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Wu CC, Fang CY, Yu BH, Chang CM, Hsu TW, Hung CL, Hung SK, Chiou WY, Tsai JH. Long-Term Usage of Proton Pump Inhibitors Associated with Prognosis in Patients with Colorectal Cancer. Cancers (Basel) 2023; 15:5304. [PMID: 37958477 PMCID: PMC10648487 DOI: 10.3390/cancers15215304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
The dose-response effect of proton pump inhibitors on colorectal cancer prognosis is still under exploration. This population-based study in Taiwan was designed to examine the effect of proton pump inhibitors on overall death, colorectal cancer-specific death, and recurrence in colorectal cancer patients with different cumulative proton pump inhibitor dose levels. This cohort study was based on the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database from 2005 to 2020. After frequency matching with a 1:1 ratio, a total of 20,889 users with proton pump inhibitors and 20,889 without proton pump inhibitors were analyzed. The cumulative defined daily dose level of proton pump inhibitor was stratified to explore the dose-response relationship. A proton pump inhibitor exposure cumulative defined daily dose > 60 after colorectal cancer diagnosis had higher risk of all-cause death than non-proton pump inhibitor users with adjusted hazard ratios of 1.10 (95% CIs: 1.04-1.18). For recurrence, a proton pump inhibitor exposure cumulative defined daily dose > 60 had reduced recurrence risk with an adjusted hazard ratio of 0.84 (95% CIs: 0.76-0.93). This study demonstrated that the long-term use of proton pump inhibitors in patients with colorectal cancer was associated with an increased risk of death that related to the proton pump inhibitor exposure cumulative defined daily dose > 60 and had different dose-response effect in various dose level.
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Affiliation(s)
- Chin-Chia Wu
- Division of Colorectal Surgery, Buddhist Tzu Chi Medical Foundation, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan; (C.-C.W.); (T.-W.H.)
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Chuan-Yin Fang
- Division of Colon and Rectal Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan;
| | - Ben-Hui Yu
- Department of Radiation Oncology, Buddhist Tzu Chi Medical Foundation, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan; (B.-H.Y.); (S.-K.H.)
| | - Chun-Ming Chang
- Department of General Surgery, Buddhist Tzu Chi Medical Foundation, Hualien Tzu Chi Hospital, Hualien 970, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Ta-Wen Hsu
- Division of Colorectal Surgery, Buddhist Tzu Chi Medical Foundation, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan; (C.-C.W.); (T.-W.H.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Chung-Lin Hung
- Department of Oncology, Buddhist Tzu Chi Medical Foundation, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan;
| | - Shih-Kai Hung
- Department of Radiation Oncology, Buddhist Tzu Chi Medical Foundation, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan; (B.-H.Y.); (S.-K.H.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Wen-Yen Chiou
- Department of Radiation Oncology, Buddhist Tzu Chi Medical Foundation, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan; (B.-H.Y.); (S.-K.H.)
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Jui-Hsiu Tsai
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
- Department of Psychiatry, Buddhist Tzu Chi Medical Foundation, Dalin Tzu Chi Hospital, Chiayi 622, Taiwan
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Hsieh KP, Huang RY, Yang YH, Ho PS, Chen KP, Tung CL, Chu YL, Tsai JH. Using PIM-Taiwan, PRISCUS, and Beers criteria to assess potentially inappropriate medication use among older adults with 90-day rehospitalization: a population-based study in Taiwan. Front Pharmacol 2023; 14:1194537. [PMID: 37521484 PMCID: PMC10374845 DOI: 10.3389/fphar.2023.1194537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/04/2023] [Indexed: 08/01/2023] Open
Abstract
Background: Multimorbidity and polypharmacy increase the risk of hospitalization in older adults receiving potentially inappropriate medication (PIM). The current study compared the ability of PIM-Taiwan, PRISCUS, and Beers criteria to predict 90-day rehospitalization in older patients with and without PIM. Methods: The retrospective cohort study used Taiwan's Longitudinal Health Insurance Database to retrieve quarterly information about prescribed medication for adults aged ≥65 years hospitalized between 2001 and 2018. We analyzed the association of PIM with 90-day rehospitalization using logistic regression. Results: The study cohort included 206,058 older adults (mean age: 72.5 years). In the analysis, 133,201 (64.6%), 97,790 (47.5%), and 147,450 (71.6%), were identified as having PIM exposure in PIM-Taiwan, PRICUS, and Beers criteria, respectively. PIM-Taiwan criteria found exposure to PIM affecting the cardiovascular (adjusted OR [aOR] 1.37, 95% confidence interval [CI] = 1.32-1.41), gastrointestinal (aOR 1.26, 95% CI = 1.23-1.30), central nervous (aOR 1.11, 95% CI = 1.08-1.14), and respiratory (aOR 1.16, 95% CI = 1.12-1.20) systems significantly increased the risk of 90-day rehospitalization, after adjustment for covariates. In PRISCUS criteria, exposure to PIM affecting the respiratory (aOR 1.48, 95% CI = 1.41-1.56), central nervous (aOR 1.12, 95% CI = 1.09-1.15), and cardiovascular (aOR 1.20, 95% CI = 1.16-1.24) systems significantly increased the risk. In Beers criteria, exposure to PIM affecting the cardiovascular (aOR 1.37, 95% CI = 1.32-1.41), gastrointestinal (aOR 1.38, 95% CI = 1.35-1.42), central nervous (aOR 1.18, 95% CI = 1.15-1.21), endocrine (aOR 1.10, 95% CI = 1.06-1.15), and respiratory (aOR 1.09, 95% CI = 1.04-1.13) systems significantly increased the risk. Patients with 90-day rehospitalization had higher rates of the potentially harmful drug-drug interaction (DDI) pairs of serotonin syndrome (n = 19; 48.8%), QT prolongation (n = 4; 30.8%), extrapyramidal symptoms (EPS) (n = 102; 24.5%), and hypokalemia (n = 275; 20.1%). Conclusion: Beers criteria was more efficient in predicting 90-day rehospitalization among older adults experiencing PIM in Taiwan than either PIM-Taiwan or PRISCUS. The risk of 90-day rehospitalization was associated with the potentially harmful DDI classes of serotonin syndrome, QT prolongation, EPS, and hypokalemia.
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Affiliation(s)
- Kun-Pin Hsieh
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ru-Yu Huang
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Yi-Hsin Yang
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Pei-Shan Ho
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuang-Peng Chen
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Chun-Liong Tung
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Ya-Lan Chu
- Department of Pharmacy, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
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Liu PI, Lin MN, Ho PS, Tsai JH, Yang YH, Wu KF, Chuang HY. Prediction and potential risk factors for electronic cigarette use behaviors among adolescents: a pilot study in Chiayi, Taiwan. Front Public Health 2023; 11:1140615. [PMID: 37397731 PMCID: PMC10311257 DOI: 10.3389/fpubh.2023.1140615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Electronic cigarette (e-cigarette) use among adolescents has become increasingly common; therefore, effectively reducing adolescent e-cigarette use is an urgent issue. We aimed to predict and identify potential factors related to adolescent e-cigarette use behaviors. Methods This cross-sectional study was conducted using anonymous questionnaires given to Taiwanese high school students in 2020. Approximately 1,289 adolescent students completed questions on e-cigarette use, personal characteristics, family environment, and substances used. We performed multivariate logistic regression analyses to assess the model's predictive performance in terms of the area under the receiver operating characteristic curve. Results We found that 9.3% of adolescent students used e-cigarettes. Tobacco smoking, close friends' reactions to e-cigarette use, and the use of other substances were independent risk factors for adolescent e-cigarette use. Furthermore, relative to tobacco nonuse, tobacco use and tobacco smoking dependence had odds ratios of 76.49 and 113.81, respectively. The predictive accuracy of adolescent e-cigarette use from personal characteristics, family environment, and substance use status was 73.13, 75.91, and 93.80%, respectively. Conclusion The present study highlights the need for early prevention of e-cigarette use among adolescents, particularly those with a history of using tobacco and other substances and those who have close friends with positive attitudes towards e-cigarette use.
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Affiliation(s)
- Ping-I Liu
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
- Department of Geriatric Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Ming-Nan Lin
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Pei-Shan Ho
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Ya-Hui Yang
- Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan
| | - Ke-Fei Wu
- Department of Business Management, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Hung-Yi Chuang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, and Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Tsai JH, Yang YH, Ho PS, Wu TN, Guo YL, Chen PC, Chuang HY. Incidence and Risk of Fatal Vehicle Crashes Among Professional Drivers: A Population-Based Study in Taiwan. Front Public Health 2022; 10:849547. [PMID: 35350475 PMCID: PMC8957854 DOI: 10.3389/fpubh.2022.849547] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Fatal vehicle crashes (FVCs) are among the leading causes of death worldwide. Professional drivers often drive under dangerous conditions; however, knowledge of the risk factors for FVCs among professional drivers remain scant. We investigated whether professional drivers have a higher risk of FVCs than non-professional drivers and sought to clarify potential risk factors for FVCs among professional drivers. We analyzed nationwide incidence rates of FVCs as preliminary data. Furthermore, by using these data, we created a 1:4 professionals/non-professionals preliminary study to compare with the risk factors between professional and non-professional drivers. In Taiwan, the average crude incidence rate of FVCs for 2003–2016 among professional drivers was 1.09 per 1,000 person-years; professional drivers had a higher percentage of FVCs than non-professional drivers among all motor vehicle crashes. In the 14-year preliminary study with frequency-matched non-professional drivers, the risk of FVCs among professional drivers was significantly associated with a previous history of involvement in motor vehicle crashes (adjustment odds ratio [OR] = 2.157; 95% confidence interval [CI], 1.896–2.453), previous history of benzodiazepine use (adjustment OR = 1.385; 95% CI, 1.215–1.579), and speeding (adjustment OR = 1.009; 95% CI, 1.006–1.013). The findings have value to policymakers seeking to curtail FVCs.
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Affiliation(s)
- Jui-Hsiu Tsai
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan.,Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.,College of Medicine, Tzu Chi University, Hualien City, Taiwan
| | - Ya-Hui Yang
- Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan
| | - Pei-Shan Ho
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Trong-Neng Wu
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Yue Leon Guo
- Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Pau-Chung Chen
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan.,Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,National Institute of Environmental Health Science, National Health Research Institutes, Miaoli, Taiwan
| | - Hung-Yi Chuang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan.,Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lin JW, Tsai JH, Huang CH, Lin TK. Early Diagnosis and Intervention of Acute Renal Infarction with Catheter-Directed Thrombolytic Therapy. Acta Cardiol Sin 2022; 38:134-140. [PMID: 35273434 PMCID: PMC8888322 DOI: 10.6515/acs.202203_38(2).20210925a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 09/25/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Acute renal infarction is a rare and under-diagnosed disease for which the optimal treatment is unknown. OBJECTIVES This study aimed to determine the utility of catheter-directed thrombolysis (CDT) to treat acute renal infarction. METHODS From November 2010 to September 2017, 13 patients with acute renal infarction were treated with CDT. The diagnosis was confirmed by contrast-enhanced computed tomography and renal angiography. RESULTS The most common symptoms and signs were flank pain (53.8%) and abdominal pain (30.8%). More than two-thirds of the patients (69.2%) had atrial fibrillation. In successful reperfusion cases, the median time from symptom onset to diagnosis was 6 hours, and the average time from diagnosis to treatment was 3.5 hours. Complete resolution of thrombi in the renal artery was achieved in 10 of the 13 patients (76.9%) and partial resolution in two patients (15.4%). Only one patient (7.7%) failed to respond to treatment. Compared with admission, renal function was significantly improved at 6 months. No major complications occurred during the course of CDT therapy. CONCLUSIONS CDT offers an alternative to surgical intervention and can achieve good angiographic results with an early diagnosis and intervention. It is relatively safe and can restore at least partial renal function.
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Affiliation(s)
- Jiunn-Wen Lin
- Division of Cardiology, Department of Internal Medicine
| | | | - Chien-Hsiu Huang
- Division of Chest, Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chia-Yi
| | - Tin-Kwang Lin
- Division of Cardiology, Department of Internal Medicine;
,
School of Medicine, Tzu Chi University, Hualien, Taiwan
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Wu CC, Lee CH, Hsu TW, Yeh CC, Lin MC, Chang CM, Tsai JH. Is Colectomy Associated with the Risk of Type 2 Diabetes in Patients without Colorectal Cancer? A Population-Based Cohort Study. J Clin Med 2021; 10:jcm10225313. [PMID: 34830601 PMCID: PMC8622203 DOI: 10.3390/jcm10225313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/22/2022] Open
Abstract
Type 2 diabetes might be influenced by colonic disease; however, the association between colonic resection and type 2 diabetes has rarely been discussed. This population-based cohort study explored the association between colectomy and type 2 diabetes in patients without colorectal cancer. A total of 642 patients who underwent colectomy for noncancerous diseases at any time between 2000 and 2012 in the National Health Insurance Research Database of Taiwan were enrolled. The enrolled patients were matched with 2568 patients without colectomy at a 1:4 ratio using a propensity score that covered age, sex, and comorbidities. The risk of type 2 diabetes was assessed using a Cox proportional hazards model. The mean (standard deviation) follow-up durations in colectomy cases and non-colectomy controls were 4.9 (4.0) and 5.6 (3.6) years, respectively; 65 (10.1%) colectomy cases and 342 (15.5%) non-colectomy controls developed type 2 diabetes. After adjustment, colectomy cases still exhibited a decreased risk of type 2 diabetes (adjusted HR = 0.80, 95% CI: 0.61–1.04). A stratified analysis for colectomy type indicated that patients who underwent right or transverse colectomy had a significantly lower risk of developing type 2 diabetes (adjusted HR = 0.57, 95% CI: 0.34–0.98). In the present study, colectomy tended to be at a reduced risk of type 2 diabetes in patients without colorectal cancer, and right or transverse colectomies were especially associated with a significantly reduced risk of type 2 diabetes.
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Affiliation(s)
- Chin-Chia Wu
- Division of Colorectal Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan; (C.-C.W.); (T.-W.H.)
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 970, Taiwan; (C.-H.L.); (C.-C.Y.)
| | - Cheng-Hung Lee
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 970, Taiwan; (C.-H.L.); (C.-C.Y.)
- Division of General Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan
| | - Ta-Wen Hsu
- Division of Colorectal Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan; (C.-C.W.); (T.-W.H.)
- College of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - Chia-Chou Yeh
- School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien 970, Taiwan; (C.-H.L.); (C.-C.Y.)
- Department of Chinese Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan
| | - Mei-Chen Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | - Chun-Ming Chang
- College of Medicine, Tzu Chi University, Hualien 970, Taiwan
- Department of General Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
- Correspondence: (C.-M.C.); (J.-H.T.)
| | - Jui-Hsiu Tsai
- College of Medicine, Tzu Chi University, Hualien 970, Taiwan
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622, Taiwan
- Ph.D. Program in Environmental and Occupation Medicine, National Health Research Institutes and Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: (C.-M.C.); (J.-H.T.)
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Yang YH, Ho PS, Wu TN, Wang PW, Lin CHR, Tsai JH, Guo YL, Chuang HY. Risk of motor vehicle collisions after methadone use. eLife 2021; 10:63954. [PMID: 34351275 PMCID: PMC8341976 DOI: 10.7554/elife.63954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 07/08/2021] [Indexed: 12/15/2022] Open
Abstract
Methadone maintenance treatment (MMT) can alleviate opioid dependence. However, MMT possibly increases the risk of motor vehicle collisions. The current study investigated preliminary estimation of motor vehicle collision incidence rates. Furthermore, in this population-based retrospective cohort study with frequency-matched controls, opiate adults receiving MMT (cases) and those not receiving MMT (controls) were identified at a 1:2 ratio by linking data from several nationwide administrative registry databases. From 2009 to 2016, the crude incidence rate of motor vehicle collisions was the lowest in the general adult population, followed by that in opiate adults, and it was the highest in adults receiving MMT. The incidence rates of motor vehicle collisions were significantly higher in opiate users receiving MMT than in those not receiving MMT. Kaplan–Meier curves of the incidence of motor vehicle collisions differed significantly between groups, with a significant increased risk during the first 90 days of follow-up. In conclusion, drivers receiving MMT have higher motor vehicle collision risk than those not receiving MMT in opiate users, and it is worthy of noticing road safety in such drivers, particularly during the first 90 days of MMT. In 2019, 58 million people were estimated to use opioids – a group of substances that include drugs like heroin and morphine. Dependence on opioids can be managed using a prescribed dose of an opioid called methadone, which is administered through a controlled treatment plan. This so-called methadone maintenance treatment manages withdrawal symptoms in opioid-dependent individuals and can reduce the occurrences of overdose, criminal activity and transmission of diseases such as HIV. However, methadone acts on the same brain receptors as other opioids, and individuals receiving methadone may experience impaired motoric and cognitive functioning, including reduced driving ability. It is therefore important to know whether methadone maintenance treatment may increase an individual’s risk to cause road accidents. To assess motor vehicle collision risk associated with individuals receiving methadone maintenance treatment, Yang et al. analysed data from the Taiwan National Health Insurance Research Database and six Taiwanese administrative registries, including the ministries of health and welfare, interior and justice, and registries in substitution maintenance therapy, road accidents and the National Police Agency. Initial analyses found that individuals receiving treatment had a higher risk to be involved in car accidents than the general adult population or those without methadone maintenance treatment. Further tests showed that individuals receiving treatment were at three times higher risk of collisions than individuals not receiving treatment, particularly in the first 90 days. These findings may help individuals undergoing methadone maintenance treatment manage their risk of motor vehicle collisions. Further investigation is needed to reveal the underlying mechanisms of methadone-related impairment of driving ability.
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Affiliation(s)
- Ya-Hui Yang
- Department of Health-Business Administration, Fooyin University, Kaohsiung, Taiwan
| | - Pei-Shan Ho
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Trong-Neng Wu
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.,Ph.D. Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung, Taiwan.,Tzu Chi University, Hualien, Taiwan
| | - Yue Leon Guo
- Ph.D. Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung, Taiwan.,Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, Taipei, Taiwan
| | - Hung-Yi Chuang
- Ph.D. Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Environmental and Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
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Lin JH, Tsai TH, Lee CS, Yang YH, Chen KP, Tung CL, Tsai JH. Long-acting injectable paliperidone palmitate in a haemodialysis patient with schizophrenia. Aust N Z J Psychiatry 2021; 55:829-830. [PMID: 32847372 DOI: 10.1177/0004867420952548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jia-Hong Lin
- Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Tsung-Huang Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Chia-Shun Lee
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Ya-Hui Yang
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Kuang-Peng Chen
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Chun-Liong Tung
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.,PhD Program in Environmental and Occupational Medicine, National Health Research Institutes and Kaohsiung Medical University, Kaohsiung, Taiwan
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Chang YP, Lee MS, Wu DW, Tsai JH, Ho PS, Lin CHR, Chuang HY. Risk factors for depression in patients with Parkinson's disease: A nationwide nested case-control study. PLoS One 2020; 15:e0236443. [PMID: 32716954 PMCID: PMC7384643 DOI: 10.1371/journal.pone.0236443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/05/2020] [Indexed: 11/30/2022] Open
Abstract
Objectives Patients with Parkinson’s disease (PD) have higher prevalence of depression than the general population; however, the risk factors for depression in PD remain uncertain. Methods/Design Using the 2000–2010 Taiwan National Health Insurance Research Database, we selected 1767 patients aged ≧ 40 years with new-onset PD during 2000–2009. Among them, 324 patients with a new incidence of depression were enrolled as cases and 972 patients without depression were randomly selected as controls. The groups were frequency-matched at a ratio of 1:3 by age, sex, and index year. Thus, this nested case-control study compared differences between the cases and the controls. Logistic regression models were used to identify risk factors for depression in PD. Results Compared with the controls, the odds ratio (OR) of anxiety disorders in the cases was 1.53 (95% confidence interval [95% CI], 1.16–2.02; P = 0.003), after adjusting for the confounding factors of age, sex, index year, geographic region, urban level, monthly income, and other coexisting medical conditions. The OR for sleep disturbances in the cases was 1.49 (95% CI, 1.14–1.96; P = 0.004) compared to the controls, after adjusting these confounding factors. Hence, the risk factors for depression in PD were nonsignificantly associated with physical comorbidities. Conclusions In the present study, depression in PD was significantly associated with anxiety disorders and sleep disturbances. Integrated care for early identification and treatment of neuropsychiatric comorbidities is crucial in patients with new-onset PD so as to prevent further PD degeneration.
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Affiliation(s)
- Yang-Pei Chang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Min-Sheng Lee
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
- Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (JHT); (PSH); (CHRL)
| | - Pei-Shan Ho
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (JHT); (PSH); (CHRL)
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
- * E-mail: (JHT); (PSH); (CHRL)
| | - Hung-Yi Chuang
- Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Occupational Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
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Yu HR, Lin CHR, Tsai JH, Hsieh YT, Tsai TA, Tsai CK, Lee YC, Liu TY, Tsai CM, Chen CC, Chang CH, Hsu TY, Niu CK. A Multifactorial Evaluation of the Effects of Air Pollution and Meteorological Factors on Asthma Exacerbation. Int J Environ Res Public Health 2020; 17:ijerph17114010. [PMID: 32512940 PMCID: PMC7313451 DOI: 10.3390/ijerph17114010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/14/2020] [Accepted: 06/02/2020] [Indexed: 01/05/2023]
Abstract
In the real world, dynamic changes in air pollutants and meteorological factors coexist simultaneously. Studies identifying the effects of individual pollutants on acute exacerbation (AE) of asthma may overlook the health effects of the overall combination. A comprehensive study examining the influence of air pollution and meteorological factors is required. Asthma AE data from emergency room visits were collected from the Taiwan National Health Insurance Research Database. Complete monitoring data for air pollutants (SO2; NO2; O3; CO; PM2.5; PM10) and meteorological factors were collected from the Environmental Protection Agency monitoring stations. A bi-directional case-crossover analysis was used to investigate the effects of air pollution and meteorological factors on asthma AE. Among age group divisions, a 1 °C temperature increase was a protective factor for asthma ER visits with OR = 0.981 (95% CI, 0.971–0.991) and 0.985 (95% CI, 0.975–0.994) for pediatric and adult patients, respectively. Children, especially younger females, are more susceptible to asthma AE due to the effects of outdoor air pollution than adults. Meteorological factors are important modulators for asthma AE in both asthmatic children and adults. When studying the effects of air pollution on asthma AE, meteorological factors should be considered.
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Affiliation(s)
- Hong-Ren Yu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kaohsiung 83301, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
- Correspondence: ; Tel.: +886-7-5252000 (ext. 4339); Fax: +886-7-5254-301
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan;
- PhD Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung 80737, Taiwan
| | - Yun-Ting Hsieh
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
| | - Ti-An Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chang-Ku Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Yi-Chen Lee
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Ta-Yu Liu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Min Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Cheng Chen
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Hao Chang
- Department of Respiratory Therapy, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Te-Yao Hsu
- Department of Obstetrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Chen-Kuang Niu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
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11
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Wu DW, Wang SW, Chang YF, Tsai JH. Effective pharmacotherapy for lung abscess in a patient with alcoholism. Respir Med Case Rep 2020; 30:101061. [PMID: 32373455 PMCID: PMC7193124 DOI: 10.1016/j.rmcr.2020.101061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 11/17/2022] Open
Affiliation(s)
- Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, 807, Kaohsiung, Taiwan
| | - Song-Wei Wang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ya-Fan Chang
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.,Environmental and Occupation Medicine, (Taiwan) National Health Research Institute and Kaohsiung Medical University, Kaohsiung, Taiwan
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12
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Yu HR, Tsai JH, Richard Lin CH, Wang JY, Wen YH, Wu SS, Hou Y, Lee IK, Tu HP, Lee YC. Is asthma a protective factor for dengue fever? In vitro experiment and nationwide population-based cohort analysis. Allergol Int 2019; 68:486-493. [PMID: 31248809 DOI: 10.1016/j.alit.2019.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/24/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Dengue fever (DF) is the most rapidly spreading mosquito-borne viral disease. Practical vaccines or specific therapeutics are still expected. Environmental factors and genetic factors affect the susceptibility of Dengue virus (DV) infection. Asthma is a common allergic disease, with house dust mites (HDMs) being the most important allergens. Asthmatic patients are susceptible to several microorganism infections. METHODS A nationwide population-based cohort analysis was designed to assess whether to determine whether asthma can be a risk factor for DF. RESULTS Unexpectedly, our data from a nationwide population-based cohort revealed asthmatic patients are at a decreased risk of DF. Compared to patients without asthma, the hazard ratio (HR) for DF in patients with asthma was 0.166 (95% CI: 0.118-0.233) after adjustment for possible confounding factors. In the age stratification, the adjusted HR for DF in young adult patients with asthma was 0.063. Dendritic cell-specific intercellular adhesion molecule 3-grabbing non-integrin (DC-SIGN) of dendritic cells (DCs) is an important entry for DV. Through another in vitro experiment, we found that HDM can diminish surface expression of DC-SIGN in monocyte-derived DCs and further decrease the cellular entry of DV. CONCLUSIONS Decreased DC-SIGN expression in DCs of allergic asthmatic patient may be one of many factors for them to be protected against DF. This could implicate the potential for DC-SIGN modulation as a candidate target for designing therapeutic strategies for DF.
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13
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Wu DW, Yang CJ, Tsai JH, Hsiao HH. Anti-tuberculosis agents may be associated with myelodysplastic syndromes. Kaohsiung J Med Sci 2019; 35:651-652. [PMID: 31373745 DOI: 10.1002/kjm2.12111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 07/03/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
| | - Chih-Jen Yang
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- PhD Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Hua Hsiao
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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14
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Wu CY, Yu HS, Chai CY, Wen YH, Wu SS, Chang YP, Lin CHR, Tsai JH. Increased ischemic stroke risk in patients with Behçet's disease: A nationwide population-based cohort study. PLoS One 2019; 14:e0218652. [PMID: 31237911 PMCID: PMC6592528 DOI: 10.1371/journal.pone.0218652] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 06/06/2019] [Indexed: 12/29/2022] Open
Abstract
Background Behçet’s disease (BD) is a recurrent, multisystemic, inflammatory disorder that mainly affects blood vessels. Because recurrent inflammation of blood vessels in the brain plays a crucial role in the development of ischemic stroke, we hypothesized that patients with BD might have an elevated risk of ischemic stroke. This potential association has been suggested in a few case reports, but not epidemiological studies. Hence, the present study aimed to examine the relation between BD and subsequent ischemic stroke in Taiwan using a nationwide, population-based database. Methods To establish a study cohort, the longitudinal data of 306 patients newly diagnosed with BD during 2000–2010 were extracted from the National Health Insurance Research Database, Taiwan. For comparison of ischemic stroke incidence, a control cohort of 1224 subjects without BD was established using a frequency-matched ratio of 1:4 for age, sex, and pre-existing comorbidities. Results During the 10-year follow-up, 13 (4.2%) patients with BD and 20 (1.6%) control subjects experienced ischemic stroke. Kaplan–Meier analysis revealed the higher prevalence of ischemic stroke in the BD group (log-rank test, p = 0.001). After adjusting for comorbidities and demographic characteristics, Cox regression analysis revealed that patients with BD had a 2.77-fold risk of ischemic stroke (95% confidence interval, 1.38–5.57) compared to control subjects. Conclusions Patients with BD have an elevated risk of ischemic stroke. Hence, BD may affect the vascular system in the brain, resulting in a stroke event.
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Affiliation(s)
- Ching-Ying Wu
- Department of Dermatology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Cosmetic Science, College of Human Ecology, Chang Gung University of Science and Technology, Kweishan, Taoyuan, Taiwan
| | - Hsin-Su Yu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (H-S Y); (C-HR L); (J-H T)
| | - Chee-Yin Chai
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Pathology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsia Wen
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shihn-Sheng Wu
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yang-Pei Chang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
- * E-mail: (H-S Y); (C-HR L); (J-H T)
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan
- * E-mail: (H-S Y); (C-HR L); (J-H T)
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Abstract
Dementia is one of the most burdensome illnesses in elderly populations worldwide. However, the literature about multiple risk factors for dementia is scant.To develop a simple, rapid, and appropriate predictive tool for the clinical quantitative assessment of multiple risk factors for dementia.A population-based cohort study.Based on the Taiwan National Health Insurance Research Database, participants first diagnosed with dementia from 2000 to 2009 and aged ≥65 years in 2000 were included.A logistic regression model with Bayesian supervised learning inference was implemented to evaluate the quantitative effects of 1- to 6-comorbidity risk factors for dementia in the elderly Taiwanese population: depression, vascular disease, severe head injury, hearing loss, diabetes mellitus (DM), and senile cataract, identified from a nationwide longitudinal population-based database.This study enrolled 4749 (9.5%) patients first diagnosed as having dementia. Aged, female, urban residence, and low income were found as independent sociodemographic risk factors for dementia. Among all odds ratios (ORs) of 2-comorbidity risk factors for dementia, comorbid depression and vascular disease had the highest adjusted OR of 6.726. The 5-comorbidity risk factors, namely depression, vascular disease, severe head injury, hearing loss, and DM, exhibited the highest OR of 8.767. Overall, the quantitative effects of 2 to 6 comorbidities and age difference on dementia gradually increased; hence, their ORs were less than additive. These results indicate that depression is a key comorbidity risk factor for dementia.The present findings suggest that physicians should pay more attention to the role of depression in dementia development. Depression is a key cormorbidity risk factor for dementia. It is the urgency of evaluating the nature of the link between depression and dementia; and further testing what extent controlling depression could effectively lead to the prevention of dementia.
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Affiliation(s)
| | - Jui-Hsiu Tsai
- Program in Environmental and Occupation Medicine, National Health Research Institutes (Taiwan) and Kaohsiung Medical University
- Calo Psychiatric Center, Pingtung
| | | | - Yang-Pei Chang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung
| | | | - Jain-Shing Liu
- Department of Computer Science and Information Engineering, Providence University, Taichung, Taiwan
| | - For-Wey Lung
- Program in Environmental and Occupation Medicine, National Health Research Institutes (Taiwan) and Kaohsiung Medical University
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Pong YH, Chang CJ, Tsai VFS, Tsai DC, Tsai JH, Lee IC, Huang PL. Genital Tuberculosis Presenting as Acute Scrotum Mimicking Fournier's Gangrene. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791302000509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Genital tuberculosis usually presents as local symptoms such as lower abdominal pain and a sensation of scrotal bloating. We report a rare case of genital tuberculosis in a 46-year-old man presenting with symptoms that mimic Fournier's gangrene. He had a progressive local symptoms of scrotal tenderness, redness, swelling, and local rise in temperature. The patient underwent emergency open debridement, and pathology confirmed tuberculosis infection. Recovery was uneventful after 6 months of anti-tuberculosis drug treatment. Literature of genital tuberculosis is also reviewed.
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Hu KF, Chou YH, Wen YH, Hsieh KP, Tsai JH, Yang P, Yang YH, Lin CHR. Antipsychotic medications and dental caries in newly diagnosed schizophrenia: A nationwide cohort study. Psychiatry Res 2016; 245:45-50. [PMID: 27526316 DOI: 10.1016/j.psychres.2016.07.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 07/05/2016] [Accepted: 07/24/2016] [Indexed: 10/21/2022]
Abstract
We investigated the association between antipsychotic medications and the risk of dental caries in patients with schizophrenia. We enroled a nationwide cohort of patients with newly diagnosed schizophrenia within 1 year of dental caries development. Exposure to antipsychotics and other medications was categorised according to their type and duration, and the association between exposure and dental caries was assessed through logistic regressions. Of the 3610 patients with newly diagnosed schizophrenia, 2149 (59.5%) exhibited an incidence of treated dental caries. Logistic regression analysis identified a younger age, female sex, high income, a 2-year history of dental caries, and exposure to first-generation antipsychotics, and antihypertensives as independent risk factors for treated dental caries in patients with schizophrenia. Hyposalivation, the adverse effect of first-generation antipsychotics and antihypertensives, was associated with an increased risk of treated dental caries. However, hypersalivation from first-generation antipsychotics for dental caries was associated with a protective factor. These findings suggest that clinicians should pay attention to the aforementioned risk factors for dental caries in patients with schizophrenia, particularly while prescribing first-generation antipsychotics and antihypertensives to such patients.
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Affiliation(s)
- Kai-Fang Hu
- Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Hsiang Chou
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Hsia Wen
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Pin Hsieh
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jui-Hsiu Tsai
- Department of Psychiatry and Ph.D. Program in Environmental and Occupational Medicine, Kaohsiung Medical College, Kaohsiung Medical University, No.100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
| | - Pinchen Yang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsin Yang
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
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18
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Abstract
Dementia is one of the most disabling and burdensome health conditions worldwide. In this study, we identified new potential risk factors for dementia from nationwide longitudinal population-based data by using Bayesian statistics.We first tested the consistency of the results obtained using Bayesian statistics with those obtained using classical frequentist probability for 4 recognized risk factors for dementia, namely severe head injury, depression, diabetes mellitus, and vascular diseases. Then, we used Bayesian statistics to verify 2 new potential risk factors for dementia, namely hearing loss and senile cataract, determined from the Taiwan's National Health Insurance Research Database.We included a total of 6546 (6.0%) patients diagnosed with dementia. We observed older age, female sex, and lower income as independent risk factors for dementia. Moreover, we verified the 4 recognized risk factors for dementia in the older Taiwanese population; their odds ratios (ORs) ranged from 3.469 to 1.207. Furthermore, we observed that hearing loss (OR = 1.577) and senile cataract (OR = 1.549) were associated with an increased risk of dementia.We found that the results obtained using Bayesian statistics for assessing risk factors for dementia, such as head injury, depression, DM, and vascular diseases, were consistent with those obtained using classical frequentist probability. Moreover, hearing loss and senile cataract were found to be potential risk factors for dementia in the older Taiwanese population. Bayesian statistics could help clinicians explore other potential risk factors for dementia and for developing appropriate treatment strategies for these patients.
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Affiliation(s)
- Yen-Hsia Wen
- From the School of Pharmacy, College of Pharmacy, Kaohsiung Medical University (Y-HW, S-SW); Department of Psychiatry (J-HT) and Department of Neurology (Y-PC), Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University; Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University (PY); and Department of Computer Science and Engineering, National Sun Yat-sen University (C-HRL, K-HT), Kaohsiung, Taiwan
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Lin HYH, Chang KT, Chang YH, Lu T, Liang CJ, Wang DC, Tsai JH, Hsu CY, Hung CC, Kuo MC, Lin CS, Hwang SJ. Nonapnea Sleep Disorders and the Risk of Acute Kidney Injury: A Nationwide Population-Based Study. Medicine (Baltimore) 2016; 95:e3067. [PMID: 26986132 PMCID: PMC4839913 DOI: 10.1097/md.0000000000003067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Nonapnea sleep disorders (NASDs) and associated problems, which are highly prevalent in patients with kidney diseases, are associated with unfavorable medical sequelae. Nonetheless, whether NASDs are associated with acute kidney injury (AKI) development has not been thoroughly analyzed. We examined the association between NASD and AKI. We conducted a population-based study by using 1,000,000 representative data from the Taiwan National Health Insurance Research Database for the period from January 1, 2000, to December 31, 2010. We studied the incidence and risk of AKI in 9178 newly diagnosed NASD patients compared with 27,534 people without NASD matched according to age, sex, index year, urbanization level, region of residence, and monthly income at a 1:3 ratio. The NASD cohort had an adjusted hazard ratio (hazard ratio [HR]; 95% confidence interval [CI] = 1.15-2.63) of subsequent AKI 1.74-fold higher than that of the control cohort. Older age and type 2 diabetes mellitus were significantly associated with an increased risk of AKI (P < 0.05). Among different types of NASDs, patients with insomnia had a 120% increased risk of developing AKI (95% CI = 1.38-3.51; P = 0.001), whereas patients with other sleep disorders had a 127% increased risk of subsequent AKI (95% CI = 1.07-4.80; P = 0.033). Men with NASDs were at a high risk of AKI (P < 0.05). This nationwide population-based cohort study provides evidence that patients with NASDs are at higher risk of developing AKI than people without NASDs.
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Affiliation(s)
- Hugo You-Hsien Lin
- From the Division of Nephrology (HY-HL, C-CH, M-CK, S-JH), Department of Internal Medicine; Neurology (C-YH), Kaohsiung Medical University Hospital, Kaohsiung Medical University; Department of Internal Medicine (HY-HL, Y-HC); Pediatrics (K-TC); Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University (J-HT); Graduate Institute of Medicine (HY-HL, C-SL, S-JH), College of Medicine, Kaohsiung Medical University; Renal Division (TL), Brigham and Women's Hospital, Harvard Medical School; Lipid Science and Aging Research Center (C-JL), Kaohsiung Medical University; Center for Lipid Bioscience (C-JL), Kaohsiung Medical University Hospital; Department of Sports Medicine (D-CW), Kaohsiung Medical University, Kaohsiung City; and Institute of Population Sciences (S-JH), National Health Research Institutes, Miaoli, Taiwan
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Chang YP, Yang CJ, Hu KF, Chao AC, Chang YH, Hsieh KP, Tsai JH, Ho PS, Lim SY. Risk factors for pneumonia among patients with Parkinson's disease: a Taiwan nationwide population-based study. Neuropsychiatr Dis Treat 2016; 12:1037-46. [PMID: 27175081 PMCID: PMC4854270 DOI: 10.2147/ndt.s99365] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Pneumonia is the leading cause of death in patients with Parkinson's disease (PD). However, few studies have been performed to explore the risk factors for pneumonia development in patients with PD. METHODS We conducted a nationwide population-based cohort study of patients with PD to identify the risk factors for these patients developing pneumonia. Participants with newly diagnosed PD between 2000 and 2009 were enrolled from the 2000-2010 National Health Insurance Research Database in Taiwan. We compared patients with PD with an incidence of hospitalization with pneumonia vs those without, and Cox proportional hazard models were used to estimate the risk of pneumonia. RESULTS Of the 2,001 enrolled patients (mean follow-up duration 5.8 years, range: 2.7-14.7 years), 381 (19.0%) had an incidence of hospitalization with pneumonia during the study period. Multivariate Cox proportional hazards analysis identified older age group (≥80 years of age, hazard ratio [HR] =3.15 [95% confidence interval 2.32-4.28]), male sex (HR =1.59 [1.29-1.96]), certain geographic regions (northern, HR =1.36 [1.04-1.78], southern and eastern, HR =1.40 [1.05-1.88]), rural areas (HR =1.34 [1.05-1.72]), chronic heart failure (HR =1.53 [1.02-2.29]), and chronic kidney disease (HR =1.39 [1.03-1.90]) as risk factors for hospitalization with pneumonia in patients with PD. However, treatment for dental caries was a protective factor (HR =0.80 [0.64-0.99]). CONCLUSION The results of this study highlight risk factors that are associated with hospitalization with pneumonia, and, for the first time, suggest a link between treated dental caries and a diminished risk of hospitalization with pneumonia in patients with PD.
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Affiliation(s)
- Yang-Pei Chang
- Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Chih-Jen Yang
- Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Kai-Fang Hu
- Department of Dentistry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - A-Ching Chao
- Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Yu-Han Chang
- Department of Management, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Kun-Pin Hsieh
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
| | - Pei-Shan Ho
- Faculty of Dental Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China; Cancer Center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan, Republic of China
| | - Shen-Yang Lim
- Faculty of Medicine, University of Malaya, Kuala lumpur, Malaysia
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Tsai JH, Yang P, Lin HH, Cheng KH, Yang YH, Wu MT, Chen CC. Association between GABA(A) receptor subunit gene cluster and zolpidem-induced complex sleep behaviors in Han Chinese. Sleep 2013; 36:197-202. [PMID: 23372267 DOI: 10.5665/sleep.2372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
STUDY OBJECTIVES To investigate and elucidate the role of GABA(A) receptor subunits, specifically the 2 genetic markers at the GABA(A) α1 and GABA(A) α6 receptors, in zolpidem-induced complex sleep behaviors (CSBs). DESIGN Genetic association study. SETTING Kaohsiung Medical University-affiliated hospitals, Kaohsiung, Taiwan. PATIENTS 30 zolpidem-induced CSB subjects and 37 controls. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS The χ(2) test demonstrated an association between the A15G variant at the GABA(A) α1 receptor subunit gene and zolpidem-induced CSBs (P = 0.007). The adjusted odds ratio of the GABA(A) α1 receptor subunit genotype for the risk of zolpidem-induced CSBs was approximately 10 (OR = 9.99, 95% CI = 1.82, 74.87; P = 0.013). CONCLUSIONS The finding reveals that the A15G variant at the GABA(A) α1 receptor subunit gene confers a high risk of zolpidem-induced CSBs and may be considered in clinical services.
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Affiliation(s)
- Jui-Hsiu Tsai
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Patel DV, Rangaswamy R, Lesley WS, Hester JL, McDonald DK, Tsai JH. Transvenous embosurgery of a left sigmoid sinus dural arteriovenous fistula via a retrograde approach from the superior ophthalmic vein, cavernous and inferior petrosal sinuses. J Neurointerv Surg 2011; 3:229-32. [PMID: 21990830 DOI: 10.1136/jnis.2010.003848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The efficacy and safety of transvenous embosurgery for sigmoid sinus dural arteriovenous fistula (DAVF) using the internal jugular vein approach is well known. Embosurgery of cavernous sinus DAVF has also been described utilizing a superior ophthalmic vein approach. The first report of a sigmoid sinus DAVF endosurgical repair via a superior ophthalmic vein approach in a patient without internal jugular vein access is presented.
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Affiliation(s)
- D V Patel
- Department of Radiology, Texas A&M University Health Science Center College of Medicine, Scott and White Clinic, Temple, Texas 76502, USA
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Tsai JH, Tang TC, Yeh YC, Yang YH, Yeung TH, Wang SY, Chen CC. The Chinese version of the Severity of Dependence Scale as a screening tool for benzodiazepine dependence in Taiwan. Kaohsiung J Med Sci 2011; 28:225-30. [PMID: 22453072 DOI: 10.1016/j.kjms.2011.06.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 04/20/2011] [Indexed: 11/27/2022] Open
Abstract
The development of an instrument to estimate the incidence, characteristics, and risk factors of benzodiazepine (BZD) dependence broadly in Taiwan is an important task. This study assessed the validity of the Chinese version of the Severity of Dependence Scale (SDS([Ch])) among regular BZD users in Taiwan (n=228). A positive correlation was shown between SDS([Ch]) and Mini-International Neuropsychiatric Interview diagnosed of BZD dependence. Thirty-six percent of the users received a Mini-International Neuropsychiatric Interview diagnosis of current BZD dependence. The dependent users tended to be divorced/widowed; not schizophrenic; and have higher SDS([Ch]) scores, a longer duration of use, and multiple-BZD use. The SDS([Ch]) for BZD dependence was shown to have high diagnostic utility (area under the receiver operating characteristic curve=0.779), a sensitivity of 80.5%, and a specificity of 85.7%, with a cutoff point of 7. The findings support that the SDS([Ch]) is a valid brief self-reported questionnaire for the assessment of BZD dependence among chronic users in Taiwan.
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Affiliation(s)
- Jui-Hsiu Tsai
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
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Abstract
Electron field emission from a single nanoemitter is a barrier tunneling, quantum mechanical process that can, therefore, be described by the well-known Fowler-Nordheim (FN) equation. At high emission current densities, however, the space charge caused by the cathode may affect the current density-voltage (J-V) characteristics predicted by the FN theory. In this study, we theoretically investigated the effect of space charge on FE nanodevices, including diode and triode structures. The J-V characteristics of FE nanodevices were obtained by analytically (diode structures) or numerically (triode structures) solving the coupled FN equation and Poisson's equation. We discuss the behavior of FE nanodiodes and nanotriodes displaying different geometries, dimensions and work functions of their emitter materials. In the high current density region, space charge plays an important role in FE nanodevices; the threshold current density of space-charge limitation is related to the electric field distributions. Besides, our theoretical results are in good agreement with the experimental results reported previously.
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Affiliation(s)
- P Y Chen
- Sky-watcher Telescope and Optics Corp., Richmond, British Columbia V7A5C8, Canada.
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Chiu NM, Tsai JH, Yong CC. Three index series of electroconvulsive therapy for psychotic depression after orthotopic liver transplantation. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33:1282-3. [PMID: 19622378 DOI: 10.1016/j.pnpbp.2009.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2009] [Revised: 07/11/2009] [Accepted: 07/14/2009] [Indexed: 11/17/2022]
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Tsai JH, Yang P, Chen CC, Chung W, Tang TC, Wang SY, Liu JK. Zolpidem-induced amnesia and somnambulism: rare occurrences? Eur Neuropsychopharmacol 2009; 19:74-6. [PMID: 18819779 DOI: 10.1016/j.euroneuro.2008.08.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 07/28/2008] [Accepted: 08/14/2008] [Indexed: 11/26/2022]
Abstract
Zolpidem, a non-benzodiazepine hypnotic of the imidazopyridine class, is very effective in treating insomnia with previous claims of little adverse effects. However, zolpidem-induced somnambulism and amnesic sleep-related behavioral problems were begun to be reported in literature but no systemic investigation has been undertaken in non-Western cultures. In our current retrospective survey, 5.1% (13 out of 255) of Taiwanese patients reported change in sleep-related behavior as adverse effects. This serves as a reminder for clinicians to inquire regarding any unusual behavior of parasomniac activities when prescribing zolpidem.
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Affiliation(s)
- Jui-Hsiu Tsai
- Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, ROC
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Abstract
In this article, we present a genetic algorithm (GA) as one branch of artificial intelligence (AI) for the optimization-design of the artificial magnetic metamaterial whose structure is automatically generated by computer through the filling element methodology. A representative design example, metamaterials with permeability of negative unity, is investigated and the optimized structures found by the GA are presented. It is also demonstrated that our approach is effective for the synthesis of functional magnetic and electric metamaterials with optimal structures. This GA-based optimization-design technique shows great versatility and applicability in the design of functional metamaterials.
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Affiliation(s)
- P Y Chen
- National Nano Device Laboratories, Hsinchu 30078, Taiwan ROC.
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Tsai JH, Liu JY, Wu TT, Ho PC, Huang CY, Shyu JC, Hsieh YS, Tsai CC, Liu YC. Effects of silymarin on the resolution of liver fibrosis induced by carbon tetrachloride in rats. J Viral Hepat 2008; 15:508-14. [PMID: 18397225 DOI: 10.1111/j.1365-2893.2008.00971.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Silymarin, a standardized extract of the milk thistle (Silybum marianum), has a long tradition as a herbal remedy, and was introduced as a hepatoprotective agent a few years ago. However, the therapeutic effects of silymarin remain undefined. Carbon tetrachloride (CCl4) is a xenobiotic used extensively to induce oxidative stress and is one of the most widely used hepatic toxins for experimental induction of liver fibrosis in the laboratory. In this study, we investigated the restoration of the CCl4-induced hepatic fibrosis by high dose of silymarin in rats. After treatment with oil (as normal group; n = 6) or CCl4 [as model (n = 7) and therapeutic (n = 7) groups] by intragastric delivery for 8 weeks for the induction of liver fibrosis, the rats in the normal and model group were administered orally normal saline four times a week for 3 weeks whilst the therapeutic group received silymarin (200 mg/kg). The histopathological changes were observed with Masson staining. The results showed that the restoration of the CCl4-induced damage of liver fibrosis in the therapeutic group was significantly increased as compared to that in the model group. Moreover, silymarin significantly decreased the elevation of aspartate aminotransferase (AST), alanine aminotransferase, and alkaline phosphatase in serum, and also reversed the altered expressions of alpha-smooth muscle actin in liver tissue. Therefore, these findings indicated that silymarin may have the potential to increase the resolution of the CCl4-induced liver fibrosis in rats.
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Affiliation(s)
- J H Tsai
- Basic Medical Science Education Center, College of Medicine and Health, Fooyin University, Kaohsiung, Taiwan.
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Tsai JH, Tang TC, Yang P, Yen CF, Yang MJ, Yen JY, Chen CC. Adjunctive Treatment of Acute Mania with Risperidone versus Typical Antipsychotics: A Retrospective Study. Kaohsiung J Med Sci 2005; 21:539-44. [PMID: 16670045 DOI: 10.1016/s1607-551x(09)70205-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Few studies have directly compared atypical antipsychotics (e.g. risperidone) with typical antipsychotics as adjunctive therapy in patients hospitalized for acute mania, especially during a lengthy hospital stay. Our retrospective, case-controlled study is a chart review of 64 patients with Diagnostic and Statistical Manual of Mental Disorders, 4th edition, defined bipolar I disorder (current episode, mania). Patients were divided into two groups according to the adjunctive medications used: the risperidone group (mood stabilizers plus risperidone) and the control group (mood stabilizers plus typical antipsychotics). Outcome at discharge, medications, adverse drug effects, and length of hospital stay were compared between groups, controlling for gender, age, number of prior admissions, and duration of illness. Results indicated no statistically significant differences between groups in the controlled factors, Global Assessment of Functioning and Clinical Global Impression-Improvement scores, and adverse drug events. Patients in the risperidone group used significantly lower doses of trihexyphenidyl than those in the control group (p < 0.05). Patients treated with risperidone had a shorter hospital stay than those treated with typical antipsychotics (p < 0.01). In conclusion, antipsychotics are effective as adjunctive agents in the treatment of acute mania. The use of risperidone, in particular, decreases the need for anticholinergics and may lead to a shorter hospital stay compared with typical antipsychotics.
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Affiliation(s)
- Jui-Hsiu Tsai
- Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Abstract
A 39-year-old man with schizophrenia developed severe catatonia, hyperthermia, muscle rigidity, tachycardia, leukocytosis, and elevated muscle enzyme levels while receiving zotepine therapy. Neuroleptic malignant syndrome (NMS) was diagnosed. After withdrawal of zotepine therapy, transfer to a neurologic intensive care unit, provision of supportive care, and administration of adjunctive bromocriptine therapy, the patient's fever and catatonia subsided. Biochemical irregularities spontaneously returned to normal with no complications. Antipsychotic therapy was restarted with risperidone 12 days after the patient's NMS resolved. After more than 1 year of follow-up, he experienced no adverse events. A recent decrease in mortality from NMS is related to increased awareness of this disorder, but not to treatment with specific agents. Clinicians need to recognize NMS early; although rare, it is a potentially fatal complication of antipsychotic treatment.
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Affiliation(s)
- Jui-Hsiu Tsai
- Department of Psychiatry, Kaohsiung Medical University Hsiaokang Hospital, Kaohsiung, Taiwan
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Abstract
Serotonin syndrome is a disorder resulting from excess stimulation of serotonin and is associated with drug interaction, single-drug therapy, and overdose. We report a case involving a 32-year-old man who developed sudden agitation, diaphoresis, subjective fever, tremor, and insomnia. These symptoms were related to doubling the dose of citalopram in combination antidepressant therapy. Discontinuation of the agent resulted in early notable clinical resolution after 1 week. This is a rare report of serotonin syndrome induced by citalopram polytherapy. Although serotonin syndrome is rare, clinicians need to recognize it early.
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Affiliation(s)
- Wu-Pin Tseng
- Department of Family Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
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Wang JJ, Tsai JH. Development, survival and reproduction of black citrus aphid, Toxoptera aurantii (Hemiptera: Aphididae), as a function of temperature. Bull Entomol Res 2001; 91:477-487. [PMID: 11818043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The development, survival, and reproduction of the black citrus aphid Toxoptera aurantii (Boyer de Fonscolombe) were evaluated at ten constant temperatures (4, 7, 10, 15, 20, 25, 28, 30, 32 and 35 degrees C). Development was limited at 4 and 35 degrees C. Between 7 and 32 degrees C, developmental periods of immature stages varied from 44.2 days at 7 degrees C to 5.3 days at 28 degrees C. Overall immature development required 129.9 degree-days above 3.8 degrees C. The upper temperature thresholds of 32.3, 28.6, 29.3, 27.2, and 28.6 degrees C were determined from a non-linear biophysical model for the development of instars 1-4 and overall immature stages, respectively. Immature survivorship varied from 82.1 to 97.7% within the temperature range of 10-30 degrees C. However, immature survivorship was reduced to 26.3% at 7 degrees C and 33.1% at 32 degrees C. Mean adult longevity was the longest (44.2 days) at 15 degrees C and the shortest (6.2 days) at 32 degrees C. The predicted upper temperature limit for adult survivorship was at 32.3 degrees C. Total nymph production increased from 16.3 nymphs per female at 10 degrees C to 58.7 nymphs per female at 20 degrees C, declining to 6.1 nymphs per female at 32 degrees C. The estimation of lower and upper temperature limits for reproduction was at 8.2 and 32.5 degrees C, respectively. The population reared at 28 degrees C had the highest intrinsic rate of increase (0.394), the shortest population doubling time (1.8 days), and shortest mean generation time (9.5 days) compared with the populations reared at six other temperatures. The population reared at 20 degrees C had the highest net reproductive rate (54.6). The theoretical lower and upper temperature limits for population development, survival and reproduction were estimated at 9.4 and 30.4 degrees C, respectively. The biology of T. aurantii was also compared with three other citrus aphid species.
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Affiliation(s)
- J J Wang
- Fort Lauderdale Research and Education Center, IFAS, University of Florida, 3205 College Avenue, Fort Lauderdale, FL 33314, USA
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Lee PP, Fitzpatrick DR, Beard C, Jessup HK, Lehar S, Makar KW, Pérez-Melgosa M, Sweetser MT, Schlissel MS, Nguyen S, Cherry SR, Tsai JH, Tucker SM, Weaver WM, Kelso A, Jaenisch R, Wilson CB. A critical role for Dnmt1 and DNA methylation in T cell development, function, and survival. Immunity 2001; 15:763-74. [PMID: 11728338 DOI: 10.1016/s1074-7613(01)00227-8] [Citation(s) in RCA: 980] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The role of DNA methylation and of the maintenance DNA methyltransferase Dnmt1 in the epigenetic regulation of developmental stage- and cell lineage-specific gene expression in vivo is uncertain. This is addressed here through the generation of mice in which Dnmt1 was inactivated by Cre/loxP-mediated deletion at sequential stages of T cell development. Deletion of Dnmt1 in early double-negative thymocytes led to impaired survival of TCRalphabeta(+) cells and the generation of atypical CD8(+)TCRgammadelta(+) cells. Deletion of Dnmt1 in double-positive thymocytes impaired activation-induced proliferation but differentially enhanced cytokine mRNA expression by naive peripheral T cells. We conclude that Dnmt1 and DNA methylation are required for the proper expression of certain genes that define fate and determine function in T cells.
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Affiliation(s)
- P P Lee
- Department of Immunology, University of Washington, Seattle, WA 98195, USA
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Wang JJ, Tsai JH, Ding W, Zhao ZM, Li LS. Toxic effects of six plant oils alone and in combination with controlled atmosphere on Liposcelis bostrychophila (Psocoptera: Liposcelididae). J Econ Entomol 2001; 94:1296-1301. [PMID: 11681697 DOI: 10.1603/0022-0493-94.5.1296] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Six plant essential oils alone as repellent and fumigant, and in combination with the controlled atmosphere against Liposcelis bostrychophila Badonnel were assessed in the laboratory. These essential oils were extracted from the leaves of six source plants: Citrus tangerina Tanaka, Citrus aurantium L., Citrus bergamia Risso et Poiteau, Pinus sylvestris L., Cupressus funebris End]., and Eucalyptus citriodora Hook. The repellency test indicated that L. bostrychophila adults were repelled by filter paper strips treated with six essential oils. Of these essential oils, the C. funebris oil was most effective followed by that of F. sylvestris, C. tangerina, C. bergamia, and E. citriodora. The average repellency of the C. aurantium oil against L. bostrychophila adults was significantly lower than other five test oils by day 14. These essential oils had a high level of toxicity in the fumigation assay against L. bostrychophila adults at both 10 and 20 ppm. When combined with two controlled atmosphere treatments (12% CO2 + 9% O2, and 10% CO2 + 5% O2, balanced N2), the toxicity of plant oils was enhanced significantly.
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Affiliation(s)
- J J Wang
- Fort Lauderdale Research and Education Center, IFAS, University of Florida, 33314, USA
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Abstract
This paper describes the design, synthesis, and structural evaluation of a compound (4) comprising three molecular templates and a peptide strand that mimics a three-stranded protein beta-sheet. Two of the templates mimic the hydrogen-bonding functionality of peptide beta-strands and serve as the top and bottom strands by embracing the peptide strand, which is located in the middle of the sheet. The remaining template holds the three strands next to each other. The synthesis of artificial beta-sheet 4 begins with the bottom template and involves the sequential addition of the middle and top strands. (1)H NMR chemical shift and NOE studies establish that this compound folds to adopt a hydrogen-bonded beta-sheetlike structure in CDCl(3) solution. Chemical shift studies indicate that triply stranded artificial beta-sheet 4 is more tightly folded than its smaller doubly stranded homologue, artificial beta-sheet 1.
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Affiliation(s)
- J S Nowick
- Contribution from the Department of Chemistry, University of California, Irvine, Irvine, California 92697-2025, USA
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Tsai JF, Chuang LY, Jeng JE, Ho MS, Lin ZY, Hsieh MY, Wang LY, Tsai JH. Sex differences in relation to serum hepatitis B e antigen and alanine aminotransferase levels among asymptomatic hepatitis B surface antigen carriers. J Gastroenterol 2001; 35:690-5. [PMID: 11023040 DOI: 10.1007/s005350070048] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study aimed to investigate sex differences in relation to hepatitis B e antigen (HBeAg) and serum alanine aminotransferase (ALT) levels in chronic asymptomatic hepatitis B virus (HBV) infection. HBeAg and ALT level were determined in 636 asymptomatic hepatitis B surface antigen carriers. There was no significant sex differences in the age-adjusted prevalence of HBeAg. Abnormal ALT level (>45 IU/l) was more frequent in carriers with HBeAg (17.5% vs 7.6%; P = 0.001). Multivariate analysis indicated that male sex (odds ratio, 2.0; 95% confidence interval, 1.1-3.6) and HBeAg (odds ratio, 2.6; 95% confidence interval, 1.6-4.3) were independent risk factors for abnormal ALT levels. Male sex and HBeAg-positivity are independent risk factors for abnormal ALT activity in chronic HBV infection. This observation may be related to sex differences in chronic HBV infection.
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Affiliation(s)
- J F Tsai
- Department of Internal Medicine, Kaohsiung Medical University College of Medicine, Taiwan
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Hsu CH, Yang YC, Lian ST, Lee SC, Shin SJ, Tsai JH, Lin SR. Significantly increased cortisol secretion in normal adrenocortical cells transfected with K-ras mutants derived from human functional adrenocortical tumors. DNA Cell Biol 2001; 20:231-8. [PMID: 11403720 DOI: 10.1089/104454901750219116] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Our previous study showed that the mutation hotspots of the K-ras proto-oncogene in human functional adrenocortical tumors are in codons 15, 16, 18, and 31, thus differing from the sites in other tumors. In addition, analyzing the K-Ras protein by a recombinant DNA technique showed that the activity of endogenic GTPase and the GTPase-activating protein (GAP)-binding ability were significantly decreased in patients with these tumors. The aim of this study was to understand whether those K-ras mutants, which were found only in human adrenocortical tumors, play an important role in these tumors. Thus, the mutant K-ras cDNA was constructed with mammalian expression vectors and transfected into normal adrenocortical cells. The amount of cortisol secreted by the transfected cells was 20 to 30 times that of normal cells. Furthermore, Northern blot analysis revealed that the expression of the three steroidogenesis-related genes P450(scc) (cholesterol side-chain cleavage enzyme), P450(C17) (17alpha-hydroxylase/17, 20-lyase), and P450(C21) (steroid 21-hydroxylase) gene increased in the transfected cells. The K-ras oncogene significantly increases cortisol secretion by normal adrenocortical cells.
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Affiliation(s)
- C H Hsu
- Department of Clinical Pathology, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
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Chen HC, Guh JY, Shin SJ, Tsai JH, Lai YH. Insulin and heparin suppress superoxide production in diabetic rat glomeruli stimulated with low-density lipoprotein. Kidney Int Suppl 2001; 78:S124-7. [PMID: 11168997 DOI: 10.1046/j.1523-1755.2001.59780124.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patients with diabetic nephropathy frequently show increased levels of circulating low-density lipoprotein (LDL) and oxidized LDL, which have been reported to be related to the generation of oxygen-free radicals. In the present study, we evaluated the effects of insulin and heparin on the superoxide production of glomeruli, which were isolated from rats with streptozotocin-induced diabetes for one week, one month, and three months, respectively, and the glomeruli were stimulated with native and oxidized LDL. LDL was isolated from normal subjects with normolipidemia, and the superoxide was measured by using a spectrophotometer. The results demonstrated that the poorly controlled diabetic rat glomeruli showed a significantly higher production of superoxide than normal glomeruli under basal status and after stimulation, and this production increased further with the progression of diabetes. Insulin suppressed both the basal and stimulated production of superoxide in diabetic glomeruli, but not in normal glomeruli. Heparin suppressed superoxide production of diabetic glomeruli stimulated by either native or oxidized LDL, and it also partly suppressed superoxide production of normal glomeruli stimulated by oxidized LDL. Our results suggest that glomerular injury in diabetics with hyperlipidemia may be mediated through enhanced generation of oxygen-free radicals, which can be partially attenuated by insulin and heparin.
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Affiliation(s)
- H C Chen
- Division of Nephrology and Endocrinology, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China
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Guh JY, Chen HC, Chuang LY, Yang CY, Tsai JH, Lai YH. Significance of salivary epidermal growth factor in peptic ulcer disease in hemodialysis patients. Nephron Clin Pract 2001; 87:134-8. [PMID: 11244307 DOI: 10.1159/000045901] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Hemodialysis (HD) patients are prone to developing peptic ulcers. However, of all the risk factors associated with peptic ulcers, none have been shown to be more prevalent in HD patients than in the general population. However, salivary epidermal growth factor (EGF) may play a role in peptic ulcer diseases. METHODS Salivary EGF levels and bioactivities were assayed in 47 maintenance HD patients and 30 normal controls, and the molecular weights of EGF were assessed using high-performance liquid chromatography (HPLC). RESULTS Salivary EGF levels were not different between both groups of subjects (4.2 +/- 0.34 vs. 5 +/- 0.54 ng/mg protein, NS), and HPLC revealed that salivary EGF in both groups had similar molecular weights. However, salivary EGF bioactivity was significantly depressed in the HD patients as compared to the normal controls (0.59 +/- 0.08 vs. 1.55 +/- 0.15 ng/mg protein, p < 0.01). Stepwise multiple regression showed that the low salivary EGF levels were associated with female gender (p < 0.05), while low salivary EGF bioactivity was associated with HD per se (p < 0.05). In the 22 HD patients who underwent gastric endoscopy, salivary EGF bioactivity was significantly lower in those with peptic ulcers than in those without (0.38 +/- 0.08 vs. 0.69 +/- 0.08 ng/mg protein, p < 0.05). CONCLUSION Decreased salivary EGF bioactivity may contribute to peptic ulcer disease among maintenance HD patients.
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Affiliation(s)
- J Y Guh
- Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
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Abstract
Motor vehicle emission factors of carbon monoxide (CO) and non-methane volatile organic compounds (NMVOCs) were calculated inside the Chung-Cheng Tunnel of Kaohsiung in Taiwan. The results were compared with those model predictions from the Mobile Taiwan 2.0 model. Individual concentrations of 21 species of NMVOCs were also determined. Photochemical potential of NMVOCs was evaluated by using the maximum incremental reactivity (MIR). Field data showed that the integrated emission factors of CO and NMVOCs for actual fleet were 6.3 and 1.5 g/veh km, respectively. The error range of these factors may be up to 45%. The predicted values by the Mobile Taiwan 2.0 model closely matched the observed data. Concentrations of isopentane, 2-methylpentane, toluene and m,p-xylene were the dominant species of NMVOCs. The ratio of maximum incremental reactivity to NMVOCs concentration was 3.9, similar to those of the studies in the US Fort McHenry and Tuscarora Tunnel.
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Affiliation(s)
- Y C Hsu
- Department of Environmental Engineering, National Cheng-Kung University, Tainan County, Taiwan, ROC
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Tsai JH, Hsieh YS, Kuo SJ, Chen ST, Yu SY, Huang CY, Chang AC, Wang YW, Tsai MT, Liu JY. Alteration in the expression of protein kinase C isoforms in human hepatocellular carcinoma. Cancer Lett 2000; 161:171-5. [PMID: 11090966 DOI: 10.1016/s0304-3835(00)00597-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study was designed to investigate the alterations of individual protein kinase C (PKC) isoforms in human liver cancer. Surgical specimens of hepatocellular carcinoma and adjacent normal tissues were extracted into cytosolic and membranous fractions. The level of membrane-bound PKCalpha in the cancer tissue was significantly lower than that in the adjacent normal tissue and consistent with the change in PKC activity. In addition, there was a significant negative correlation between PKCalpha and tumor size. In both cytosolic and membrane fractions, levels of PKCdelta and PKCzeta was significantly higher in the cancer tissue than those in the adjacent normal liver tissue. The alterations in the PKC isoforms signify their roles in the hyperproliferation in liver cancer.
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Affiliation(s)
- J H Tsai
- Department of Nursing, Fooyin Institute of Technology, ROC, Kaohsiung 831, Taiwan
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Abstract
The biology of the citrus psyllid Diaphorina citri Kuwayama was studied at 25 degrees C on four commonly grown citrus and related plants [rough lemon, Citrus jambhiri Lush; sour orange, C aurantium L.; grapefruit, C. paradisi Macfadyen; and orange jessamine, Murraya paniculata (L.) Jack] in the laboratory. The biological characteristics of each life stage are described. The average egg incubation periods on orange jessamine, grapefruit, rough lemon, and sour orange varied very little (4.1-4.2 d). The average nymphal developmental periods on these four host plants were essentially the same except the fifth stadium. Survival of immatures on orange jessamine, grapefruit, rough lemon, and sour orange was 75.4, 84.6, 78.3, and 68.6%, respectively. Female adults lived an average of 39.7, 39.7, 47.6, and 43.7 d on these respective host plants. The average number of eggs laid per female on grapefruit (858 eggs) was significantly more than those on other hosts (P < 0.05). The intrinsic rate of natural increase (r(m)) for D. citri on grapefruit was highest. Jackknife estimates of r(m) varied from 0.188 on grapefruit to 0.162 on orange jessamine and rough lemon. The mean population generation time on these hosts ranged from 31.6 to 34.1 d. The continuous flushes produced by orange jessamine could play an important role in maintaining high populations of this vector when the new flushes are not available in the commercial citrus groves.
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Affiliation(s)
- J H Tsai
- Fort Lauderdale Research and Education Center, IFAS, University of Florida, 33314, USA
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Hsiao PJ, Tsai KB, Lai FJ, Yeh KT, Shin SJ, Tsai JH. Thyroid metastasis from intraductal papillary-mucinous carcinoma of the pancreas. A case report. Acta Cytol 2000; 44:1066-72. [PMID: 11127736 DOI: 10.1159/000328599] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Intraductal papillary-mucinous carcinoma (IPMC) of the pancreas is a newly identified clinicopathologic entity of the exocrine pancreas. It has been considered a slowly growing and less-aggressive carcinoma with a favorable prognosis. There have been only a few documents reporting its distant metastasis and cytologic features, with no report of thyroid metastasis until the present. CASE A case of IPMC occurred in a 45-year-old male, who was admitted with rapid growth and tenderness of the thyroid. Abdominal computed tomography showed the typical cystic dilatation of IPMC with adjacent organ metastasis. Fine needle aspiration of the thyroid yielded papillary fronds of carcinoma cells with nuclear pleomorphism, abundant cytoplasm and prominent nucleoli in a mucinous background. Immunohistochemical findings from the skin and thyroid characterized the papillary-mucinous carcinoma as having originated in the pancreas. CONCLUSION This case suggests that papillary carcinoma fronds aspirated from the thyroid should be further differentiated from the primary site and that a pleomorphic nucleus in a mucinous background is a useful feature to exclude a thyroid origin. Before this, distant metastasis of IPMC to the skin and thyroid has not been reported. The prognosis of IPMC with wide, distant metastasis at an advanced stage is poor.
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Affiliation(s)
- P J Hsiao
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, R.O.C
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Chen HC, Sheu MM, Tsai JH, Lai YH. Acute tubulo-interstitial nephritis and uveitis with anti-neutrophil cytoplasmic antibodies in an adult: an autoimmune disorder? Nephron Clin Pract 2000; 78:372. [PMID: 9546714 DOI: 10.1159/000044963] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
Activated carbon kinetic studies show that both H2S and CH3SH yielded pore diffusion coefficients from 10(-6) to 10(-8) cm2/s. Results indicated that pore structures could influence effective diffusivity. Under the same adsorbate concentration, CH3SH exhibited a greater effective pore diffusion coefficient than H2S. This may be attributed to the fact that CH3SH has both polar (-SH) and non-polar (-CH3) functional groups and dissolves into water easier, thus providing more attraction for the activated carbon surface. In addition, the saturation vapor pressure of CH3SH is lower than that of H2S. Therefore, CH3SH is easier to adsorb onto activated carbon than H2S.
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Affiliation(s)
- H L Chiang
- Department of Environmental Engineering, Fooyin Institute of Technology, Kaoshiung Hsien, Taiwan, ROC.
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Hsieh MC, Lin SR, Hsieh TJ, Hsu CH, Chen HC, Shin SJ, Tsai JH. Increased frequency of angiotensin-converting enzyme DD genotype in patients with type 2 diabetes in Taiwan. Nephrol Dial Transplant 2000; 15:1008-13. [PMID: 10862639 DOI: 10.1093/ndt/15.7.1008] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Diabetes is one of the major causes of end-stage renal failure in the Taiwanese population. Previous studies have shown that angiotensin-converting enzyme (ACE) inhibitor can improve glucose utilization and suppress hepatic glucose production and the renin-angiotensin system may play an important role in the initiation and progression of diabetic nephropathy. Thus, ACE gene polymorphism may be associated with type 2 diabetes and diabetic nephropathy. METHODS To investigate the distribution of ACE-I/D genotype in type 2 diabetes and diabetic nephropathy, we examined 336 patients with type 2 diabetes (157 without nephropathy and 179 with nephropathy) and 263 age-matched normal controls. The diagnosis of nephropathy was made when daily protein loss exceeded 500 mg. ACE gene polymorphism was analysed by use of polymerase chain reaction. RESULTS Our study revealed that the frequency of the D allele of the ACE gene was 29.3% in normal controls. The frequency of ACE DD genotype was significantly higher in type 2 diabetics compared with normal controls (18.2 vs 9.1%, P<0.01). The frequency of ACE DD genotype in patients with diabetic nephropathy was significantly higher than in patients without nephropathy (22.3 vs 13.4%, P<0.05). To determine whether ACE gene polymorphism was associated with the severity of diabetic nephropathy, we divided patients with diabetic nephropathy into dialysis and non-dialysis groups. The frequency of ACE DD genotype in the dialysis group was significantly higher than in non-dialysis group (28.7 vs 15.3%, P<0.05). CONCLUSION Our results indicate that the frequency of ACE DD genotype is markedly higher in patients with type 2 diabetes, and the ACE DD genotype is significantly associated with diabetic nephropathy.
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Affiliation(s)
- M C Hsieh
- Departments of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Wang J, Zhao Z, Tsai JH. Resistance and some enzyme activities in Liposcelis bostrychophila Badonnel (Psocoptera: Liposcelididae) in relation to carbon dioxide enriched atmospheres. J Stored Prod Res 2000; 36:297-308. [PMID: 10758268 DOI: 10.1016/s0022-474x(99)00051-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Two populations (S-1 and S-2) of the psocid, Liposcelis bostrychophila Badonnel were exposed to carbon dioxide enriched atmospheres. Carbon dioxide resistance developed at steady rates in these two populations during this study period. Selection with 35 and 55% CO(2) resulted in resistance development as expressed by LT(50). Resistance increased steadily under continuous selection to 4.6- and 5.3-fold by generation F(30) for S-1 and S-2, respectively. Throughout the selection process, the slopes of regression lines were always lower than that of the control. The results of biochemical assays showed that the activities of carboxyl esterase (CarE) and superoxide dismutase (SOD) in vitro increased in the selection process. Exposure to higher CO(2) content (HCC) resulted in a gradual decrease in CarE activity in both selected and control populations. Although the induction effect of CO(2) on SOD was brief, the induction times for the S-1 and S-2 were greater than those of the control. The elevated catalase (CAT) activity in association with resistance development was also evident, but no statistical correlation was found between CAT activity and HCC resistance. No significant differences were found in acid phosphatase and alkaline phosphatase activities in both selected and control populations during this study. This study demonstrated that high CarE and SOD activities were positively correlated to CO(2) resistance.
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Affiliation(s)
- J Wang
- Fort Lauderdale Research and Education Center, IFAS, University of Florida, 3205 College Avenue, Fort Lauderdale, FL, USA
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