Yee-hsuan Chiou | National Yang Ming Chiao Tung University (original) (raw)

Papers by Yee-hsuan Chiou

Journal of Infection and Public Health

Journal of the Formosan Medical Association

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Zhonghua Minguo xiao er ke yi xue hui za zhi [Journal]. Zhonghua Minguo xiao er ke yi xue hui, 1990

From June 1986 to October 1989, ten children suffering from end stage renal disease (ESRD) were t... more From June 1986 to October 1989, ten children suffering from end stage renal disease (ESRD) were treated with continuous ambulatory peritoneal dialysis (CAPD). Their ages ranged from 4 to 16 years; 3 were boys and 7 were girls. IgM mesangial nephropathy (IgMN) (three cases) were the most common causes of renal failure in the patients. All patients were trained in the hospital. After CAPD treatment, serum BUN and creatinine dropped significantly. Serum levels of potassium, phosphorus, and alkaline phosphatase dropped and serum sodium and calcium rose significantly after treatment. Improvement of anemic state and control of hypertension were also noted. Hypercholesterolemia and hypertriglyceridemia developed after CAPD treatment. Despite protein loss through the peritoneal cavity, there was no evidence of protein malnutrition. Total serum protein and albumin increased significantly after treatment. The most common complication was peritonitis. Three of these 10 patients developed an ep...

Systemic Lupus Erythematosus (SLE), which may exhibit different clinical manifestations, is easil... more Systemic Lupus Erythematosus (SLE), which may exhibit different clinical manifestations, is easily misdiagnosed as other disease at first visit especially with children. We collected 100 SLE patients with disease onset under 20 years old and analyzed the clinical and laboratory features of these patients. Demographic data reveals that the female to male ratio is 8.1:1 (89 females and 11 males), with an average disease onset of 14.4+3.6 year-old. The percentage of different organ involvements in these patients is 60% of nephropathy, 37% of arthritis, 48% of mucocutaneous lesions, 11% of CNS involvements, and 38% of fever. Laboratory abnormalities include ANA 93.4%, anti-ds DNA antibody 81.9%, anti-cardiolipin antibody 48% and 40% of anemia. These results indicate that Juvenile-onset SLE have more renal involvement but less malar skin rashes than adult-onset.

Thrombosis Research, 2018

Introduction: Immune thrombocytopenia (ITP) is an immune-mediated disease; it has been reported t... more Introduction: Immune thrombocytopenia (ITP) is an immune-mediated disease; it has been reported to be associated with several diseases. The data on ITP in patients with hepatitis B, tuberculosis, or thyroid diseases are relatively scarce. In addition, these diseases are not rare in Taiwan, together with hepatitis C and Helicobacter pylori which are also related to ITP. Methods and materials: We identified 1223 ITP patients and characterized these patients between 2000 and 2013 from the National Health Insurance Research Database. The adult ITP patients were matched with non-ITP patients. Results: The overall incidence of ITP was 2.59/100,000 person-years. The frequencies of hepatitis B and C in adult ITP patients were much higher than those indicated in previous studies. The frequencies of non-traumatic intracerebral hemorrhage and gastrointestinal bleeding during hospitalization among ITP patients were low. The diseases associated with increased risks of ITP included hepatitis B (OR＝18.70, 95% CI＝9.71-36.03), hepatitis C (OR＝54.43, 95% CI ＝15.94-185.88), hepatitis B and hepatitis C (OR＝7.02, 95% CI＝1.47-33.56), tuberculosis (OR ＝5.37, 95% CI＝2.72-10.61), Helicobacter pylori infection (OR＝5.93, 95% CI＝3.16-11.10), hyperthyroidism (OR＝3.43, 95% CI＝2.09-5.64), hypothyroidism (OR＝6.70, 95% CI＝2.35-19.13), and simple and unspecified goiter (OR＝2.68, 95% CI＝1.43-5.03). Conclusions: Surveying for the diseases which are frequent and related to increased risks of ITP among patients with newly diagnosed ITP should be considered.

American Journal of Kidney Diseases, 2001

In this study, we intend to establish a connection between star fruit and acute oxalate nephropat... more In this study, we intend to establish a connection between star fruit and acute oxalate nephropathy and also investigate predisposing factors for its development. Male Sprague-Dawley rats of 180 to 200 g were assigned to four groups; namely, control, experimental, fasting, and water-deprivation groups. The former two groups were subjected to both fasting and water deprivation, whereas the latter two groups were subjected to either fasting or water deprivation, respectively. Except for tap water for controls, the remaining groups were administered 4 mL/100 g of body weight of sour star fruit juice with an oxalate concentration of 2.46 g/dL. After these procedures, serial measurement of serum creatinine levels and kidney pathological examination were performed. Peak serum creatinine levels in the control, experimental, fasting, and water-deprivation groups were 0.50 +/- 0.04, 1.46 +/- 0.26, 0.68 +/- 0.20, and 0.52 +/- 0.08 mg/dL, respectively. The experimental group had a greater peak serum creatinine level (P < 0.05). Mean serum creatinine levels of the experimental group days 0, 1, 2, 3, 4, and 5 were 0.43 +/- 0.03, 1.11 +/- 0.18, 1.31 +/- 0.27, 1.16 +/- 0.28, 0.8 +/- 0.26, and 0.82 +/- 0.28 mg/dL, respectively. Mean serum creatinine levels days 1 to 3 were greater than that day 0 (P < 0.05). Pearson's correlation analysis of peak serum creatinine level and kidney weight for the experimental group showed a significant correlation (R = 0.75; P < 0.05; n = 9). In addition to typical changes of oxalate nephropathy, kidney pathological examination showed many refractile oxalate crystals with all rainbow colors under polarized light microscopy in the experimental group. In conclusion, sour star fruit with abundant oxalate contents could cause acute oxalate nephropathy in rats under the conditions of fasting and water deprivation.

Pediatrics & Neonatology

Background: Children with urinary tract infections (UTIs) are prone to kidney scarring if they ar... more Background: Children with urinary tract infections (UTIs) are prone to kidney scarring if they are not treated promptly; however, ambiguous symptoms before fever onset makes the early detection of UTIs difficult. Our study aimed to identify urethral discharge as an early manifestation in children with UTI. Methods: This study enrolled 678 children younger than 24 months with paired urinalysis and culture performed between 2015 and 2021; 544 children were diagnosed with UTIs. Clinical symptoms, urinalysis, and paired urine culture results were compared. Results: Urethral discharge was observed in 5.1% of children with UTI and yielded a specificity of 92.5% for diagnosing UTI. Children with urethral discharge had a less severe UTI course, furthermore, nine of them received antibiotics before fever occurred and seven of them were free of fever during UTI course. Urethral discharge was associated with alkalotic urine and Klebsiella pneumonia infection.Conclusions: Urethral discharge is ...

Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi, 2004

OBJECTIVES OF STUDY To gain new insights into the epidemiology, genitourinary (GU) tract anomalie... more OBJECTIVES OF STUDY To gain new insights into the epidemiology, genitourinary (GU) tract anomalies, etiologies, susceptibility of urinary pathogens to antibiotics in children with urinary tract infection (UTI) during the past decade in Taiwan. MATERIALS AND METHODS By reviewing medical charts for patients admitted to Kaohsiung Veterans General Hospital between January 1995 and December 2003, we identified and enrolled patients 14 years of age or less admitted due to UTI that was confirmed by positive urine culture. RESULTS A total of 597 patients made up our sample. Sixty-eight percent of patients were 1 year old or younger. Boys predominated infant cohort (68.1%). Twenty-seven point one percent of the patients were found in urinalysis to have 5 white blood cells or fewer per high power field and 17.6% had positive nitrite reaction. The pathogens were Escherichia coli, the most common (74.7%), followed by Proteus spp. (6.7%), and Klebsiella spp. (6.4%). E. coli was resistant to ampi...

Materials Science and Engineering: C, 2021

Neutrophil extracellular traps (NETs) are chromatin-based structures that are released from neutr... more Neutrophil extracellular traps (NETs) are chromatin-based structures that are released from neutrophils during infections and prevent microbes from spreading in the body through efficient degradation of their composition. Based on this chromatin-driven strategy of capturing and killing bacteria, we designed NET-like structures using DNA and ZnO nanoparticles (NPs). DNA was first purified from kiwifruit and treated with HCl to increase hydroxyl groups in the opened-deoxylribose form. The carboxyl groups of citric acid were then thermally crosslinked with said hydroxyl and primary amine groups in DNA, forming DNA-HCl nanogels (NGs). ZnO NPs were then used as positively charged granule enzymes, adsorbed onto the DNA-HCl NG, obtaining ZnO/DNA-HCl NGs (with NET biomimicry). In an anti-inflammatory assay, ZnO/DNA-HCl NGs significantly inhibited TNF-α, IL-6, iNOS and COX-2 expression in LPS-stimulated Raw264.7 cells. Moreover, the ZnO/DNA-HCl NGs markedly alleviated clinical symptoms in LPS-induced mouse peritonitis. Finally, ZnO/DNA-HCl NGs suppressed E. coli from entering circulation in septic mice while prolonging their survival. Our results suggest that the ZnO/DNA-HCl NGs, which mimic NET-like structures in the blocking of bacteria-inducted inflammation, may be a potential therapeutic strategy for bacterial infections.

Iranian Journal of Pediatrics, 2020

Background: Detecting early predictors of acute pyelonephritis (APN) is essential for the prognos... more Background: Detecting early predictors of acute pyelonephritis (APN) is essential for the prognosis, but few studies have focused on young infants specifically. Objectives: The aim of our research was to determine the relationship between APN and laboratory parameters in the age group less than 4 months. Methods: This retrospective study included patients aged less than 4 months with first time febrile urinary tract infection (UTI) between January 2012 and December 2018. White blood cells (WBC), C-reactive protein (CRP), and blood neutrophil/lymphocyte ratio (NLR) were analyzed. Patients were divided into two groups according to the presence of renal defects on dimercaptosuccinic acid (DMSA) scans. Results: In total, 205 patients were screened; 107 patients were in the APN group, and 98 patients were in the non-APN group. Compared with the non-APN group, the APN group showed significant differences in therapeutic response time (TRT), CRP, and NLR (all P values < 0.001). Multiple ...

Journal of Clinical Medicine, 2018

There is little information available on the association between primary renal disease (PRD) and ... more There is little information available on the association between primary renal disease (PRD) and long-term mortality in the pediatric dialysis population. The objective of this study was to explore mortality risks in children and adolescents on chronic dialysis, specifically focused on the risk of various PRDs. The study cohort included children and adolescents with end-stage renal disease (ESRD) (aged < 20 years) who had received dialysis for at least 90 days between 2000 and 2014 and were identified from Taiwan’s National Health Insurance medical claims. A total of 530 children and adolescents were included in the study. The median age of the included patients was 13.6 years and 305 (57.5%) patients were males. One hundred and seven patients died during the follow-up period and the median survival time was 6.0 years. Mortality was highest in the youngest patients. For patients with the following PRDs, mortality was significantly higher than that in patients with primary glomeru...

Journal of the Formosan Medical Association = Taiwan yi zhi, Jan 17, 2018

Nocturnal enuresis causes significant psychological distress to affected children and their famil... more Nocturnal enuresis causes significant psychological distress to affected children and their family and requires appropriate management. A 12-member expert committee of pediatric urologists and pediatric nephrologists in Taiwan with extensive experience in treating enuresis was established to develop consensus statements and a recommended treatment algorithm for the management of patients with nocturnal enuresis in Taiwan after careful consideration of current evidence, existing guidelines, and expert opinion as well as local practice and culture. The finalized consensus statements were reviewed by and have received endorsement from the Taiwan Urological Association and the Taiwan Pediatric Association. Patients with suspected enuresis should undergo a thorough initial assessment to fully evaluate urinary signs and symptoms and to rule out underlying causes of diurnal and nocturnal incontinence. Behavioral therapy is recommended throughout the course of management. Desmopressin in th...

Journal of Nuclear Medicine

Revista española de medicina nuclear e imagen molecular, 2013

To evaluate the prognostic value of initial direct radionuclide cystography (DRC) for spontaneous... more To evaluate the prognostic value of initial direct radionuclide cystography (DRC) for spontaneous resolution of vesicoureteral reflux (VUR). Fifty-one children with initial diagnosis and 1-6 years' follow-up of VUR by DRC were enrolled in this study. VUR was graded according to the anatomic grading as (1) mild reflux corresponding to tracer just in ureter, (2) moderate reflux with accumulation of activity in a non-dilated collecting system and ureter, and (3) severe reflux equated with a dilated ureter and collecting system. The severity of VUR was also expressed according to the functional classification as (1) transient reflux, which occurred at filling or voiding phase only and (2) persistent reflux, present in both filling and voiding phases. Twenty-nine of the 51 children had unilateral VUR, and the other 22 had bilateral VUR. In the total of 73 refluxing ureters, there were 12 mild, 49 moderate and 12 severe VUR according to anatomic grading, and 30 transient and 43 persis...

Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi

Idiopathic thrombocytopenic purpura (ITP) is an acquired disorder characterized by immune-mediate... more Idiopathic thrombocytopenic purpura (ITP) is an acquired disorder characterized by immune-mediated platelet destruction. The aims of this study were to compare initial platelet count elevation and to determine the chance of developing persistent profound thrombocytopenia by intravenous immunoglobulin (IVIG) or prednisolone in the treatment of children with ITP. Eighty-seven children, aged from 3 months to 14 years old, diagnosed with ITP and initial platelet count less than 20 x 10(3)/mm3 were divided into two groups. Fifty-four patients received IVIG (1 g/kg/dose) for two days. Then, they received prednisolone treatment at a dose of 1 mg/kg/d starting on day 8 to maintain platelet count, followed by a tapering dose until day 60. Thirty-three patients received prednisolone (2 mg/kg/day) for 14-21 days, followed by a tapering dose until day 60. Platelet counts were evaluated on presentation days 2, 3, 5, 7, 30, 60, 90, 120, 150 and 180. Forty-four of 54 patients (81.5%) treated with ...