Hsiao‐En Tsai

National Taiwan University Hospital

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Yu‐Ting Cheng

Yuan Ze University

Yih‐Sharng Chen

National Taiwan University Hospital

Nai‐Hsin Chi

National Taiwan University Hospital

Hsi‐Yu Yu

National Taiwan University Hospital

Chih‐Kuo Lee

National Taiwan University Hospital

Shyh‐Jye Chen

National Taiwan University Hospital

Chih‐Hsien Wang

National Taiwan University Hospital

Ing‐Sh Chiu

National Taiwan University Hospital

Nai‐Kuan Chou

National Taiwan University Hospital

Chih‐Cheng Wu

National Taiwan University

Cooperative Institutions

National Taiwan University Hospital

National Taiwan University

National Yang Ming Chiao Tung University

Monash University

National Cheng Kung University

University of Melbourne

National Health Research Institutes

Chang Gung University

Taichung Veterans General Hospital

Cardiovascular Research Center

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Different clinical outcomes between ECMO consultation units for ARDS: single non-referral center experience

Hsiao‐En Tsai Ming‐Hsien Lin Ling-Yi Wei Yingying Su Chia-Pang Shih

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Left Pulmonary Artery Coarctoplasty by Using the Right Pulmonary Artery Flap Near the Arterial Duct

The Annals of Thoracic Surgery (2011)

Hsiao‐En Tsai Shu‐Chien Huang Shyh‐Jye Chen Chun-Min Fu Ing‐Sh Chiu

Right pulmonary artery

Main Pulmonary Artery

Left pulmonary artery

10.1016/j.athoracsur.2011.03.115

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Blood Reflux-Induced Epigenetic Factors HDACs and DNMTs Are Associated with the Development of Human Chronic Venous Disease

International Journal of Molecular Sciences (2022)

Shun‐Fu Chang Hsiao‐En Tsai Jong‐Tar Kuo Yu-Rong Ruan Chiu-Yen Chen

Blood reflux and metabolic regulation play important roles in chronic venous disease (CVD) development. Histone deacetylases (HDACs) and DNA methyltransferases (DNMTs) serve as repressors that inhibit metabolic signaling, which is induced by proatherogenic flow to promote aortic endothelial cell (EC) dysfunction and atherosclerosis. The aim of this study was to elucidate the relationship between blood reflux and epigenetic factors HDACs and DNMTs in CVD. Human varicose veins with different levels of blood reflux versus normal veins with normal venous flow were examined. The results show that HDAC-1, -2, -3, -5, and -7 are overexpressed in the endothelium of varicose veins with blood reflux. Blood reflux-induced HDACs are enhanced in the varicose veins with a longer duration time of blood reflux. In contrast, these HDACs are rarely expressed in the endothelium of the normal vein with normal venous flow. Similar results are obtained for DNMT1 and DNMT3a. Our findings suggest that the epigenetic factors, HDACs and DNMTs, are induced in venous ECs in response to blood reflux but are inhibited in response to normal venous flow. Blood reflux-induced HDACs and DNMTs could inhibit metabolic regulation and promote venous EC dysfunction, which is highly correlated with CVD pathogenesis.

Venous blood

10.3390/ijms232012536

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Very late recurrence of sinus of Valsalva aneurysm rupture after patch repair

BMC Surgery (2014)

Ting‐Tse Lin Hsiao‐En Tsai Lin Lin Tsung-Yan Chen Cheng-Pin Lee

Sinus of Valsalva aneurysm (SVA) is an uncommon cardiac defect accounting for only 1% of congenital cardiac anomalies and the most common complication is ruptured into the atrium or ventricle. Very late recurrence of ruptured SVA after patch repair is extremely rare. We present a case of 57-year-old man had received repair for ruptured Sinus of Valsalva aneurysm at 19 ages. In the clinics, he presented with exertional dyspnea and leg swelling. The serial examination disclosed he had bicuspid aortic valve and very late rupture of SVA connecting to right atrium. After surgical repair again, he was discharged smoothly. A very late recurrence of ruptured SVA after surgical repair was rare. We reported a case with unique echocardiographic presentation and a successful repair.

Sinus (botany)

Presentation (obstetrics)

10.1186/1471-2482-14-73

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Incidence and management of metabolic acidosis with sodium bicarbonate in the ICU: An international observational study

Critical Care (2021)

Tomoko Fujii Andrew Udy Alistair Nichol Rinaldo Bellomo Adam M. Deane

Abstract Background Metabolic acidosis is a major complication of critical illness. However, its current epidemiology and its treatment with sodium bicarbonate given to correct metabolic acidosis in the ICU are poorly understood. Method This was an international retrospective observational study in 18 ICUs in Australia, Japan, and Taiwan. Adult patients were consecutively screened, and those with early metabolic acidosis (pH < 7.3 and a Base Excess < –4 mEq/L, within 24-h of ICU admission) were included. Screening continued until 10 patients who received and 10 patients who did not receive sodium bicarbonate in the first 24 h (early bicarbonate therapy) were included at each site. The primary outcome was ICU mortality, and the association between sodium bicarbonate and the clinical outcomes were assessed using regression analysis with generalized linear mixed model. Results We screened 9437 patients. Of these, 1292 had early metabolic acidosis (14.0%). Early sodium bicarbonate was given to 18.0% (233/1292) of these patients. Dosing, physiological, and clinical outcome data were assessed in 360 patients. The median dose of sodium bicarbonate in the first 24 h was 110 mmol, which was not correlated with bodyweight or the severity of metabolic acidosis. Patients who received early sodium bicarbonate had higher APACHE III scores, lower pH, lower base excess, lower PaCO 2 , and a higher lactate and received higher doses of vasopressors. After adjusting for confounders, the early administration of sodium bicarbonate was associated with an adjusted odds ratio (aOR) of 0.85 (95% CI, 0.44 to 1.62) for ICU mortality. In patients with vasopressor dependency, early sodium bicarbonate was associated with higher mean arterial pressure at 6 h and an aOR of 0.52 (95% CI, 0.22 to 1.19) for ICU mortality. Conclusions Early metabolic acidosis is common in critically ill patients. Early sodium bicarbonate is administered by clinicians to more severely ill patients but without correction for weight or acidosis severity. Bicarbonate therapy in acidotic vasopressor-dependent patients may be beneficial and warrants further investigation.

Sodium bicarbonate

Base excess

Bicarbonate

10.1186/s13054-020-03431-2

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Citations (31)

Review of Risk Factors in Four Cases of Cryptococcosis After Heart Transplantation

Transplantation Proceedings (2008)

Hsiao‐En Tsai Nai‐Kuan Chou Nai‐Hsin Chi Yih‐Sharng Chen Jiun‐Ling Wang

10.1016/j.transproceed.2008.08.060

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Risk stratification and cost‐effectiveness analysis of adult patients receiving extracorporeal membrane oxygenation

Journal of Evaluation in Clinical Practice (2022)

Min‐Tsun Liao Ming‐Hsien Lin Hsiao‐En Tsai Jo‐Hsuan Wu James L. Caffrey

Abstract Rationale, Aims, and Objectives A more effective allocation of critical care resources is important as the cost of intensive care increases. A model has been developed to predict the probability of in‐hospital death among patients who received extracorporeal membrane oxygenation (ECMO). Cost‐effectiveness analyses (CEA) were performed regarding the relationship between hospitalization expenses and predicted survival outcomes. Methods Adult patients who received ECMO in a medical center in Taiwan (2005–2016) were included. A logistic regression model was applied to a spectrum of clinical measures obtained before and during ECMO institutions to identify the risk variables for in‐hospital mortality. CEA were reported as a predictive risk in quintiles and defined as the cost of each quality‐adjusted life‐year (QALY). The distribution of the cost‐effectiveness ratio (CER) was measured by the ellipse and acceptability curve methods. Results A total of 919 patients (659 males, mean age: 53.7 years) were enrolled. Ten variables emerged as significant predictors of in‐hospital death. The area under the receiver operating characteristic curve was 0.75 (95% confidence interval: 0.72–0.79). In‐hospital and total follow‐up times were 40,366 and 660,205 person‐days, respectively. The total in‐hospital expense was $31,818,701 USD and the total effectiveness was 1687.3 QALY. For the lowest to the highest risk quintile, the mean mortality risks were 0.30, 0.48, 0.61, 0.75, and 0.88, and mean adjusted CER were $24,230, $43,042, $54,929, $84,973, and $149,095 per QALY, respectively. Conclusions The efficient allocation of limited and costly resources is most important when one is forced to decide between groups of critically ill patients. The current analyses of ECMO outcomes should assist in identifying candidates with the greatest prospect for survival while avoiding futile treatments.

10.1111/jep.13681

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Citations (4)

Intraoperative Assessment of Partial Atrioventricular Septal Defect with a Cleft Mitral Valve by Real-Time Three-Dimensional Transesophageal Echocardiography

Anesthesia & Analgesia (2012)

Hsiao‐Liang Cheng Chi‐Hsiang Huang Hsiao‐En Tsai Meng-Yu Chen Shou‐Zen Fan

Atrioventricular Septal Defect

Atrioventricular valve

10.1213/ane.0b013e3182468db3

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Citations (12)

Flexible Inkjet Printed Ag/rGO/Nafion-Ru(NH₃)₆^3+/2+ Two-Electrode Hydrogen Sulfide Sensor for Real-Time Monitoring in Liquids

IEEE Journal on Flexible Electronics (2023)

Kun-Lin Tsou Yu-De Chou Yu‐Ting Cheng Hsiao‐En Tsai Yong‐Sheng Chen

In this paper, we demonstrate real-time hydrogen sulfide monitoring in liquid using a flexible inkjet printed Ag/rGO/Nafion-Ru(NH ₃ ) _6^3+/2+ two-electrode amperometric sensor. The electrodes are inkjet-printed on a flexible substrate, Kapton film, where silver nanoparticles (Ag NPs) are printed as conductive electrodes. The working and reference electrodes are printed Ag/rGO/Nafion-Ru(NH ₃ ) _6^3+/2+ and Ag/AgCl _(s) /PU layers respectively. The as-printed sensor exhibits a linear sensitivity of 40 nA/μM/cm ² (R=99.7%) and a LoD of 0.75 μM in the range of 1 to 120 μM. The sensor shows the tendency of increase and saturation of the hydrogen sulfide released from cysteine in heating eggs indicating the effectiveness of the sensor for real-time monitoring.

Nafion

10.1109/jflex.2023.3317814

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Long-term outcomes of surgical treatment for intravascular leiomyomatosis

Journal of the Formosan Medical Association (2018)

Hsi‐Yu Yu Hsiao‐En Tsai Nai‐Hsin Chi Kuan‐Ting Kuo Shoei‐Shen Wang

Intravascular leiomyomatosis (IVL) is relatively rare. The optimal surgical method and long-term outcomes are not completely understood. Medical records between 2007 and 2017 in our hospital were analyzed to identify IVL cases with surgical intervention. Their medical records, operative details, and follow-up were collected by chart review and telephone communication. Eight patients with IVL were included in the study, accounting for 0.26% of all uterine leiomyoma cases. Primary IVL was confined to pelvic cavity in three patients, extended to the inferior vena cava (IVC) below renal vein in one, reached IVC and right atrium in three, and reached main pulmonary artery in one. One-stage operation was performed for seven patients. Cardiopulmonary bypass was done in four patients, and aortic cross-clamp and temporary circulatory arrest was performed in two patients. None of the four patients with intrapulmonary tumors received concomitant pulmonary tumor resection. There was no operative mortality and four morbidities, including ureter injury (2), bladder injury (1), and femoral vein thrombosis (1). During follow-up, two patients exhibited local recurrence of the tumor in the pelvis, and one patient had rapidly growing intrapulmonary tumor three months post-operatively. Intrapulmonary tumors in the other three patients remained stationary at 6, 84, and 120 months post-operatively. One-stage operation to completely remove IVL is feasible and with good long-term outcomes, which is recommended if the patient can tolerate the operation. Concomitant intrapulmonary tumors can be followed up watchfully except when associated with pleural effusion or the pathology indicating trend of increasing malignancy.

Leiomyomatosis

10.1016/j.jfma.2018.08.023

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Citations (10)