碩士 / 國立臺北藝術大學 / 文創產業國際藝術碩士學位學程(IMCCI) / 105 / Have you ever been emotionally tired? That type of weariness that comes from worrying too much, from over thinking to a point that your mind goes numb? Then after a whole day of fighting with yourself, you go to bed, close your eyes and the next minute your alarm is going off and you feel even more tired than before. When “yes, I am fine” becomes the words you tell everyone because if not, they might look at you in an awkward way. You feel alone and do not let anyone else know what is going on, because why would anyone want to know anyway? These are just a few things out of many that people with an anxiety disorder and depression go through on a daily basis. People that are mentally exhausted and can not talk about it because it is too hard for them, or because they are afraid of the stigma behind mental illness. People who feel they are lost in their own minds and need some type of outlet to let go of these overwhelming thoughts. This is where photography comes in, a medium that can be used to communicate thoughts, express feelings and discover oneself. Presented in the pages of this thesis is information about the possibility of using photography as self-therapy for coping with anxiety and depression. Starting out with literature gathered from experts in the field of phototherapy (photography in therapy), I describe ways this medium can help with mental healing, while also weaving in my own experiences with this topic. Also described are interviews and recounts of other people, that have successfully used therapeutic photography (photography as therapy) for coping with their own mental illnesses, giving their opinions of how photography has had a positive impact on their lives and how this art form has been beneficial for their internal healing. Photo-taking, viewing, planning, and posing, along with all photo-based activities are a part of therapeutic photography. In these modern times, we have become accustomed to being surrounded by images, and what better way to express and find ourselves than with the universal language of photography. Keywords: Therapeutic photography, phototherapy, photography, art therapy, anxiety disorder, depression, mental illness.

碩士 / 中臺科技大學 / 醫學影像暨放射科學系暨研究所 / 105 / This paper proposes a novel biodegradable nerve conduit made using genipin-cross-linked chitosan and carbon nanotubes (GCC). The aim of this study was to evaluate the influence of phototherapy using a 640-nm-wavelength light-emitting diode on the neurorehabilitation of transected sciatic nerves after bridging the GCC nerve guide conduit in rats. The proposed GCC nerve guide conduit has a cylindrical shape, dark blue color; the interior of the nerve bridge was hollow to aid in guiding the growth of the damaged nerve fiber. The rats were divided into three groups: a sham-irradiated group (GCC/Sham group); an experimental group, undergoing light-emitting diode (LED) phototherapy (GCC/LED group); and a control group, undergoing autologous nerve grafts (Autograft group). Each group consisted of six rats, or a total of 18 rats were included in the examination. Initially, twelve weeks after implantation, the mean sciatic functional index (SFI) of the GCC/LED group was higher than the mean SFI of the GCC/Sham group in each period after surgery. Before the rats were sacrificed, there were no observable pathological phenomena, and the conduit had adequate structural strength and biocompatibility. Muscle atrophy in the GCC/LED and Autograft groups was significantly reduced (P< 0.05) compared with that the GCC/Sham group. The histomorphological assessments revealed that the GCC/LED group had undergone more rapid nerve regeneration than the GCC/Sham group. This study investigated the effectiveness of different modes of LED phototherapy in the repair of damaged sciatic nerves. The improvements in the motor function, muscular reinnervation, and histomorphometric assessments demonstrate that LED phototherapy accelerates the repair of a transected peripheral nerve in rats after bridging with GCC conduit.

碩士 / 國立成功大學 / 護理學系 / 104 / Background: In recent years, Ministry of Health and Welfare committed to promote the policy of baby friendly hospital and breastfeeding. However, the length of hospital stay reduced due to budget of health insurance. Therefore, assist mothers to learn effectively correct knowledge and skills of breastfeeding, and provide sufficient breast milk to babies is very important. Recent studies of the relationship between perinatal education and breastfeeding duration is deficient, thus the author decided to focus on this topic. Aim: There are three purposes of the study. First, is to explore the effect of health education on primiparas’ cognition and skills of breastfeeding and the rate of exclusive breastfeeding. Second purpose is to examine the effect of education program on self-efficacy of breastfeeding. Last, is to explore the effect of exclusive breastfeeding on neonates’ hospitalization rate of hyperbilirubinemia. Method: This study is an experimental research design. Primiparas of pregnancy over 32 weeks were recruited from a local community teaching hospital in Tainan. Subjects were randomly assigned to experimental and control groups. Thirty eight primiparas were in the experimental group, and 19 primparas were in the control group. Subjects in the experimental group received a breastfeeding placement class to teach cognition and skills of breastfeeding. Subjects in the control group received ordinary routine health education. The placement class started from subjects between 32-36 weeks of gestation. Subjects of two groups received the pretest of cognition and self-efficacy of breastfeeding questionnaire on the day of recruitment and the second day after delivering babies as the posttest. Subjects received the third time of self-efficacy assessment one month postpartum. Newborns’ body weight changes were recorded during one -three days and one month after birth. Hospitalization rate for phototherapy due to hyperbilirubinemia within two weeks of birth was documented. In this study, we used descriptive statistics, independent samples t-test, paired samples t-test, Pearson's product-moment correlation, two-factor mixed design ANOVA to analyze data. Results: (1) The knowledge and skill on breastfeeding of women received placement breastfeeding education were higher than those received ordinary health education. (2) The breastfeeding self-efficacy scores of women in the experiment group on the second day and month postpartum were significantly higher than those in the control group. (3) Pure breastfeeding rate during postnatal one month of experiment group was significantly higher that of the control group. (4) The neonates’ body weight was not different between the pure breastfeeding and infant formula and breast milk mixed feeding groups, one month after birth. (5)The hospitalization rate of neonatal hyperbilirubinemia with pure breastfeeding rate was not related. Conclusion: The results of the study will help to establish local data, as the reference to amend perinatal education content, and provide a guide to develop in-service education for maternal and child care team. Summary:The study is to explore the effect of health education on primiparas’ cognition and skills of breastfeeding and the rate of exclusive breastfeeding. Second purpose is to examine the effect of education program on self-efficacy of breastfeeding. Last, is to explore the effect of exclusive breastfeeding on neonates’ hospitalization rate of hyperbilirubinemia. Results: (1) The knowledge and skill on breastfeeding of women received placement breastfeeding education were higher than those received ordinary health education. (2) The breastfeeding self-efficacy scores of women in the experiment group on the second day and month postpartum were significantly higher than those in the control group. (3) Pure breastfeeding rate during postnatal one month of experiment group was significantly higher that of the control group. (4) The neonates’ body weight was not different between the pure breastfeeding and infant formula and breast milk mixed feeding groups, one month after birth. (5)The hospitalization rate of neonatal hyperbilirubinemia with pure breastfeeding rate was not related. The results of the study will help to establish local data, as the reference to amend perinatal education content, and provide a guide to develop in-service education for maternal and child care team.

A importância da modulação da inflamação no tratamento de doenças inflamatórias bem como a dificuldade na determinação dos parâmetros de irradiação laser levou-nos a estudar os efeitos de diferentes protocolos de fototerapia com laser em baixa intensidade (potência, energia, local e momento de irradiação) no tratamento e prevenção do processo inflamatório agudo utilizando o modelo experimental de edema de pata induzido por carragenina (CGN) em três linhagens de camundongos (Balb-c, SWISS e C57BL/6). A primeira etapa do trabalho avaliou diferentes combinações de energia (1J e 3J) com diferentes potências (30, 60 e 100mW) em camundongos Balb-c irradiados na pata 1 e 2h após a injeção da CGN. A segunda etapa estudou diferentes combinações de local (pata, linfonodo inguinal e ambos) e momentos de irradiação (2 e 1h antes, 1h e imediatamente antes da CGN, 1 e 2h após e 3,5 e 4,5h após a CGN) utilizando parâmetros de irradiação fixos (1J, 100mW , 35J/cm2, área do spot 0,028cm2). A terceira etapa comparou diferentes linhagens de camundongos (Balb-c e C57Bl/6) nos melhores parâmetros de local e momento encontrados na etapa 2. Em todas as etapas foi avaliada a alteração de volume da pata através da pletismografia e o infiltrado inflamatório por histomorfometria ou análise da mieloperoxidase (MPO). Os resultados mostraram que a fototerapia com laser preveniu e tratou o edema assim como modulou o processo inflamatório com irradiações na pata e no linfonodo inguinal, de acordo com os parâmetros e a linhagem utilizada. / The importance of modulation of inflammation on the treatment of inflammatory diseases and the difficulty in determining the laser irradiation parameters has led us to study the effects of different protocols of phototherapy with low intensity laser (power, energy, time and place of irradiation) in the treatment and prevention of edema in acute inflammatory process using the experimental model of paw edema induced by carrageenan (CGN) in three strains of mice (Balb-c, Swiss and C57BL/6). The first stage of the study evaluated different combinations of energy (1J and 3J) with different powers (30, 60 and 100mW) in Balb-C mice paw irradiated 1 and 2h after injection of CGN. The second stage studied different combinations of location (foot, inguinal lymph nodes and both) and exposure time (2 and 1h before, 1h and immediately before the CGN, 1 and 2h and 3.5 and 4.5h after CGN) using fixed irradiation parameters (1J, 100mW, 35J/cm2, spot area of 0.028 cm2). The third stage compared different strains of mice Balb-c and C57BL/6) in the best local and time parameters found in step 2. At all stages, we evaluated the change in paw volume by plethysmography and inflammatory infiltrate by histomorphometry or analysis of myeloperoxidase (MPO). The results showed that laser phototherapy treated and prevented edema and modulated the inflammatory process with paw and inguinal lymph nodes irradiations accordingly with the parameters and mice strain used.

Os bisfosfonatos (BFs) têm sido amplamente utilizados para o tratamento de doenças do metabolismo ósseo, principalmente na prevenção de metástases ósseas e na prevenção e tratamento da osteoporose. No entanto, existem efeitos colaterais indesejáveis sendo um deles, a indução da Osteonecrose dos Maxilares (Medication-Related Osteonecrosis of the Jaws - MRONJ), uma complicação de difícil tratamento e solução. Até o presente momento, não foi definida a fisiopatologia da MRONJ e nem estabelecido protocolo de tratamento eficaz para esta doença. Diversas terapias vem sendo descritas na literatura para o tratamento da MRONJ dentre elas a laserfototerapia. Assim sendo, os objetivos deste estudo foram: inicialmente avaliar in vitro o efeito de diferentes concentrações dos BFs mais empregados na atualidade (alendronato e ácido zoledrônico) na viabilidade de células envolvidas na reparação de lesões MRONJ (osteoblastos e fibroblastos); secundariamente estudar o efeito da fototerapia com laser de baixa potência sobre estas células previamente induzidas pelos BFs. Foram utilizados osteoblastos-símile da linhagem OSTEO 1 e fibroblastos de mucosa bucal humana da linhagem FMM1. Após terem sido submetidos aos testes de citotoxicidade expondo as células as concentrações de 1?M, 10?M e 100?M de alendronato sódico e 3?M, 5?M e 10?M de ácido zoledrônico por 24 horas, os grupos testes foram irradiados com laser de diodo no modo contínuo, puntual e de contato (InGaAIP, 660nm, 30mW, spot 0,028cm2 ) com duas densidades de energia diferentes 5J/cm2 (4,5s) e 10J/cm2 (9s). Duas irradiações com intervalo de 6 horas entre cada uma delas foram executadas. A viabilidade celular foi determinada utilizando o ensaio de redução do MTT, e a atividade de fosfatase alcalina dos osteoblastos foi avaliada utilizando ensaio de ponto final. Os resultados obtidos foram submetidos à análise estatística ANOVA 1 critério complementado por Tukey (p<0,05). Foi possível concluir que: as concentrações de 100?M e 10?M do alendronato sódico foram tóxicas para os osteoblastos e fibroblastos em cultura. As concentrações de 3?M, 5?M e 10?M do ácido zoledrônico foram tóxicas para os osteoblastos e fibroblastos a longo prazo (48h e 72h). A atividade da fosfatase alcalina nos osteoblastos foi afetada por todas as concentrações de ácido zoledrônico testadas (3?M, 5?M e 10?M). Nos parâmetros aqui aplicados a LPT não teve efeito sobre a atividade da fosfatase alcalina das células tratadas com o alendronato de sódio ou ácido zoledrônico. E a laserfototerapia de baixa potência nos parâmetros utilizados nesse estudo não foi capaz de reverter a toxicidade dos bisfosfonatos testados, independentemente das concentrações destas substâncias / Bisphosphonates (BPs) have been widely used for treating bone metabolism diseases, especially for prevention of bone metastasis and osteoporosis. However, there are undesirable side effects and one of them, the induction of Osteonecrosis of the Jaw (Medication-Related Osteonecrosis of the Jaws - MRONJ), a complication of difficult treatment and solution. Until now the pathophysiology and an effective treatment protocol for MRONJ have not been established. Various therapies have been described in the literature for the treatment of MRONJ including laserphototherapy. The objectives of this study were to evaluate the effect of different concentrations of two BPs used today (alendronate and zoledronic acid) on the viability of cells involved in the repair of MRONJ lesions (osteoblasts and fibroblasts); and to study the effect of phototherapy with low power laser on these cells previously treated with referred BPs. After being submitted to cytotoxicity testing by exposing the cells to concentrations of 1?M, 10?M and 100?M of sodium alendronate and 3?M, 5?M and 10?M of zoledronic acid for 24 hours, the test groups were irradiated with diode laser in continuous mode, punctual and contact (InGaAIP, 660nm, 30mW, spot 0,028cm2) with two different energy densities 5 J/cm2 (4,5s) and 10J/cm2 (9s). Two irradiations with an interval of 6 hours between each of them were performed. Cell viability was determined using the MTT reduction assay, and the alkaline phosphatase activity of osteoblasts was evaluated using the end point assay. The results were submitted to statistical analysis using ANOVA 1 criteria complemented by Tukey (p <0.05). It was possible to conclude that: concentrations of 100?M and 10?M of alendronate were toxic to osteoblasts and fibroblasts in culture. The concentrations of 3?M, 5?M and 10?M of zoledronic acid was toxic to osteoblasts and fibroblasts in long-term (48h and 72h). The activity of alkaline phosphatase in osteoblasts was affected by all the zoledronic acid concentrations tested (3?M, 5?M and 10?M). In the LPT parameters applied here had no effect on alkaline phosphatase activity of the cells treated with the sodium alendronate or zoledronic acid. And low power laserphototherapy, in the parameters used in this study, was unable to reverse the toxicity of bisphosphonates tested, irrespective of the concentrations of these substances.

碩士 / 國立臺灣大學 / 醫學工程學研究所 / 105 / Alopecia is a disturbing syndrome for modern people, it means that many men and women have suffered from it. . Although there are different methods such as phototherapy , drug treatments, and hair follicles implantations et al to solve the hair loss problem, none of them have stable and effective treatment results. Also, they may have some side effects which could affect patient&apos;&apos;s health. Due to the development of tissue engineering and study on hair regeneration over the few decades, the researchers open a new door to improve the unmet needs for hair loss. The natural hair developing process depends on a series of interactions between epidermal cells and the dermal papilla (DP)cell, located in the bottom of hair bulb, which is a specialized mesenchymal stem cell. When those DP cells are cultured in three-dimentional spheroid structure , followed by adding epidermal cells , the epidermal cells will cover the DP spheroid, forming core-shell micro-tissue. The ability to induce hair regeneration could be retained in vitro even the cells are cultured after a few passages. As a result, the aim of this study is to develop a method to form DP-epidermal microtissue easily, and to investigate whether these microtissues could induce hair regeneration in vitro. Polydimethylsiloxane (PDMS), used in this study, is a suitable material for culturing DP spheroids, because it is characterized by excellent biocompatibility, and low attachment for cell culture. After the epidermal cells are co-cultured with DP to form "core-shell" structure, their hair inductive activity is confirmed by immunochemistry staining , such as α-SMA and NCAM. In addition, to provide the DP-epidermal microtissue with an appropriate developing environment, the porcine skin treated by a series of decellularization process was fabricated by laser engraving to produce microwell arrays on the surface. Then, the DP-epidermal microtissues are implanted into the acellular skin microwell arrays for pre-determined intervals ,and the cells morphology on the skin scaffold during cultivation was observed and validated by histological analysis to prove that 3D cells culture and a suitable growing environment could mimic the natural developing process in vivo and have potential for hair regeneration.

碩士 / 國立虎尾科技大學 / 生物科技系碩士班 / 106

碩士 / 國立中央大學 / 生醫科學與工程學系 / 106 / HER2-expressing breast cancer has long been recognized as one of the most lethal gynecological disease for women due to high incidence, its drug resistance and poor prognosis. On the other hand, treatment of breast cancer in its early stage may dramatically enhance the 5-year survival rate to > 90 %, indicating that in addition to development of an effective therapeutic strategy, successful early detection plays a crucial role in the improvement of survival rate of HER2+ breast cancer. In this study, a type of theranostic agent named human epidermal growth factor receptor 2 (HER2)-target Indocyanine green (ICG)-Camptothecin (CPT)-loaded perfluorocarbon double-nanoemulsions (HICPDNEs) was developed for use in photochemotherapy and fluorescence diffuse optical tomography (FDOT) diagnostics. According to our result, the size and zeta potential of HICPDNEs is 292.2 ± 5.6 nm and -13.5 ± 3.1 mV, respectively. The encapsulation efficiency for CPT and ICG is 40.31 ± 7.6 % and 99.12 ± 0.33 %, respectively. Under incubated at 37 ℃ for 48 hr, The degradation of HICPDNEs almost prolong 73 % compared with Free ICG, and only 4.29 % drug release. Hyperthermia effect of HICPDNEs under 808 nm laser exposure with intensity of 6 W/cm2 for 5 min, 20 μM of HICPDNEs can achieve 42 ℃. To generation of singlet oxygen, HICPDNEs are higher than the free ICG enormously at the same concentration, showed the potential of the phototherapy. Compare to the ICPDNEs, HICPDNEs are more effective to combine the HER2+ breast cancer cell (MDA-MB-453) due to its target mechanism, indicated HICPDNEs has specification on HER2 positive cancer cell. In cytotoxicity, HICPDNEs incubated with cell for 16 hr and expose the 808 nm laser (6 W/cm2) for 5 min. its cell viability indicated good effective than the free CPT in high concentration (> 40 μM). In diagnosis, Tumor-like inclusions containing HICPDNEs in breast phantoms could be detected up to a depth of 4.5 cm using a FDOT system, according to 「Tumor resection quality index」, the best value is 24.89 in 1μM of HICPDNEs. Above of all, HICPDNEs has a good potential to be a theranostic agent for treatment and early diagnosis in breast cancer. More studies that we need to further validate in the future.

碩士 / 國立臺北護理健康大學 / 護理研究所 / 106 / Abstract Background Chronic diseases has been the leading causes of death in 2015 to 2017 based on the National database. In particular, cerebrovascular disease was the third in 2015, the fourth in 2016 and 2017. In the Statistical Office of the Ministry of Health and Welfare (2016, 2017,2018). Previous studies have suggested that nearly 30% of the stroke victims present with signs of depression within the first 5 years of illness. Since post-stroke depression significantly affects the patient both physically and psychologically, the emotional disturbances impede the progress and effectiveness of rehabilitation. Regarding the non-pharmacological treatment of melancholia, the phototherapy has been used to treat psychological, behavioral or emotional disorders with satisfactory outcomes.Furthermore, many studies has suggested that artificial light should mimic natural sunlight to reach optimal effect. The benefit of sunlight in human wellbeing has been well documented, therefore we intend to utilize sunlight therapy for stroke patients in order to improve their physical and mental health. Purpose To utilize sunlight therapy in post-stroke patients in order to improve the depression and active daily function. Method This study is an experimental interventional study for two groups with pretest and posttest analysis. The subjects of the study met the inclusion criteria and were recruited by intention sampling method. They were randomly assigned to the experimental group and the control groups. This is a single-blind study with sunlight exposure as intervention. Appropriate clothing, skin protection measures were given. The calf portion of feet, forearms and hands were exposed to sunlight for at least 30 minutes per day, at least 14 days of exposure with intensity at least 10000lux over duration of 4 weeks. A total of 46 patients were recruited and 4 have lost follow up. 21 patients from each group have completed the study. The research tools include: depression status (TDS scale), physical activity function (Barthel Index), the severity of cognitive function (MMSE) and severity of stroke (NIHSS). Each patient was evaluated 3 times during the study: on the day of enrollment (pre-test), 2 to 4 weeks since enrollment (1st post-test) and 6-8 weeks after enrollment (2nd post-test). Statistical analysis was performed with the following variables: depression, cognitive function (MMSE), severity of stroke (NIHSS) and the Barthel Index for daily function. Result The statistically significant attributes of the subject to the state of depression are age, sex, time of stroke and rehabilitation. After analyzing with the generalized estimating equation (GEE), significant improvement was noted among the experimental ground in 2nd post-test depression score (p = .032), daily function ( p = .045 ; p = .033) after the first and second interventions , in terms of disease severity. the first time in the post-test after the intervention in the experimental group at 4 weeks after a stroke that is a significant difference (p = .013), but to no cognitive function of the difference statistically, then GEE model for analysis and found that depression improvement is statistically significant for the following variables: duration after stroke, age, gender, and frequency of rehabilitation. Conclusion This study confirms that sunlight therapy improves the mental health of post-stroke patients with depressed mood. It also enhances daily activity and facilitates the recovery to a health state. The results are significant and the intervention is nearly cost-free. It also increases the level of vitamin D in the blood and reduces bone mass (Sato, Metoki , Iwamoto, & Satoh, 2003) .This non-invasive intervention can be widely applied to nursing care to improve the quality of life and promote mental health.

博士 / 國立臺灣科技大學 / 化學工程系 / 106 / Nanoparticles with surface modified and conjugated with targeting groups are of central importance in biomedical applications. In this regard, I-III-VI semiconductor nanomaterials are a particular interest in multimodal imaging, biosensing, chemotherapy, photothermal therapy and photodynamic therapy as a whole in theranostic applications due to their fascinating properties when they interact with cancer cells. However, the synthesis process remains a problem in finding an approach to fabricate in large scale with monodispersed nanoparticles, related to a way of finding water-soluble nanoparticles and how to make them effective and efficient probe for diagnosis and therapeutic applications of cancer cells. In the present study, for the first time, CuFeS2 nanocrystals were successfully prepared through a facile noninjection-based synthetic strategy, by reacting Cu and Fe precursors with dodecanethiol in a 1-octadecene solvent. This one-pot noninjection strategy features easy handling, large-scale production, and high synthetic reproducibility. Following hyaluronic acid (HA) encapsulation, CuFeS2 nanocrystals coated with HA (CuFeS2@HA) not only readily dispersed in water and showed improved biocompatibility but also possessed a tumor-specific targeting ability of cancer cells bearing the cluster determinant 44 (CD44) receptors. The encapsulated CuFeS2@HA showed broad optical absorbance from the visible to the near-infrared (NIR) region and high photothermal conversion efficiencies of about 74.2%. They can, therefore, be utilized for the photothermal ablation of cancer cells with NIR light irradiation. In addition, toxicity studies in vitro (B16F1 and HeLa) and in vivo (zebrafish embryos), as well as in vitro blood compatibility studies, indicated that CuFeS2@HA show low cytotoxicity at the doses required for photothermal therapy. More importantly, CuFeS2@HA can be used as delivery vehicles for chemotherapy cisplatin(IV) prodrug forming CuFeS2@HA-Pt(IV). Their release profile revealed pH- and glutathione-mediated drug release from CuFeS2@HA-Pt(IV), which may minimize the side effects of the drug to normal tissues during therapy. Subsequent in vitro experiments confirmed that the use of CuFeS2@HA-Pt(IV) provides an enhanced and synergistic therapeutic effect compared to that from the use of either chemotherapy or photothermal therapy alone. The second part of this thesis presents, CuFeS2 nanoparticles functionalized and phase transferred with the help of bovine serum albumin (BSA), for improved solubility, biocompatibility, and physiological stability. The as-prepared CuFeS2@BSA nanoparticles further conjugated with folic acid and chlorin e6 (Ce6), Ce6:CuFeS2@BSA-FA, for tumor-targeted PTT and PDT applications upon single-laser irradiations. The cytotoxicity of the prepared Ce6:CuFeS2@BSA-FA nanoprobe was verified in vitro (using HeLa and HepG2 cells) and in vivo using zebrafish embryos. The combined single-laser-induced phototherapeutic were then performed in vitro using HeLa and HepG2 cells. The results demonstrate combined phototherapy with single-laser-induced approach effectively killed cancer cells and showed higher levels of reactive oxygen species (ROS) generations. The multifunctional applications of our material showed a promising approach for combinational therapy for future biomedical applications to battle cancer, by canceling the use of different wavelength lasers.