Publications by authors named "Siew-Na Lim"

Article Synopsis
  • The study investigates the clinical features, treatment approaches, and long-term outcomes of patients with reflex epilepsies (RE) in Taiwan, particularly focusing on their responses to specific triggers.
  • A total of 81 patients were analyzed, revealing that those with extrinsic triggers (like photosensitivity) were generally younger and had more spontaneous seizures compared to those with intrinsic triggers (like Mah-Jong).
  • Results showed a high usage of antiseizure medications among patients, with a notable difference in treatment methods and stimulus avoidance behaviors between the two groups, but both achieved similar seizure control outcomes.*
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  • Colorectal cancer (CRC) poses a significant global health risk, making the use of adjuvant chemotherapy post-surgery crucial for reducing recurrence and improving survival, especially in intermediate-stage patients.
  • This study investigates the genetic mechanisms influencing the effectiveness of 5-fluorouracil (5-FU)-based chemotherapy using a genome-wide association study (GWAS) on 226 intermediate-stage CRC patients who received surgery followed by treatment.
  • Key findings highlight the genetic variant -rs62139523, particularly the "A/G" genotype, as a promising biomarker that predicts better survival outcomes in these patients, though its efficacy varies based on certain demographic and clinical factors.
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  • Various COVID-19 vaccines, including viral vector, mRNA, and inactivated types, have been linked to central nervous system inflammatory demyelinating diseases (CNS IDDs), with a case study highlighting the AstraZeneca vaccine and 78 other reported cases.
  • The majority of the CNS IDD cases involved patients who received viral vector vaccines (62%), followed by mRNA (25.3%) and inactivated vaccines (12.7%), with male patients being more affected by viral vector vaccines.
  • The study identified significant correlations between vaccine type, age, gender, and the presence of specific autoantibodies (like anti-MOG and anti-AQP4), suggesting the need for further research to understand underlying mechanisms and guide
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Background: Perampanel (PER) is a newly developed antiseizure medication (ASM). This study aimed to determine the utilization of therapeutic drug monitoring (TDM) for PER in a real-world clinical setting and investigate the influence of concomitant use of ASMs on the plasma concentration profile of PER.

Method: We analyzed data from the Chang Gung Research Database, which is the largest multi-institutional electronic medical records database in Taiwan.

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Background: The clinical value of therapeutic drug monitoring (TDM) for newer anti-seizure medications (ASMs) remains uncertain. This study aimed to assess the impact of newer ASM TDM on clinical decision making in patients with epilepsy.

Methods: We retrospectively identified all plasma requests for newer ASM level measurement as part of routine clinical management in the outpatient departments of seven medical institutes across Taiwan between September 2016 and May 2019.

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Background: Combination therapy with antiseizure medications (ASMs) is a rational strategy if monotherapy cannot effectively control seizures, thereby aiming to improve tolerance and treatment persistence.

Objectives: To compare the efficacy of different ASM combinations among patients.

Design: Patients with epilepsy on monotherapy who had a second ASM added as concomitant two-drug therapy from January 2009 to May 2019 in the Chang Gung Research Database, Taiwan, were included in the analysis.

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Colorectal cancer (CRC) is a prevalent malignancy worldwide and is associated with a high mortality rate. Changes in bioenergy metabolism, such as the Warburg effect, are often observed in CRC. Aldolase B (ALDOB) has been identified as a potential regulator of these changes, but its exact role in CRC cell behavior and bioenergetic homeostasis is not fully understood.

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Cancer cells exhibit metabolic reprogramming and bioenergetic alteration, utilizing glucose fermentation for energy production, known as the Warburg effect. However, there are a lack of comprehensive reviews summarizing the metabolic reprogramming, bioenergetic alteration, and their oncogenetic links in gastrointestinal (GI) cancers. Furthermore, the efficacy and treatment potential of emerging anticancer drugs targeting these alterations in GI cancers require further evaluation.

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Article Synopsis
  • A study on juvenile myoclonic epilepsy (JME) found that 51% of patients continued to experience seizures despite treatment with antiseizure medications (ASMs).
  • Factors contributing to worse seizure outcomes included the presence of epileptiform discharges on EEG and having seizures during sleep.
  • Seizure-free patients had a significantly higher employment rate (75%) compared to those who continued experiencing seizures (32%), highlighting potential socioeconomic impacts of JME.
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Background And Objectives: Diabetes mellitus (DM) contributes significantly to metabolic syndrome and cardiovascular events, and it may be a comorbidity of epilepsy. The objective of this study was to investigate whether long-term antiseizure medication (ASM) use is associated with the risk of developing type 2 diabetes.

Methods: We analyzed data from the Chang Gung Research Database.

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The high incidence of hepatocellular carcinoma (HCC) recurrence negatively impacts outcomes of patients treated with curative intent despite advances in surgical techniques and other locoregional liver-targeting therapies. Over the past few decades, the emergence of transcriptome analysis tools, including real-time quantitative reverse transcription PCR, microarrays, and RNA sequencing, has not only largely contributed to our knowledge about the pathogenesis of recurrent HCC but also led to the development of outcome prediction models based on differentially expressed gene signatures. In recent years, the single-cell RNA sequencing technique has revolutionized our ability to study the complicated crosstalk between cancer cells and the immune environment, which may benefit further investigations on the role of different immune cells in HCC recurrence and the identification of potential therapeutic targets.

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Objective: Limited hippocampal radiofrequency thermocoagulation (RFTC) for patients with mesial temporal lobe epilepsy was associated with good short-term seizure control and few complications. We aimed to demonstrate the neuropsychologic outcomes and assess the prognostic factors of long-term seizure control in these patients.

Methods: We included all patients with mesial temporal lobe epilepsy who underwent limited hippocampal RFTC from January 2016 to December 2020.

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Article Synopsis
  • Researchers studied patients who had a procedure called endoscopic variceal ligation (EVL) to treat dangerous bleeding in the esophagus caused by liver issues.
  • They found that a small number of these patients had a complication called post-banding ulcer bleeding (PBUB), which can lead to a high chance of dying shortly after.
  • They discovered that certain scores (MELD and ALBI) can help predict who is at risk for PBUB and who might die within six weeks after having it.
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Electroencephalography (EEG) can reveal the abnormalities of dopaminergic subcortico-cortical circuits in patients with Parkinson's disease (PD). However, conventional time-frequency analysis of EEG signals cannot fully reveal the non-linear processes of neural activities and interactions. A novel Holo-Hilbert Spectral Analysis (HHSA) was applied to reveal non-linear features of resting state EEG in 99 PD patients and 59 healthy controls (HCs).

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Background: Low-dose aspirin and clopidogrel have demonstrated potential chemoprevention for colorectal cancer (CRC). Proton-pump inhibitors (PPI) are commonly prescribed with anticoagulation drugs, but the relationship between PPI and CRC is unclear. Moreover, evidence of CRC risk under direct oral anticoagulant (DOAC) is limited.

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Juvenile myoclonic epilepsy (JME) is a primary generalized epilepsy which is closely related to the sleep-wake cycle. This study aimed to investigate whether sleep disturbance is more common among patients with JME and the impact this may have on their quality of life (QOL). Thirty-four patients with JME and age- and gender-matched controls were recruited into this case control study, and assessed using validated sleep questionnaires including the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Stanford Sleepiness Scale (SSS).

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Mitochondrial DNA (mtDNA) has been identified as a significant genetic biomarker in disease, cancer and evolution. Mitochondria function as modulators for regulating cellular metabolism. In the clinic, mtDNA variations (mutations/single nucleotide polymorphisms) and dysregulation of mitochondria-encoded genes are associated with survival outcomes among cancer patients.

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Oxidative phosphorylation (OXPHOS) consists of four enzyme complexes and ATP synthase, and is crucial for maintaining physiological tissue and cell growth by supporting the main bioenergy pool. Cytochrome oxidase (COX) has been implicated as a primary regulatory site of OXPHOS. Recently, COX subunit 5B (COX5B) emerged as a potential biomarker associated with unfavorable prognosis by modulating cell behaviors in specific cancer types.

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. By detecting abnormal white matter changes, diffusion magnetic resonance imaging (MRI) contributes to the detection of juvenile myoclonic epilepsy (JME). In addition, deep learning has greatly improved the detection performance of various brain disorders.

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This study aimed to evaluate the efficacy and tolerability of perampanel (PER) as adjunctive therapy in patients with pharmacoresistant sleep-related hypermotor epilepsy (SHE). Patients diagnosed with SHE who received PER treatment between 2016 and 2019 were included, and their data were reviewed retrospectively. Diagnosis was based on reports of patients or family members witnessing the events and clinical characteristics of seizures captured by video or during video-electroencephalography monitoring.

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Background: The effective dose of perampanel in status epilepticus (SE), refractory SE (RSE), and super-refractory SE (SRSE) in humans is unknown, and the potential of perampanel in treating SE has not been evaluated in a large cohort.

Methods: Data of intensive care patients with RSE and SRSE treated with perampanel were retrospectively reviewed and analyzed.

Results: Eighty-one patients received perampanel, including 39 females with median age 64 [17-91] years, perampanel responders (n = 27), and non-responders (n = 54).

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Mitochondrial DNA (mtDNA) mutations are highly associated with cancer progression. The poor prognosis of hepatocellular carcinoma (HCC) is largely due to high rates of tumor metastasis. This emphasizes the urgency of identifying these patients in advance and developing new therapeutic targets for successful intervention.

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Rationale: Lacosamide (LCM) was initially approved in Taiwan in March 2014 for use as adjunctive therapy for focal impaired awareness seizures and secondarily generalized seizures (SGS) in patients with epilepsy ≥16 years of age. The efficacy and tolerability of adjunctive LCM for the treatment of patients with focal seizures have been demonstrated in randomized, placebo-controlled trials. However, the trials do not reflect a flexible dose setting.

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Background: Delayed post-polypectomy bleeding (PPB) is a major complication of polypectomy. The effect of prophylactic hemoclipping on delayed PPB is uncertain. The aim of this study was to evaluate the effectiveness of prophylactic hemoclipping and identify the risk factors of delayed PPB.

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Traumatic brain injury (TBI) could result in edema and cause an increase in intracranial pressure of the brain resulting in mortality and morbidity. Although there is hyperosmolarity therapy available for this pathophysiological event, it remains controversial. Recently, several groups have shown docosahexaenoic acid (DHA) to improve functional and histological outcomes following brain injury based on reduction of neuroinflammation and apoptosis.

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