Improving Computer-Aided Thoracic Disease Diagnosis through Comparative Analysis Using Chest X-ray Images Taken at Different Times.

Medical professionals in thoracic medicine routinely analyze chest X-ray images, often comparing pairs of images taken at different times to detect lesions or anomalies in patients. This research aims to design a computer-aided diagnosis system that enhances the efficiency of thoracic physicians in comparing and diagnosing X-ray images, ultimately reducing misjudgments. The proposed system encompasses four key components: segmentation, alignment, comparison, and classification of lung X-ray images. Utilizing a public NIH Chest X-ray14 dataset and a local dataset gathered by the Chiayi Christian Hospital in Taiwan, the efficacy of both the traditional methods and deep-learning methods were compared. Experimental results indicate that, in both the segmentation and alignment stages, the deep-learning method outperforms the traditional method, achieving higher average IoU, detection rates, and significantly reduced processing time. In the comparison stage, we designed nonlinear transfer functions to highlight the differences between pre- and post-images through heat maps. In the classification stage, single-input and dual-input network architectures were proposed. The inclusion of difference information in single-input networks enhances AUC by approximately 1%, and dual-input networks achieve a 1.2-1.4% AUC increase, underscoring the importance of difference images in lung disease identification and classification based on chest X-ray images. While the proposed system is still in its early stages and far from clinical application, the results demonstrate potential steps forward in the development of a comprehensive computer-aided diagnostic system for comparative analysis of chest X-ray images.

Patchouli alcohol induces G0 /G1 cell cycle arrest and apoptosis in vincristine-resistant non-small cell lung cancer through ROS-mediated DNA damage.

BACKGROUND: Lung cancer, especially non-small cell lung cancer (NSCLC), is one of the leading causes of cancer-related deaths worldwide. Vincristine (VCR) is a chemotherapeutic agent for lung cancers; however, its effectiveness is limited by side effects and the development of drug resistance. Patchouli alcohol (PA), from Pogostemon cablin extract, is known to possess anti-inflammatory and anticancer properties. In this study, we investigated the role of PA in inducing reactive oxygen species (ROS)-mediated DNA damage in A549 and VCR-resistant A549/V16 NSCLC cells. METHODS: The anticancer potential of PA was studied using the MTT assay, colony formation, flow cytometry analysis, western blotting, DCFDA staining, immunofluorescence staining, and TUNEL assay techniques. RESULTS: The intracellular ROS levels were enhanced in PA-treated cells, activating the CHK1 and CHK2 signaling pathways. PA further inhibited proliferation and colony-forming abilities and induced cell cycle arrest at the G0 /G1 phase by regulating p53/p21 and CDK2/cyclin E1 expression. Moreover, PA increased the percentage of cells in the subG1 phase and induced apoptosis by activating the Bax/caspase-9/caspase-3 intrinsic pathway. In addition, drug resistance (p-glycoprotein) and cancer stem cell (CD44 and CD133) markers were downregulated after PA treatment. Furthermore, combining PA and cisplatin exhibited synergistic inhibitory activity in A549 and A549/V16 cells. CONCLUSIONS: PA induced ROS-mediated DNA damage, triggered cell cycle arrest and apoptosis, attenuated drug resistance and cancer stem cell phenotypes, and synergistically inhibited proliferation in combination with cisplatin. These findings suggest that PA has the potential to be used for the treatment of NSCLC with or without VCR resistance.

Misuse of inhalers among COPD patients in a community hospital in Taiwan.

PURPOSE: Respiratory inhalers, which directly deliver medication to the airway, are important for controlling symptoms and preventing exacerbations of chronic obstructive pulmonary disease (COPD). The inhaler misuse rate of patients with COPD in Taiwan is unclear. In this study, the inhaler techniques and patient characteristics associated with incorrect inhaler techniques among patients with COPD were evaluated. PATIENTS AND METHODS: This cross-sectional study enrolled 298 patients with COPD (mean age 72.10 years) who used at least one inhaler device. The following five types of inhalers were included: metered-dose inhaler (MDI) with spacer, Diskus®, Turbuhaler®, Respimat®, and Breezhaler®. The inhaler technique was evaluated step by step. Misuse of an individual inhaler was defined as an error in at least one step. The sociodemographic characteristics, vision, hearing ability, type and number of inhalers, and inhaler-related knowledge of these patients were recorded. RESULTS: The misuse rates of the five types of inhalers ranged from 65.00% to 87.89%. The Respimat inhaler was the most likely to be assembled incorrectly. The steps that were most commonly performed incorrectly were "breathing out fully" and "holding breath". In the logistic regression analysis, poor hearing was related to misuse of the MDI with spacer (adjusted odds ratio [aOR] 9.85; 95% CI 1.40-69.30); the number of acute exacerbations was related to misuse of Breezhaler (aOR 4.07; 95% CI 1.50-11.08). Incorrect inhaler-related knowledge was significantly associated with misuse in handling the MDI with spacer (aOR 9.58; 95% CI 2.14-42.80), Respimat (aOR 5.14; 95% CI 2.07-12.76), and Breezhaler (aOR 6.98; 95% CI 1.95-25.08). CONCLUSION: The misuse rates were high for all five types of inhaler. Poor hearing and the number of acute exacerbations were device-specific factors related to the misuse of inhalers. Inhaler-related knowledge was significantly associated with misuse, emphasizing the importance of inhaler education.

Prevalence, risk factors, and health-related quality of life of osteoporosis in patients with COPD at a community hospital in Taiwan.

BACKGROUND: Data regarding osteoporosis in COPD patients in Taiwan remain limited. The primary end point of this study was to evaluate the prevalence and risk factors of osteoporosis in COPD patients in Taiwan. The secondary end point was to examine the association between osteoporosis and health-related quality of life (HRQL) in COPD patients. MATERIALS AND METHODS: This prospective cross-sectional study enrolled 125 COPD patients (mean age 73.6 years, forced expiratory volume in 1 second [FEV1] 1.19±0.43 L) who had bone mineral-density measurements performed consecutively. Demographic data, lung function, and HRQL including modified Medical Research Council dyspnea scale, St George's Respiratory Questionnaire, oxygen-cost diagram, Center for Epidemiologic Studies - depression scale, and COPD Assessment Test scores were recorded. RESULTS: A total of 50 (40%) participants were diagnosed as having osteoporosis. In a multivariate logistic regression model including age, smoking amount (pack-year), body mass index (BMI), and FEV1, only BMI (odds ratio 0.824, 95% confidence interval 0.73-0.93; P=0.002) and FEV1 (odds ratio 0.360, 95% confidence interval 0.13-0.98; P=0.046) were negatively associated with an increased risk of osteoporosis in COPD patients. In addition, COPD patients with osteoporosis had significantly higher modified Medical Research Council dyspnea scale scores (1.7±0.8 vs 1.4±0.8, P=0.046), St George's Respiratory Questionnaire scores (36.6 vs 28.0, P=0.01), and COPD Assessment Test scores (14.7±8 vs 11.5±7, P=0.019), and lower oxygen-cost diagram score (4.8±1.8 vs 5.4±1.6, P=0.045) than patients without osteoporosis. CONCLUSION: The prevalence of osteoporosis in COPD patients was high at a community hospital in Taiwan. BMI and FEV1 were the independent risk factors for osteoporosis in COPD. In addition, COPD patients with osteoporosis had worse HRQL than those without osteoporosis.

A putative novel protein, DEPDC1B, is overexpressed in oral cancer patients, and enhanced anchorage-independent growth in oral cancer cells that is mediated by Rac1 and ERK.

BACKGROUND: The DEP domain is a globular domain containing approximately 90 amino acids, which was first discovered in 3 proteins: Drosophila disheveled, Caenorhabditis elegans EGL-10, and mammalian Pleckstrin; hence the term, DEP. DEPDC1B is categorized as a potential Rho GTPase-activating protein. The function of the DEP domain in signal transduction pathways is not fully understood. The DEPDC1B protein exhibits the characteristic features of a signaling protein, and contains 2 conserved domains (DEP and RhoGAP) that are involved in Rho GTPase signaling. Small GTPases, such as Rac, CDC42, and Rho, regulate a multitude of cell events, including cell motility, growth, differentiation, cytoskeletal reorganization and cell cycle progression. RESULTS: In this study, we found that it was a guanine nucleotide exchange factor and induced both cell migration in a cultured embryonic fibroblast cell line and cell invasion in cancer cell lines; moreover, it was observed to promote anchorage-independent growth in oral cancer cells. We also demonstrated that DEPDC1B plays a role in regulating Rac1 translocated onto cell membranes, suggesting that DEPDC1B exerts a biological function by regulating Rac1. We examined oral cancer tissue; 6 out of 7 oral cancer tissue test samples overexpressed DEPDC1B proteins, compared with normal adjacent tissue. CONCLUSIONS: DEPDC1B was a guanine nucleotide exchange factor and induced both cell migration in a cultured embryonic fibroblast cell line and cell invasion in cancer cell lines; moreover, it was observed to promote anchorage-independent growth in oral cancer cells. We also demonstrated that DEPDC1B exerts a biological function by regulating Rac1. We found that oral cancer samples overexpressed DEPDC1B proteins, compared with normal adjacent tissue. Suggest that DEPDC1B plays a role in the development of oral cancer. We revealed that proliferation was linked to a novel DEPDC1B-Rac1-ERK1/2 signaling axis in oral cancer cell lines.