Browsing by Author "Lee, Chien-Ching"

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A Novel Smart Assistance System for Blood Vessel Approaching: A Technical Report Based on Oximetry
(2020-04-01)
Lee, Chien-Ching
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Chuang, Chia-Chun
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Lai, Bo-Cheng
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Huang, Yi-Chia
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Chen, Jen-Yin
In clinical practice, the catheter has to be placed at an accurate position during anesthesia administration. However, effectively guiding the catheter to the accurate position in deeper tissues can be difficult for an inexperienced practitioner. We aimed to address the current issues associated with catheter placement using a novel smart assistance system for blood vessel catheter placement. We used a hollow introducer needle embedded with dual wavelength (690 and 850 nm) optical fibers to advance the tip into the subclavian vessels in anesthetized piglets. The results showed average optical density changes, and the difference between the absorption spectra and hemoglobin concentrations of different tissue components effectively identified different tissues (p < 0.05). The radial basis function neural network (RBFNN) technique was applied to distinguish tissue components (the F-measure value and accuracy were 93.02% and 94%, respectively). Finally, animal experiments were designed to validate the performance of the proposed system. Using this system based on oximetry, we easily navigated the needle tip to the target vessel. Based on the experimental results, the proposed system could effectively distinguish different tissue layers of the animals.
An innovative nonpharmacological intervention combined with intravenous patient-controlled analgesia increased patient global improvement in pain and satisfaction after major surgery
(2017-01-01)
Chuang, Chia-Chun
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Lee, Chien-Ching
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Wang, Li-Kai
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Lin, Bor-Shyh
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Wu, Wen-Ju
Purpose: This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit) into standard operating procedure (SOP) in acute pain service (APS) improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA). Patients and methods: This was a nonrandomized before-after study. Adult patients (aged between 20 and 80 years) who received IV-PCA after major surgery were included. Implementing CICARE into SOP was conducted in APS. Anonymous questionnaires were used to measure outcomes in this prospective two-part survey. The first part completed by APS nurses contained patients' characteristics, morphine dosage, delivery/demand ratios, IV-PCA side effects and pain at rest measured with an 11-point numeric rating scale (NRS, 0-10). A score of NRS. 4 was defined as inadequately treated pain. The ten-question second part was completed by patients voluntarily after IV-PCA was discontinued. Each question was assessed with a 5-point Likert scale (1: extremely poor; 5: excellent). Patients were separated into "before" and "after" CICARE groups. Primary outcomes were patient global impression of improvement in pain (PGI-Improvement) and patient satisfaction. Secondary outcomes included quality of communication skills, instrument proficiency and accessibility/availability of IV-PCA. Results: The response rate was 55.3%, with 187 usable questionnaires. CICARE effectively improved patient global impression of improvement in pain, patient satisfaction, communication skills and accessibility/availability of IV-PCA. No significant differences were noted in instrument proficiency, morphine dosage, delivery/demand ratios, rates of inadequately treated pain at rest and side effects of IV-PCA between groups. Paradoxical findings were noted between the rates of inadequately treated pain/side effects and PGI-Improvement in pain/patient satisfaction, which were affected by psychological factors. Conclusion: Nonpharmacological interventions carried out by implementing CICARE into SOP for APS effectively improved patient satisfaction and postoperative pain management quality, but this did not affect actual pain.
Convolutional denoising autoencoder based SSVEP signal enhancement to SSVEP-based BCIs
(1970-01-01)
Chuang, Chia-Chun
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Lee, Chien-Ching
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Yeng, Chia-Hong
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So, Edmund-Cheung
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Lin, Bor-Shyh
For steady state visually evoked potential (SSVEP) based brain computer interfaces (BCIs), the elicited SSVEP signals always contain noises and then the performance of SSVEP-based BCIs would be greatly degraded in practical applications. Therefore, to develop an SSVEP signal enhancement would be able to increase the accuracy of SSVEP-based BCIs. In this study, a convolutional denoising autoencoder based SSVEP signal enhancement is proposed to suppress the noise components. The convolutional denoising autoencoder is applied to estimate and suppress the noise components. To effectively estimate the noise components, a sinusoid wave is designed as an ideal SSVEP signal. To ignore the effects of phase, cross correlation is adopted to estimate the phase in the training stage. The experimental results evaluated by using signal-to-noise ratio and canonical correspondence analysis showed that the proposed approaches can effectively suppress the noises components. Therefore, the proposed approach can be applied to develop robust SSVEP-based BCIs.
Dual-wavelength fiber-optic technique to assist needle cricothyroidotomy
(1970-01-01)
Lee, Chien-Ching
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Chuang, Chia-Chun
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Lai, Bo-Cheng
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Lu, Chin-Li
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So, Edmund Cheung
The traditional needle cricothyroidotomy procedure is performed blindly without any medical equipment. Complications including posterior tracheal wall perforation, accidental vessel puncture, and missed tracheal puncture are reported. Therefore, we proposed a dual-wavelength fiber-optic technique based on the technique of near-infrared spectroscopy to assist operators performing needle cricothyroidotomy in a swine model. We embedded optical fibers in a 16-gauge intravenous needle catheter. Real-time data were displayed on an oscilloscope, and we used the program to analyze the data immediately. The change of optical density corresponding to 690-nm and 850-nm wavelengths and hemoglobin parameters (HbO(2)and Hb concentrations) was analyzed immediately using the program in the laptop. Unique and significant optical differences were presented in this experiment. We could easily identify every different tissue by the change of optical density corresponding to 690-nm and 850-nm wavelengths and hemoglobin parameters (HbO(2)and Hb concentrations). Statistical method (Kruskal-WallisHtest) was used to compare differences in tissues at each time-point, respectively. Thepvalues in every tissue in optical density change corresponding to 690 nm and 850 nm were all < 0.001. Furthermore, thepvalues in every tissue in Hb and HbO(2)were also all < 0.001. The results were statistically significant. This is the first and novel study to introduce a dual-wavelength embedded fibers into a standard cricothyroidotomy needle. This proposed system might be helpful to provide us real-time information of the advanced needle tip to decrease possible complications.
High Effectiveness in Actions of Carfilzomib on Delayed-Rectifier K+ Current and on Spontaneous Action Potentials
(2019-10-07)
So, Edmund Cheung
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Liu, Ping-Yen
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Lee, Chien-Ching
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Wu, Sheng-Nan
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影像與生醫光電研究所
Carfilzomib (CFZ, Kyprolis (R)) is widely recognized as an irreversible inhibitor of proteasome activity; however, its actions on ion currents in electrically excitable cells are largely unresolved. The possible actions of CFZ on ionic currents and membrane potential in pituitary GH(3), A7r5 vascular smooth muscle, and heart-derived H9c2 cells were extensively investigated in this study. The presence of CFZ suppressed the amplitude of delayed-rectifier K+ current (I-K(DR)) in a time-, state-, and concentration-dependent manner in pituitary GH(3) cells. Based on minimal reaction scheme, the value of dissociation constant for CFZ-induced open-channel block of I-K(DR) in these cells was 0.33 mu M, which is similar to the IC50 value (0.32 mu M) used for its efficacy on inhibition of I-K(DR) amplitude. Recovery from I-K(DR) block by CFZ (0.3 mu M and 1 mu M) could be well fitted by single exponential with 447 and 645 ms, respectively. The M-type K+ current, another type of K+ current elicited by low-threshold potential, was slightly suppressed by CFZ (1 mu M). Under current-clamp condition, addition of CFZ depolarized GH(3) cells, broadened the duration of action potentials as well as raised the firing frequency. In A7r5 vascular smooth muscle cells or H9c2 cardiac cells, the CFZ-induced inhibition of I-K(DR) remained efficacious. Therefore, our study led us to reflect that CFZ or other structurally similar compounds should somehow act on the activity of membrane K-V channels through which they influence the functional activities in different types of electrically excitable cells such as endocrine, neuroendocrine cells, smooth muscle cells, or heart cells, if similar in vivo findings occur.
Higher-Order-Statistics-Based Fractal Dimension for Noisy Bowel Sound Detection
(2015-07-01)
Sheu, Ming-Jen
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Lin, Ping-Yi
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Chen, Jen-Yin
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Lee, Chien-Ching
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Lin, Bor-Shyh
Bowel sounds is an important physiological parameter of distinguishing the gastrointestinal motility dysfunction. Auscultation of bowel sounds provides a noninvasive way for clinical diagnosis, but it is also easily affected by environmental noise. In this study, a novel higher-order-statistics (HOS)-based fractal dimension algorithm was proposed for detecting noisy bowel sounds. By using the nature of preserving non-Gaussianity for higher order statistics technique, the proposed method can effectively detect bowel sounds under different noise conditions, and its performance is insensitive to the change of noise type and noise level.
Less postoperative pain in patients receiving trans-oral vestibular endoscopic thyroidectomy: a plausible finding?
(2017-08-01)
Lan, Kuo-Mao
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Chen, Chia-Ming
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Chuang, Chia-Chun
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Lee, Chien-Ching
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Wang, Li-Kai
Noise Suppression by Minima Controlled Recursive Averaging for SSVEP-Based BCIs With Single Channel
(2017-12-01)
Lee, Chien-Ching
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Chuang, Chia-Chun
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Yeng, Chia-Hong
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Chen, Yeou-Jiunn
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Lin, Bor-Shyh
Subjects with amyotrophic lateral sclerosis (ALS) consistently experience decreasing quality of life because of this distinctive disease. Thus, a practical brain-computer interface (BCI) application can effectively help subjects with ALS to participate in communication. In practices, the noise would greatly reduce the performance of BCIs. In this study, minima controlled recursive averaging is applied to suppress noise and improve the performance of practical BCI applications. Minima controlled recursive averaging is used to correctively track the noise. To suppress these noises, a log-spectral amplitude estimator is selected as the gain function and used to effectively estimate the power spectrum of the noises. Eight subjects were asked to attend a performance test of the proposed approach and the canonical correlation analysis (CCA) was adopted to compare the proposed approach. The average recognition rates based on single channel are 69.57% and 74.63% for CCA and proposed approach, respectively. The experimental results demonstrated that our approach is able to improve performance in practice.