as low B with nearly constant δ11B, when compared with long-range transported continental endmembers derived from nearby regions. This study provides preliminary B and δ11B levels in aerosols derived from LRT/local emissions and discusses potential monsoonal effects on aerosols offshore of NE Taiwan

Thrombomodulin Regulates Keratinocyte Differentiation and Promotes Wound Healing

The membrane glycoprotein thrombomodulin (TM) has been implicated in keratinocyte differentiation and wound healing, but its specific function remains undetermined. The epidermis-specific TM knockout mice were generated to investigate the function of TM in these biological processes. Primary cultured keratinocytes obtained from TMlox/lox; K5-Cre mice, in which TM expression was abrogated, underwent abnormal differentiation in response to calcium induction. Poor epidermal differentiation, as evidenced by downregulation of the terminal differentiation markers loricrin and filaggrin, was observed in TMlox/lox; K5-Cre mice. Silencing TM expression in human epithelial cells impaired calcium-induced extracellular signal–regulated kinase pathway activation and subsequent keratinocyte differentiation. Compared with wild-type mice, the cell spreading area and wound closure rate were lower in keratinocytes from TMlox/lox; K5-Cre mice. In addition, the lower density of neovascularization and smaller area of hyperproliferative epithelium contributed to slower wound healing in TMlox/lox; K5-Cre mice than in wild-type mice. Local administration of recombinant TM (rTM) accelerated healing rates in the TM-null skin. These data suggest that TM has a critical role in skin differentiation and wound healing. Furthermore, rTM may hold therapeutic potential for the treatment of nonhealing chronic wounds

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Preliminary Study of Online Detection in Thin Channel

[[abstract]]本論文主要關於利用雷射、光纖、光電倍增管 (PMT) 在微通道分離槽中發展線上偵測的方法之研究。自行將雷射光聚光到光纖進而激發螢光奈米粒子，再用另外一條光纖進行收光動作。再將收到的螢光透過光纖傳輸到光電倍增管前端，觀察光電倍增管訊號變化。 在本實驗中，我們將製備好的螢光奈米粒子，配製於不同的濃度。利用雷射激發樣品，在光電倍增管訊號中可以發現訊號強度會隨著樣品本身的濃度改變，呈現線性成長，但是到達一定濃度之後便無明顯變化，偵測範圍為3x1014 ~ 1x1015 顆/毫升，主要線性範圍為3x1014 ~ 8x1014 顆/毫升，進而達到微通道中線上偵測方法。[[abstract]]This study grow a method of online detection in microchannel by using laser, optical fibers, and photomultiplier tube (PMT). We used the laser light focusd by optical fiber to excite the fluorescent nanopartilces. The responded fluorescent signal is collected and transferred to the PMT by another optical fiber, and the change of the signal is observed. In our experiment, we use laser light to excite the samples, and found that the intensity of the signal is in direct proportion to the concentration of samples. The detection range is from 3x1014 to 1x1015 particles/ml, and the linear range is from 3x1014 to 8x1014 particles/ml.[[note]]碩

Effectiveness of a training program on the role recognition and case portrayal of standardized patients

Objective: Standardized patient (SP) scenarios could provide medical situations of high fidelity for teaching or examinations, which would otherwise be difficult with real patients. Moreover, SPs can also be used to reliably evaluate or certify the competence of medical trainees. Since the interactions between examinee and SP are dynamic and complex, SPs need to portray the case reliably and consistently across different examinees. Thus, we developed a 1-day program for newly recruited SPs to teach basic competence in case portrayal. The purpose of this study is to assure the effectiveness of this training program in role recognition as a SP and case portrayal. Materials and Methods: A total of 80 SPs were recruited from 2010 to 2013. They were asked to complete questionnaires before and after the training program using a five-point, Likert-type scale (1 – strongly disagree and 5 – strongly agree). The questionnaire comprised 16 items covering SP characteristics, role recognition, and case portrayal. The results were analyzed using PASW Statistics 18, paired t-test, to determine the effectiveness of the training program. Results: A total of 78 questionnaires were collected for a response rate of 97.5%. The mean age of the SPs was 50.2 ± 7.9 (25–68) years. Most SPs showed improvement in role recognition. In the domain of case portrayal, three of nine items (consistency, obedience, and commitment) showed significant difference (P<0.05). Conclusions: This study suggests that this program is useful for reinforcing role recognition in newly recruited SPs. With respect to case portrayal, only consistency, obedience, and commitment were improved

Subcutaneous injection-induced cellulites

In the hospice ward where patients are in the terminal stages of cancer, it is common practice to give them a subcutaneous injection of pain relievers to reduce their pain and make them more comfortable. Most of these patients are elderly and have low blood pressure or poor veins, which often makes it difficult to inject them because of the calcification at previous injection sites. Thus, subcutaneous injections are a convenient way to maintain analgesia and patient comfort. Our patient, a 73-year-old aboriginal woman, was diagnosed with gastric adenocarcinoma and peritoneal carcinomatosis in March, 2004. While she was in the inpatient hospice ward, a subcutaneous injection site became infected and localized cellulitis developed. The patient’s quality of life began to decline and her hospice stay was lengthened due to these complications. This case is offered as a reference case of subcutaneous injection complications encountered by elderly patients in hospice care

Outcome of Hematopoietic Stem Cell Recipients Who Were Mechanically Ventilated and Admitted to Intensive Care Units

To evaluate the ICU mortality rate of mechanically ventilated hematopoietic stem cell transplantation (HSCT) recipients and to identify the factors that were associated with ICU mortality. The impact of surgical lung biopsy (SLB) in patients with unexplained pulmonary infiltrates was also evaluated. Methods: Forty-one mechanically ventilated HSCT recipients admitted to the ICU during the study period were enrolled. The medical records were reviewed and data at ICU admission were analyzed. Data were compared between ICU survivors and nonsurvivors. The pathologic findings of SLB and the resulting impact on treatment were analyzed. Results: Eight patients (19.5%) survived the ICU stay, and seven (17%) lived to hospital discharge. The most common etiologies of ICU mortality included bacterial pneumonia, cytomegalovirus pneumonia, diffuse alveolar hemorrhage, sepsis, and aspergillosis. The factors associated with higher mortality were older age when performing HSCT, older age at ICU admission, higher acute physiology and chronic health evaluation (APACHE) II score, shock, higher respiratory rate, and higher heart rate at the time of ICU admission. Ten patients underwent SLB which resulted in treatment changes in five of them. Three patients had complications of SLB and one patient died of complications. Conclusion: The ICU mortality rate of mechanically ventilated HSCT recipients was high. Factors associated with ICU mortality were older age, high APACHE II score, presence of shock, and higher respiratory or heart rate at the time of ICU admission. SLB might provide specific diagnosis in HSCT recipients with unexplained pulmonary infiltrates and aid modification of treatment. [J Formos Med Assoc 2007;106(4):295-301