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  1. Article ; Online: Presentation of glomerulocystic disease in a young onset diabetes: A case report.

    Huang, Wen-Hung / Tu, Kun-Hua / Chen, Tai-Di / Weng, Cheng-Hao / Hsu, Ching-Wei

    Medicine

    2024  Volume 103, Issue 4, Page(s) e36952

    Abstract: Rationale: This case report presents a challenging medical scenario involving a young adult male who exhibited an unusual combination of symptoms, including abrupt weight loss, declining renal function, proteinuria, and concurrent onset of diabetes ... ...

    Abstract Rationale: This case report presents a challenging medical scenario involving a young adult male who exhibited an unusual combination of symptoms, including abrupt weight loss, declining renal function, proteinuria, and concurrent onset of diabetes mellitus. Remarkably, the patient had no previous medical history or family history of similar conditions, necessitating a comprehensive investigation.
    Patient concerns: On March 10, 2021, a 25-year-old male sought medical attention due to the aforementioned symptoms. Initial assessments revealed stage 5 chronic kidney disease, with elevated blood urea nitrogen (BUN) and serum creatinine (Cr) levels, as well as significant proteinuria. The only notable physical finding was obesity, and renal ultrasound showed normal-sized kidneys without cysts.
    Diagnosis: A treatment plan was initiated to stabilize creatinine levels, including medications such as Glimepiride, Glyxambi, Bisoprolol, Amlodipine, and Valsartan. However, despite diligent medication management, proteinuria persisted, prompting further evaluation. A renal biopsy was performed on April 12th, 2023, leading to the diagnosis of glomerulocystic kidney disease with early-stage changes indicative of diabetic nephropathy.
    Interventions: The patient continues to receive ongoing care and follow-up at our outpatient clinic to optimize therapeutic interventions and elucidate the underlying etiology of this complex clinical scenario.
    Outcomes: Ongoing investigations and therapeutic interventions are crucial to understand the underlying cause and optimize patient care in this intricate clinical scenario.
    Lessons: This case underscores the complexity of diagnosing and managing a young adult presenting with concurrent renal dysfunction, proteinuria, and diabetes mellitus in the absence of prior underlying conditions. It highlights the importance of comprehensive evaluation and ongoing care in such challenging cases.
    MeSH term(s) Adult ; Humans ; Male ; Diabetes Mellitus ; Diabetic Nephropathies/complications ; Diabetic Nephropathies/diagnosis ; Kidney/pathology ; Kidney Failure, Chronic/therapy ; Obesity/complications ; Proteinuria/etiology
    Language English
    Publishing date 2024-01-26
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80184-7
    ISSN 1536-5964 ; 0025-7974
    ISSN (online) 1536-5964
    ISSN 0025-7974
    DOI 10.1097/MD.0000000000036952
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Thermal stability of L1

    Fernandez, Eduardo / Tu, Kun-Hua / Ho, Pin / Ross, Caroline A

    Nanotechnology

    2018  Volume 29, Issue 46, Page(s) 465301

    Abstract: Arrays of 14 nm thick ... ...

    Abstract Arrays of 14 nm thick L1
    Language English
    Publishing date 2018-08-31
    Publishing country England
    Document type Journal Article
    ZDB-ID 1362365-5
    ISSN 1361-6528 ; 0957-4484
    ISSN (online) 1361-6528
    ISSN 0957-4484
    DOI 10.1088/1361-6528/aade2f
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Incidence of Mortality, Acute Kidney Injury and Graft Loss in Adult Kidney Transplant Recipients with Coronavirus Disease 2019: Systematic Review and Meta-Analysis.

    Chen, Jia-Jin / Kuo, George / Lee, Tao Han / Yang, Huang-Yu / Wu, Hsin Hsu / Tu, Kun-Hua / Tian, Ya-Chung

    Journal of clinical medicine

    2021  Volume 10, Issue 21

    Abstract: The adverse impact of Coronavirus disease 2019 (COVID-19) on kidney function has been reported since the global pandemic. The burden of COVID-19 on kidney transplant recipients, however, has not been systematically analyzed. A systematic review and meta- ... ...

    Abstract The adverse impact of Coronavirus disease 2019 (COVID-19) on kidney function has been reported since the global pandemic. The burden of COVID-19 on kidney transplant recipients, however, has not been systematically analyzed. A systematic review and meta-analysis with a random-effect model was conducted to explore the rate of mortality, intensive care unit admission, invasive mechanical ventilation, acute kidney injury, kidney replacement therapy and graft loss in the adult kidney transplant population with COVID-19. Sensitivity analysis, subgroup analysis and meta-regression were also performed. Results: we demonstrated a pooled mortality rate of 21% (95% CI: 19-23%), an intensive care unit admission rate of 26% (95% CI: 22-31%), an invasive ventilation rate among those who required intensive care unit care of 72% (95% CI: 62-81%), an acute kidney injury rate of 44% (95% CI: 39-49%), a kidney replacement therapy rate of 12% (95% CI: 9-15%), and a graft loss rate of 8% (95% CI: 5-15%) in kidney transplant recipients with COVID-19. The meta-regression indicated that advancing age is associated with higher mortality; every increase in age by 10 years was associated with an increased mortality rate of 3.7%. Regional differences in outcome were also detected. Further studies focused on treatments and risk factor identification are needed.
    Language English
    Publishing date 2021-11-04
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm10215162
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Recent progress in unraveling cardiovascular complications associated with primary aldosteronism: a succinct review.

    Wang, Wei-Ting / Wu, Tsung-Hui / Er, Leay-Kiaw / Huang, Chien-Wei / Tu, Kun-Hua / Fan, Kang-Chih / Tsai, Cheng-Hsuan / Wang, Shu-Yi / Wu, Chun-Yi / Huang, Shu-Heng / Liu, Han-Wen / Tseng, Fen-Yu / Wu, Wan-Chen / Chang, Chin-Chen / Cheng, Hao-Min / Lin, Liang-Yu / Chueh, Jeff S / Lin, Yen-Hung / Hwu, Chii-Min /
    Wu, Vin-Cent

    Hypertension research : official journal of the Japanese Society of Hypertension

    2024  Volume 47, Issue 5, Page(s) 1103–1119

    Abstract: This comprehensive review offers a thorough exploration of recent advancements in our understanding of the intricate cardiovascular complications associated with Primary Aldosteronism (PA). PA encompasses a spectrum of conditions characterized by ... ...

    Abstract This comprehensive review offers a thorough exploration of recent advancements in our understanding of the intricate cardiovascular complications associated with Primary Aldosteronism (PA). PA encompasses a spectrum of conditions characterized by hypertension and excessive production of aldosterone operating independently of the renin-angiotensin system. Given its association with an elevated risk of cardiovascular and cerebrovascular complications, as well as a higher incidence of metabolic syndrome in comparison to individuals with essential hypertension (EH), an accurate diagnosis of PA is of paramount importance. This review delves into the intricate interplay between PA and cardiovascular health and focuses on the key pathophysiological mechanisms contributing to adverse cardiac outcomes. The impact of different treatment modalities on cardiovascular health is also examined, offering insights into potential therapeutic approaches. By highlighting the significance of recognizing PA as a significant contributor to cardiovascular morbidity, this review emphasizes the need for improved screening, early diagnosis, and tailored management strategies to both enhance patient care and mitigate the burden of cardiovascular diseases. The findings presented herein underscore the growing importance of PA in the context of cardiovascular medicine and emphasize the potential for translating these insights into targeted interventions to improve patient outcomes.
    MeSH term(s) Humans ; Hyperaldosteronism/complications ; Cardiovascular Diseases/etiology
    Language English
    Publishing date 2024-01-16
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1175297-x
    ISSN 1348-4214 ; 0916-9636
    ISSN (online) 1348-4214
    ISSN 0916-9636
    DOI 10.1038/s41440-023-01538-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: The role of confirmatory tests in the diagnosis of primary aldosteronism.

    Huang, Chien-Wei / Tu, Kun-Hua / Fan, Kang-Chih / Tsai, Cheng-Hsuan / Wang, Wei-Ting / Wang, Shu-Yi / Wu, Chun-Yi / Hu, Ya-Hui / Huang, Shu-Heng / Liu, Han-Wen / Tseng, Fen-Yu / Wu, Wan-Chen / Chang, Chin-Chen / Lin, Yen-Hung / Wu, Vin-Cent / Hwu, Chii-Min

    Journal of the Formosan Medical Association = Taiwan yi zhi

    2023  Volume 123 Suppl 2, Page(s) S104–S113

    Abstract: Confirmatory tests for diagnosis of primary aldosteronism (PA) play an important role in sparing patients with a false-positive aldosterone-to-renin ratio (ARR) screening test from undergoing invasive subtyping procedures. We recommend that patients with ...

    Abstract Confirmatory tests for diagnosis of primary aldosteronism (PA) play an important role in sparing patients with a false-positive aldosterone-to-renin ratio (ARR) screening test from undergoing invasive subtyping procedures. We recommend that patients with a positive ARR test should undergo at least one confirmatory test to confirm or exclude the diagnosis of PA before directly proceeding to subtype studies, except for patients with significant PA phenotypes, including spontaneous hypokalemia, plasma aldosterone concentration >20 ng/dL plus plasma renin activity below a detectable level. Although a gold standard confirmatory test has not been identified, we recommend that saline infusion test and captopril challenge test, which were widely used in Taiwan. Patients with PA have been reported to have a higher prevalence of concurrent autonomous cortisol secretion (ACS). ACS is a biochemical condition of mild cortisol overproduction from adrenal lesions, but without the typical clinical features of overt Cushing's syndrome. Concurrent ACS may result in incorrect interpretation of adrenal venous sampling (AVS) and may lead to adrenal insufficiency after adrenalectomy. We recommend screening for ACS in patients with PA scheduled for AVS examinations as well as for adrenalectomy. We recommend the 1-mg overnight dexamethasone suppression test as screening method to detect ACS.
    MeSH term(s) Humans ; Aldosterone ; Hyperaldosteronism/diagnosis ; Renin ; Hydrocortisone ; Captopril ; Hypertension
    Chemical Substances Aldosterone (4964P6T9RB) ; Renin (EC 3.4.23.15) ; Hydrocortisone (WI4X0X7BPJ) ; Captopril (9G64RSX1XD)
    Language English
    Publishing date 2023-05-11
    Publishing country Singapore
    Document type Journal Article ; Review
    ZDB-ID 2096659-3
    ISSN 1876-0821 ; 0929-6646
    ISSN (online) 1876-0821
    ISSN 0929-6646
    DOI 10.1016/j.jfma.2023.04.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: All-cause and immune checkpoint inhibitor-associated acute kidney injury in immune checkpoint inhibitor users: a meta-analysis of occurrence rate, risk factors and mortality.

    Chen, Jia-Jin / Lee, Tao-Han / Kuo, George / Yen, Chieh-Li / Lee, Cheng-Chia / Chang, Chih-Hsiang / Tu, Kun-Hua / Chen, Yung-Chang / Fang, Ji-Tseng / Hung, Cheng-Chieh / Yang, Chih-Wei / Chou, Wen-Chi / Chi, Ching-Chi / Tu, Yu-Kang / Yu Yang, Huang-

    Clinical kidney journal

    2023  Volume 17, Issue 1, Page(s) sfad292

    Abstract: Background: Immune checkpoint inhibitors (ICIs) have been associated with acute kidney injury (AKI). However, the occurrence rate of ICI-related AKI has not been systematically examined. Additionally, exposure to proton pump inhibitors (PPIs) and non- ... ...

    Abstract Background: Immune checkpoint inhibitors (ICIs) have been associated with acute kidney injury (AKI). However, the occurrence rate of ICI-related AKI has not been systematically examined. Additionally, exposure to proton pump inhibitors (PPIs) and non-steroidal anti-inflammatory drugs (NSAIDs) were considered as risk factors for AKI, but with inconclusive results in ICI-related AKI. Our aim was to analyse the occurrence rate of all-cause AKI and ICI-related AKI and the occurrence rates of severe AKI and dialysis-requiring AKI, and to determine whether exposure to PPIs and NSAIDs poses a risk for all-cause and ICI-related AKI.
    Methods: This study population was adult ICI recipients. A systematic review was conducted by searching MEDLINE, Embase and PubMed through October 2023. We included prospective trials and observational studies that reported any of the following outcomes: the occurrence rate of all-cause or ICI-related AKI, the relationship between PPI or NSAID exposure and AKI development or the mortality rate in the AKI or non-AKI group. Proportional meta-analysis and pairwise meta-analysis were performed. The evidence certainty was assessed using the Grading of Recommendations Assessment, Development and Evaluation framework.
    Results: A total of 120 studies comprising 46 417 patients were included. The occurrence rates of all-cause AKI were 7.4% (14.6% from retrospective studies and 1.2% from prospective clinical trials). The occurrence rate of ICI-related AKI was 3.2%. The use of PPIs was associated with an odds ratio (OR) of 1.77 [95% confidence interval (CI) 1.43-2.18] for all-cause AKI and an OR of 2.42 (95% CI 1.96-2.97) for ICI-related AKI. The use of NSAIDs was associated with an OR of 1.77 (95% CI 1.10-2.83) for all-cause AKI and an OR of 2.57 (95% CI 1.68-3.93) for ICI-related AKI.
    Conclusions: Our analysis revealed that approximately 1 in 13 adult ICI recipients may experience all-cause AKI, while 1 in 33 adult ICI recipients may experience ICI-related AKI. Exposure to PPIs and NSAIDs was associated with an increased OR risk for AKI in the current meta-analysis.
    Language English
    Publishing date 2023-11-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2655800-2
    ISSN 2048-8513 ; 2048-8505
    ISSN (online) 2048-8513
    ISSN 2048-8505
    DOI 10.1093/ckj/sfad292
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Vacancy Defects Inductive Effect of Asymmetrically Coordinated Single-Atom Fe─N

    Zhao, Yilin / Chen, Hsiao-Chien / Ma, Xuelu / Li, Jiaye / Yuan, Qing / Zhang, Peng / Wang, Minmin / Li, Junxi / Li, Min / Wang, Shifu / Guo, Han / Hu, Ruanbo / Tu, Kun-Hua / Zhu, Wei / Li, Xuning / Yang, Xuan / Pan, Yuan

    Advanced materials (Deerfield Beach, Fla.)

    2023  Volume 36, Issue 11, Page(s) e2308243

    Abstract: The development of facile, efficient synthesis method to construct low-cost and high-performance single-atom catalysts (SACs) for oxygen reduction reaction (ORR) is extremely important, yet still challenging. Herein, an atomically dispersed N, S co-doped ...

    Abstract The development of facile, efficient synthesis method to construct low-cost and high-performance single-atom catalysts (SACs) for oxygen reduction reaction (ORR) is extremely important, yet still challenging. Herein, an atomically dispersed N, S co-doped carbon with abundant vacancy defects (NSC-vd) anchored Fe single atoms (SAs) is reported and a vacancy defects inductive effect is proposed for promoting electrocatalytic ORR. The optimized catalyst featured of stable Fe─N
    Language English
    Publishing date 2023-12-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1474949-X
    ISSN 1521-4095 ; 0935-9648
    ISSN (online) 1521-4095
    ISSN 0935-9648
    DOI 10.1002/adma.202308243
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Supplementation with Folic Acid and Cardiovascular Outcomes in End-Stage Kidney Disease: A Multi-Institution Cohort Study.

    Tu, Yi-Ran / Tu, Kun-Hua / Lee, Cheng-Chia / Fan, Pei-Chun / Yen, Chieh-Li / Wu, Victor Chien-Chia / Fang, Ji-Tseng / Chen, Yung-Chang / Chu, Pao-Hsien / Chang, Chih-Hsiang

    Nutrients

    2022  Volume 14, Issue 19

    Abstract: Background: Folate is a water-soluble vitamin and is essential for maintaining cell functions. Dialysis removes folate, and folate deficiency is reported in patients with end-stage kidney disease (ESKD). However, there is no consensus as to the ... ...

    Abstract Background: Folate is a water-soluble vitamin and is essential for maintaining cell functions. Dialysis removes folate, and folate deficiency is reported in patients with end-stage kidney disease (ESKD). However, there is no consensus as to the appropriate dosage of folate supplements and their advantages and disadvantages for patients with ESKD.
    Methods: This study was based on the electronic medical records of the Chang Gung Research Database (CGRD) of the Chang Gung Medical Foundation. We included patients who were diagnosed with ESKD, initiated hemodialysis, and were given folic acid supplements at any point from 1 January 2001 to 31 December 2019. The patients were divided into weekly and daily folic acid supplementation groups. We reduced the effects of confounding through the inverse probability of treatment weighting based on the propensity score.
    Results: We identified 2081 and 954 newly diagnosed patients with ESKD, who received daily and weekly folic acid supplements. The mean follow-up time was 5.8 years, and the event rates of arteriovenous access thrombosis were 17.0% and 23.6% in the daily and weekly folic acid supplementation groups (sub-distribution hazard ratio = 0.69, 95% confidence interval = 0.61 to 0.77), respectively. Neither group significantly differed in the occurrence of other clinical events, such as major cardiovascular cardiac events (e.g., myocardial infarction and ischemic stroke), all-cause mortality, cardiovascular death, infection death, malignancy, and adverse effects.
    Conclusion: a daily 5 mg folic acid supplementation might result in a lower event rate of arteriovenous access thrombosis in patients with ESKD than weekly folic acid supplementation. Further prospective studies are warranted to explore the preventive effect of folate on thrombosis.
    MeSH term(s) Cohort Studies ; Dietary Supplements ; Folic Acid ; Humans ; Kidney Failure, Chronic/drug therapy ; Renal Dialysis ; Thrombosis/chemically induced ; Vitamins ; Water
    Chemical Substances Vitamins ; Water (059QF0KO0R) ; Folic Acid (935E97BOY8)
    Language English
    Publishing date 2022-10-07
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu14194162
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  9. Article ; Online: End-to-end interstitial fibrosis assessment of kidney biopsies with a machine learning-based model.

    Liu, Zhi-Yong / Lin, Chi-Hung / Wang, Hsiang-Sheng / Wen, Mei-Chin / Lin, Wei-Chou / Huang, Shun-Chen / Tu, Kun-Hua / Kuo, Chang-Fu / Chen, Tai-Di

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2022  Volume 37, Issue 11, Page(s) 2093–2101

    Abstract: Background: The extent of interstitial fibrosis in the kidney not only correlates with renal function at the time of biopsy but also predicts future renal outcome. However, its assessment by pathologists lacks good agreement. The aim of this study is to ...

    Abstract Background: The extent of interstitial fibrosis in the kidney not only correlates with renal function at the time of biopsy but also predicts future renal outcome. However, its assessment by pathologists lacks good agreement. The aim of this study is to construct a machine learning-based model that enables automatic and reliable assessment of interstitial fibrosis in human kidney biopsies.
    Methods: Validated cortex, glomerulus and tubule segmentation algorithms were incorporated into a single model to assess the extent of interstitial fibrosis. The model performances were compared with expert renal pathologists and correlated with patients' renal functional data.
    Results: Compared with human raters, the model had the best agreement [intraclass correlation coefficient (ICC) 0.90] to the reference in 50 test cases. The model also had a low mean bias and the narrowest 95% limits of agreement. The model was robust against colour variation on images obtained at different times, through different scanners, or from outside institutions with excellent ICCs of 0.92-0.97. The model showed significantly better test-retest reliability (ICC 0.98) than humans (ICC 0.76-0.94) and the amount of interstitial fibrosis inferred by the model strongly correlated with 405 patients' serum creatinine (r = 0.65-0.67) and estimated glomerular filtration rate (r = -0.74 to -0.76).
    Conclusions: This study demonstrated that a trained machine learning-based model can faithfully simulate the whole process of interstitial fibrosis assessment, which traditionally can only be carried out by renal pathologists. Our data suggested that such a model may provide more reliable results, thus enabling precision medicine.
    MeSH term(s) Humans ; Creatinine ; Fibrosis ; Reproducibility of Results ; Kidney/pathology ; Biopsy ; Machine Learning
    Chemical Substances Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2022-06-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfac143
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  10. Article ; Online: Machine Learning Predictions of Block Copolymer Self-Assembly.

    Tu, Kun-Hua / Huang, Hejin / Lee, Sangho / Lee, Wonmoo / Sun, Zehao / Alexander-Katz, Alfredo / Ross, Caroline A

    Advanced materials (Deerfield Beach, Fla.)

    2020  Volume 32, Issue 52, Page(s) e2005713

    Abstract: Directed self-assembly of block copolymers is a key enabler for nanofabrication of devices with sub-10 nm feature sizes, allowing patterning far below the resolution limit of conventional photolithography. Among all the process steps involved in block ... ...

    Abstract Directed self-assembly of block copolymers is a key enabler for nanofabrication of devices with sub-10 nm feature sizes, allowing patterning far below the resolution limit of conventional photolithography. Among all the process steps involved in block copolymer self-assembly, solvent annealing plays a dominant role in determining the film morphology and pattern quality, yet the interplay of the multiple parameters during solvent annealing, including the initial thickness, swelling, time, and solvent ratio, makes it difficult to predict and control the resultant self-assembled pattern. Here, machine learning tools are applied to analyze the solvent annealing process and predict the effect of process parameters on morphology and defectivity. Two neural networks are constructed and trained, yielding accurate prediction of the final morphology in agreement with experimental data. A ridge regression model is constructed to identify the critical parameters that determine the quality of line/space patterns. These results illustrate the potential of machine learning to inform nanomanufacturing processes.
    Language English
    Publishing date 2020-11-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1474949-X
    ISSN 1521-4095 ; 0935-9648
    ISSN (online) 1521-4095
    ISSN 0935-9648
    DOI 10.1002/adma.202005713
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