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ABSTRACT: Visible light is a treatment option for segmental vitiligo (SV), and visible light-induced repigmentation is associated with normalization of sympathetic dysfunction. Currently, it is difficult to predict individual patients' response to visible light therapy.
To test whether cutaneous blood flow can serve as a response predictor for visible light on treating SV.
Fourteen patients with SV were recruited in this prospective pilot study. Laser Doppler flowmetry was used to evaluate the cutaneous blood flow over SV lesions and contralateral normal skin. The pretreatment blood flow evaluation consisted of two stages: stage 1, following cold stress without prior visible light irradiation, and stage 2, following cold stress with prior visible light irradiation. Subsequently, the patients received regular visible light treatment for 3months, and a comparison of the pretreatment blood flow patterns between the visible light responding and nonresponding groups was carried out at the end of the study period.
The SV lesions showed different blood flow profiles as compared with the contralateral normal skin. At the end of the 3-month study period, seven (50%) patients showed clinical repigmentation of >25%. The visible light responding group showed a more consistent occurrence of increased blood flow after stage 2 of the pretreatment evaluation while the nonresponding counterpart showed no significant changes.
Normalization of sympathetic dysfunction may account for the efficacy of visible light in treating SV. Evaluation of cutaneous blood flow with and without prior visible light irradiation on cold-stressed SV lesions may serve as a treatment response predictor.
British Journal of Dermatology 11/2010; 164(4):759-64. · 3.67 Impact Factor
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ABSTRACT: Second-hand Smoke (SHS) exposure is a significant public health problem that may be responsible for serious health hazards for child. This study aimed to examine the exposure status of SHS and the factors associated with SHS avoidance behavior among the mothers of pre-school children.
A cross-sectional study was used to obtain a sample of the mothers of pre-school children (n = 1,020) in 30 registered kindergartens in eastern Taiwan. Overall, 919 (a response rate of 90%) completed the questionnaires. Regression models were used to identify factors with respect to the avoidance behavior of SHS.
The prevalence of exposure to SHS was 70% and 50% for the mothers and their children, respectively. After adjusting for other variables, mothers who were current smokers (β = -0.260, p < 0.001), had spouses who smoked (β = -0.060, p < 0.05), SHS exposure (β = -0.138, p < 0.001), and/or children with exposure to SHS (β = -0.084, p < 0.05) were found to be less likely to avoid SHS, whereas mothers with a high knowledge score about SHS (β = 0.082, p < 0.01), positive attitudes (β = 0.274, p < 0.001) and a high self-efficacy level in regard to the avoidance of SHS (β = 0.397, p < 0.001) were observed to be more likely to avoid SHS. Regression analyses confirmed that the significantly factors associated with the avoidance behavior of SHS were self-efficacy, being a current smoker, and the attitude toward the avoidance of SHS to be that of 55.5% of the total variance explained (p < 0.001).
The high prevalence rate of exposure to SHS for mothers and their children suggests that a well-designed future intervention program should be implemented in regard to pre-school children's mothers in order to prevent these mothers and their children from SHS exposure hazards, more particularly, to strengthen the knowledge base, to enhance self-efficacy and to foster a more positive attitude toward the avoidance of SHS in the mothers.
BMC Public Health 10/2010; 10:606. · 2.00 Impact Factor
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ABSTRACT: The purpose of this study was to examine the prognostic value of pretreatment quality of life (QoL) data on locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) in patients with nasopharyngeal carcinoma (NPC).
A total of 347 new patients with NPC, who were curatively treated by conformal radiotherapy from March 2003 to December 2007, were recruited. The Taiwan Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 was completed before treatment. Multivariate Cox's proportional hazards models were used to analyze the impact of clinical and QoL variables on the treatment results.
The 5-year LRC, DMFS, and OS rates were 72.9%, 79.1%, and 68.4%, respectively. After adjusting the clinical variables, 10 QoL variables were observed to be significantly (P < .05) related to OS, and four QoL variables were related to DMFS. No QoL variable was predictive of LRC. Among the QoL variables that significantly predicted OS and DMFS, physical functioning was the most powerful predictor. A 10-point increase in the physical functioning score was associated with a 23% (95% CI, 12% to 34%) reduction in the likelihood of death and a 22% (95% CI, 9% to 36%) reduction in the likelihood of distant metastasis.
Our findings indicate that pretreatment QoL variables, especially physical functioning, provide easily available prognostic value for distant metastasis and survival in patients with NPC.
Journal of Clinical Oncology 10/2010; 28(28):4384-9. · 18.37 Impact Factor
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ABSTRACT: The spread of influenza and highly pathogenic avian influenza (H5N1) presents a significant threat to human health. Avian influenza outbreaks in downwind areas of Asian dust storms (ADS) suggest that viruses might be transported by dust storms.
We developed a technique to measure ambient influenza and avian influenza viruses. We then used this technique to measure concentrations of these viruses on ADS days and background days, and to assess the relationships between ambient influenza and avian influenza viruses, and air pollutants.
A high-volume air sampler was used in parallel with a filter cassette to evaluate spiked samples and unspiked samples. Then, air samples were monitored during ADS seasons using a filter cassette coupled with a real-time quantitative polymerase chain reaction (qPCR) assay. Air samples were monitored during ADS season (1 January to 31 May 2006).
We successfully quantified ambient influenza virus using the filtration/real-time qPCR method during ADS days and background days. To our knowledge, this is the first report describing the concentration of influenza virus in ambient air. In both the spiked and unspiked samples, the concentration of influenza virus sampled using the filter cassette was higher than that using the high-volume sampler. The concentration of ambient influenza A virus was significantly higher during the ADS days than during the background days.
Our data imply the possibility of long-range transport of influenza virus.
Environmental Health Perspectives 04/2010; 118(9):1211-6. · 7.04 Impact Factor
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ABSTRACT: The aim was to comprehensively examine school-based tobacco policy status, implementation and students' perceived smoking at school in regard to gender-specific differences in smoking behavior. We conducted a multilevel-based study to assess two-level effects for smoking among 2350 grades three to six students in 26 randomly selected elementary schools in southern Taiwan. A series of multilevel models were analyzed separately for male and female students. The school-level variables appear to be related to smoking behavior in male students. Among males, the risk of ever-smoking was significantly associated with those schools without antitobacco health education activities or curricula [adjusted odds ratio (aOR) = 6.23, 95% confidence interval (CI): 2.55-15.24], with a high perceived smoking rate (aOR = 3.08, 95% CI: 1.41-6.72) and located in a mountainous region (aOR = 2.53, 95% CI: 1.15-5.58). The risk of ever-smoking among females was significantly associated with those schools without antitobacco activities or curricula (aOR = 3.10, 95% CI: 1.27-7.55). As compared with female counterparts, the specific school that the male students attended had a positive significant effect on the risk of being ever-smokers. The findings suggest that effective tobacco policy implementation should be considered in elementary schools that are currently putting children at the greatest risk for cigarette smoking, especially in regard to male students.
Health Education Research 03/2010; 25(3):451-63. · 1.66 Impact Factor
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Chia-Fang Wu,
Nan-Hsiung Feng,
Inn-Wen Chong,
Kuen-Yuh Wu, Chien-Hung Lee,
Jhi-Jhu Hwang,
Chia-Tsuan Huang,
Chung-Ying Lee,
Shao-Ting Chou,
David C Christiani,
Ming-Tsang Wu
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ABSTRACT: Cigarette smoking cannot fully explain the epidemiologic characteristics of chronic obstructive pulmonary disease (COPD) in women, particularly for those who rarely smoke, but COPD risk is not less than men. The aim of our study is to investigate the relationship between second-hand smoke (SHS) exposure and chronic bronchitis in Taiwanese women.
We used Taiwan's National Health Insurance Bureau claims data in 1999, and cross-checked using criteria set by the American Thoracic Society; there were 33 women with chronic bronchitis, 182 with probable chronic bronchitis, and 205 with no chronic bronchitis during our interview time between 2000 and 2005. We measured second-hand smoke (SHS) exposure by self-reported measures (household users and duration of exposure), and validated this by measuring urinary cotinine levels of a subset subjects. Classification of chronic bronchitis was also based on spirometry defined according to the GOLD guidelines to get the severity of COPD.
Women who smoked and women who had been exposed to a lifetime of SHS were 24.81-fold (95% CI: 5.78-106.38) and 3.65-fold (95% CI: 1.19-11.26) more likely to have chronic bronchitis, respectively, than those who had not been exposed to SHS. In addition, there was a significant increasing trend between the severity of COPD and exposure years of SHS (p < 0.01). The population attributable risk percentages of chronic bronchitis for smokers and those exposed to SHS were 23.2 and 47.3% respectively.
These findings indicate that, besides cigarette smoking, exposure to SHS is a major risk factor for chronic bronchitis in Taiwanese women.
BMC Public Health 01/2010; 10:44. · 2.00 Impact Factor
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Chien-Hung Lee,
Sheau-Fang Yang,
Chiung-Yu Peng,
Ruei-Nian Li,
Yu-Chieh Chen,
Te-Fu Chan,
Eing-Mei Tsai,
Fu-Chen Kuo,
Joh-Jong Huang,
Hsiu-Ting Tsai,
Yu-Hsiu Hung,
Hsiao-Ling Huang,
Sharon Tsai,
Ming-Tsang Wu
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ABSTRACT: Although cooking emission from high-temperature frying has been deemed a Group 2A carcinogen by the International Agency for Research on Cancer, little is known about its impact on cervical tumorigenesis. To investigate the precancerous consequence of cooking oil fumes on cervical intraepithelial neoplasm (CIN), a community-based case-control study, which takes all known risk factors into consideration, was conducted in Taiwan. From 2003 to 2008, in a Pap smear screening and biopsy examination network, 206 pathology-verified women with inflammations/atypical squamous cells of undetermined significance or CIN grade-1 (CIN1) and 73 with CIN2-3 (defined as low-grade squamous intraepithelial lesions (LGSIL) and high-grade squamous intraepithelial lesions (HGSIL), respectively); and 1,200 area-and-age-matched controls with negative cytology were recruited. Multinomial logistic regression was applied in the multivariate analysis to determine the likelihood of contracting LGSIL or HGSIL. The risks of the two lesions increased with the increase of carcinogenic high-risk human papillomavirus DNA load, with a clear dose-response relationship. Chefs were observed to experience a 7.9-fold elevated HGSIL risk. Kitchens with poor fume ventilation during the main cooking life-stage correlated to a 3.7-fold risk of HGSIL, but not for LGSIL. More than 1 hr of daily cooking in kitchens with poor fume conditions appeared to confer an 8.4-fold HGSIL risk, with an 8.3-fold heterogeneously higher odds ratio than that (aOR = 1.0) for LGSIL. Similar risk pattern has been reproduced among never-smoking women. Our findings demonstrate the association between indoor exposure to cooking fumes from heated oil and the late development of cervical precancerous lesions. This final conclusion needs to be verified by future research.
International Journal of Cancer 12/2009; 127(4):932-41. · 5.44 Impact Factor
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Hung-Pin Tu,
Albert Min-Shan Ko,
Shu-Jung Wang, Chien-Hung Lee,
Rod A Lea,
Shang-Lun Chiang,
Hung-Che Chiang,
Tsu-Nai Wang,
Meng-Chuan Huang,
Tsan-Teng Ou,
Gau-Tyan Lin,
Ying-Chin Ko
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ABSTRACT: Taiwanese aborigines have a high prevalence of hyperuricemia and gout. Uric acid levels and urate excretion have correlated with dopamine-induced glomerular filtration response. MAOs represent one of the major renal dopamine metabolic pathways. We aimed to identify the monoamine oxidase A (MAOA, Xp11.3) gene variants and MAO-A enzyme activity associated with gout risk. This study was to investigate the association between gout and the MAOA single-nucleotide polymorphisms (SNPs) rs5953210, rs2283725, and rs1137070 as well as between gout and the COMT SNPs rs4680 Val158Met for 374 gout cases and 604 controls. MAO-A activity was also measured. All three MAOA SNPs were significantly associated with gout. A synonymous MAOA SNP, rs1137070 Asp470Asp, located in exon 14, was associated with the risk of having gout (P = 4.0 x 10(-5), adjusted odds ratio 1.46, 95% confidence intervals [CI]: 1.11-1.91). We also showed that, when compared to individuals with the MAOA GAT haplotype, carriers of the AGC haplotype had a 1.67-fold (95% CI: 1.28-2.17) higher risk of gout. Moreover, we found that MAOA enzyme activity correlated positively with hyperuricemia and gout (P for trend = 2.00 x 10(-3) vs. normal control). We also found that MAOA enzyme activity by rs1137070 allele was associated with hyperuricemia and gout (P for trend = 1.53 x 10(-6) vs. wild-type allele). Thus, our results show that some MAOA alleles, which have a higher enzyme activity, predispose to the development of gout.
Human Genetics 11/2009; 127(2):223-9. · 5.07 Impact Factor
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Hung-Pin Tu,
Chung-Jen Chen,
Silent Tovosia,
Albert Min-Shan Ko, Chien-Hung Lee,
Tsan-Teng Ou,
Gau-Tyan Lin,
Shun-Jen Chang,
Shang-Lun Chiang,
Hung-Che Chiang,
Ping-Ho Chen,
Shu-Jung Wang,
Han-Ming Lai,
Ying-Chin Ko
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ABSTRACT: To study the associations of gout, tophi and uric acid levels with the gout-related SLC2A9 (solute carrier family 2, member 9) single nucleotide polymorphisms (SNPs) between two different racial groups.
Eight SLC2A9 SNPs were genotyped in 109 subjects with gout and 191 control subjects from Han Chinese men in Taiwan and 69 subjects with gout and 168 control subjects from the Solomon Islands.
Non-synonymous SLC2A9 rs3733591 Arg265His was associated with risk for gout and tophaceous gout in Han Chinese subjects (p=0.0012 and p=0.0044). The genetic effect of this SNP on tophaceous gout was replicated in Solomon Islanders (p=0.0184). Patients with SLC2A9 Arg265His risk C-allele consistently had a higher risk for tophi (OR 2.05-2.15) than non-tophi (OR 0.91-1.62). SNP rs3733591 described 3.68% and 5.98% of the total variability in uric acid levels for Chinese and Solomon Island subjects, respectively.
Non-synonymous SNP rs3733591 variant within the SLC2A9 gene from two geographically diverse populations served as an important genetic checkpoint for tophaceous gout and increased uric acid levels.
Annals of the rheumatic diseases 10/2009; 69(5):887-90. · 8.11 Impact Factor
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Hung-Pin Tu,
Chung-Jen Chen, Chien-Hung Lee,
Silent Tovosia,
Albert Min-Shan Ko,
Shu-Jung Wang,
Tsan-Teng Ou,
Gau-Tyan Lin,
Shang-Lun Chiang,
Hung-Che Chiang,
Ping-Ho Chen,
Shun-Jen Chang,
Han-Ming Lai,
Ying-Chin Ko
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ABSTRACT: Gout is characterised by monosodium urate crystals in hyperuricemic individuals.[1, 2] Impaired excretion of urate exacerbates this condition.[1] Urate transporter 1 (encoded by SLC22A12) is an urate-anion exchanger in the kidneys mediating urate transportation across the proximal tubules' apical membrane.[3, 4] SLC22A12 has been reported to influence urate homeostasis in Caucasian and Japanese[5-8] but SNPs' genotype effect on gout is unclear. We studied four SLC22A12 single-nucleotide polymorphisms' (SNPs) associations with gout and urate levels in male Han Chinese of Taiwan and Solomon Islanders.
Annals of the rheumatic diseases 09/2009; 69(6):1252-4. · 8.11 Impact Factor
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Cheng-Che E Lan, Chien-Hung Lee,
Yi-Wei Lu,
Chi-Ling Lin,
Hsiu-Hui Chiu,
Tsai-Ching Chou,
Stephen Chu-Shung Hu,
Ching-Ying Wu,
Yi-Ying Kim,
Hui-Ju Yang,
Yin-Chun Chen,
Ching-Shuang Wu,
Hui-Yu Hsu,
Sheng-Lan Shieh,
Hsin-Su Yu,
Ying-Chin Ko,
Gwo-Shing Chen
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ABSTRACT: Atopic dermatitis (AD) is a chronic, relapsing dermatosis. Previous studies have focused mostly on pediatric patients, and investigations emphasizing adult AD have been limited.
We set out to determine the 1-year prevalence and evaluate the validity of the International Study of Asthma and Allergies in Childhood (ISAAC) and United Kingdom Working Party (UKWP) AD questionnaires of adult AD in Taiwan.
We conducted a cross-sectional study among nursing staff at a university hospital. The 1-year prevalence of AD was assessed by ISAAC and UKWP questionnaires. Subsequently, the dermatologists' diagnosis based on Hanifin and Rajka criteria was used as a reference for validation.
The overall response rate was 92.9%, equivalent to 1131 complete questionnaires. Ninety adult patients with AD (8%) were identified by dermatologists' diagnosis whereas ISAAC identified 107 (9.5%); sensitivity and specificity were 36.7% and 92.9%, respectively. UKWP identified 42 (3.7%) patients with AD; sensitivity and specificity were 42.2% and 99.6%, respectively. Using the receiver operating characteristic curve analysis, the UKWP criteria performed significantly better than its ISAAC counterpart. Further analysis indicated that modification of these criteria resulted in significant improvement in their diagnostic efficacy. More specifically, modified ISAAC showed 90.0% and 55.2% sensitivity and specificity, respectively, whereas modified UKWP demonstrated 82.2% and 94.2% sensitivity and specificity, respectively.
Most of the study subjects were female with a high educational background.
Currently available questionnaire instruments do not perform well in the identification of adult patients with AD. Modification of the original questionnaires may allow for future large-scale epidemiologic studies.
Journal of the American Academy of Dermatology 08/2009; 61(5):806-12. · 3.99 Impact Factor
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ABSTRACT: To retrospectively compare computed tomographic virtual gastroscopy (VG) and conventional optical gastroendoscopy for the differentiation of malignant and benign gastric ulcers.
The institutional review board approved this study and confirmed that informed consent was not required. Gastric ulcers in 115 patients (mean age, 64.7 years; range, 31-86 years; 61 men, 54 women) were evaluated by using endoscopy and VG. Ulcer shape, base, and margin and periulcer folds were evaluated by two independent reviewers. Malignant gastric ulcers were identified by irregular, angulated, or geographic shape; uneven base; irregular or asymmetric edges; and disrupted or moth-eaten appearance of periulcer folds near the crater edge and/or clubbed or fused folds. Benign gastric ulcers were identified by smooth and regular shapes, even bases, clearly demarcated and regular edges, and folds that tapered and converged toward the ulcer. The performance of VG and endoscopy for the diagnosis of benign and malignant gastric ulcers was evaluated by using histopathologic results as the reference standard. The McNemar test was used to compare VG and endoscopic data. A P value less than .05 was considered to indicate a significant difference.
At histopathologic examination, 39 gastric ulcers were benign, while 76 were malignant. VG and endoscopy had sensitivities of 92.1% (70 of 76) and 88.2% (67 of 76), respectively, for overall diagnosis of malignant gastric ulcers, and specificities of 91.9% (34 of 37) and 89.5% (34 of 38), respectively, for overall diagnosis of malignant gastric ulcers. Endoscopy was more sensitive in depicting malignancy according to ulcer base (85.5% [65 of 76] vs 68.4% [52 of 76]) (P = .034), and VG was more specific in depicting malignancy according to ulcer margin (78.4% [29 of 37] vs 63.2% [24 of 38]) (P = .034).
VG and endoscopy were almost equally useful in distinguishing between malignant and benign gastric ulcers.
http://radiology.rsnajnls.org/cgi/content/full/2522081249/DC1.
Radiology 07/2009; 252(2):410-7. · 5.73 Impact Factor
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Yu-Kuei Chen, Chien-Hung Lee,
I-Chen Wu,
Jia-Sin Liu,
Deng-Chyang Wu,
Jang-Ming Lee,
Yih-Gang Goan,
Shah-Hwa Chou,
Chia-Tsuan Huang,
Chun-Ying Lee,
Hsin-Chia Hung,
Jeng-Fu Yang,
Ming-Tsang Wu
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ABSTRACT: The main objective of this study was to further elucidate the effect of consuming various foods on the development of squamous cell carcinoma (SCC) in three different sections of the esophagus.
A total of 343 patients with SCC of the esophagus and 755 cancer-free control subjects were recruited for this study from 1996 to 2005.
We found that intake of vegetables, raw onions/garlic, and fruits are significantly protective against esophageal SSC risk, whereas intake of hot foods can significantly increase its risk. There was a significant inverse relation between the frequency of tea consumption and esophageal SCC risk (P for trend = 0.005), with a 0.5-fold lower risk associated with the intake of unfermented tea (green tea, oolong tea, or jasmine tea). The effects of dietary factors on esophageal SCC were similar in all subsites, with the exception of consumption of coffee. Coffee consumption was more pronounced in having a protective effect in the middle third section compared with the lower third section of the esophagus (adjusted odds ratio 0.4, 95% confidence interval 0.2-0.9), although this protective effect was marginally significant (adjusted odds ratio 0.6, 95% confidence interval 0.4-1.0) against esophageal SCC in all subsites. Our data also suggest that discomfort when eating hot foods may exert a carcinogenic effect by direct contact with the esophageal mucosa and tend to have more harmful effects in the upper than in the lower esophagus. In contrast, vegetables, fruits, and tea with components that are thought to inhibit carcinogenesis by absorbed components affected all subsites similarly.
Our results add additional information that certain dietary components may affect carcinogenesis locally and systemically.
Nutrition 05/2009; 25(7-8):753-61. · 3.03 Impact Factor
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ABSTRACT: Obesity is a well known risk factor for insulin resistance and type 2 diabetes. Recently discovered adipocyte-derived proteins (leptin and adiponectin) might contribute to the pathologic mechanism linking obesity and insulin resistance. A total of 190 non-diabetic women were recruited from the Obesity Clinic of Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, between February 2003 and February 2004. All participants completed a simple questionnaire. Blood pressure and body mass index were measured; blood samples for fasting glucose, total cholesterol, high-density lipoprotein cholesterol, triglyceride, leptin, adiponectin, and fasting insulin level were collected after an overnight fast. Two-hour glucose level after a 75-g glucose tolerance test was determined. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as the index of insulin resistance. Multivariate linear regression analyses were used to analyze the relationship between adipocytokines and insulin resistance after adjusting for possible confounding factors. Leptin and adiponectin were found to be independently associated with HOMA-IR and fasting insulin concentration, but in divergent directions, after adjusting for potential confounding factors. Adiponectin, but not leptin, was associated with impaired glucose tolerance after adjusting for potential confounding factors. The results suggest that leptin and adiponectin may be involved in the pathophysiologic link between obesity and insulin resistance independently. Low levels of adiponectin may increase the risks of developing impaired glucose metabolism and type 2 diabetes.
The Kaohsiung journal of medical sciences 04/2009; 25(3):116-25. · 0.61 Impact Factor
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ABSTRACT: The effect of betel quid chewing on colorectal cancer (CRC) risk has not been reported. In addition, there is no consensus about the causal relationship between smoking or alcohol consumption and CRC risk. This study investigated the impact of betel quid chewing, cigarette smoking or alcohol consumption on CRC risk in Taiwan.
Two hundred and fifty-eight patients with pathologically proven CRC (153 men, 105 women; mean age, 63.1 years) were recruited from two hospitals in southern Taiwan. The controls were 533 age- and gender-matched cancer-free subjects from the same hospitals. All subjects were interviewed using a standardized questionnaire to collect demographic and substance use data.
After adjusting for potential confounding factors, smoking (adjusted odds ratio [aOR], 1.65; 95% CI, 1.1-2.3), but not betel quid chewing (aOR, 1.3; 95% CI, 0.7-2.4) or alcohol drinking (aOR, 1.1; 95% CI, 0.7-1.8), was an independent significant risk factor for developing CRC. The significant risk effect of smoking was seen mainly among men, because the frequency of smokers was much higher among Taiwanese men than women.
Our results indicated that consumption of cigarettes but not betel quid or alcohol was a risk factor for male CRC. A large study is necessary to investigate the risk factors for female CRC in Taiwan, and to understand the effect of betel quid exposure on male CRC.
Journal of the Formosan Medical Association 03/2009; 108(2):155-63. · 1.13 Impact Factor
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ABSTRACT: Previous to this research, no literature had explored the clustering of betel quid chewing at the school-level and the contextual factors contributing to this behavior among elementary schoolchildren. This study therefore examines this in clusters stratified according to school geography and the rate of aboriginal students in each school. Individual-level characteristics are controlled in the study.
The data used derive from student and parent surveys of the School Smoking Survey Project from a sampling of third and fourth grade children from 13 elementary schools in Tao-Yuan County, Taiwan (n = 1585). The individual- and school-level characteristics regarding betel quid chewing were estimated using multi-level logistic regression analysis.
Compared to their counterparts, students attending schools with higher percentages of aboriginal students (OR = 3.60, 95% CI: 1.31-9.95), or those schools located in a mountainous region (OR = 2.82, 95% CI: 1.19-6.70), were found to have a greater risk of chewing behavior. Other observed characteristics having a significant relationship to student chewing behavior were drinking alcohol and smoking cigarettes.
The new findings from this study suggest that the specific school attended is an important point of intervention. Therefore, effective policies and preventive programs should be strongly considered for implementation in schools that are putting students at the greatest risk for betel quid chewing behavior. Our study also confirmed the relationship between betel quid chewing, cigarette smoking, and alcohol drinking, suggesting that multifaceted intervention strategies need to be considered in regard to such behaviors among elementary schoolchildren.
Community Dentistry And Oral Epidemiology 03/2009; 37(1):58-67. · 1.89 Impact Factor
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Chien-Hung Lee,
Deng-Chyang Wu,
I-Chen Wu,
Yih-Gang Goan,
Jang-Ming Lee,
Shah-Hwa Chou,
Te-Fu Chan,
Hsiao-Ling Huang,
Yu-Hsiu Hung,
Meng-Chuan Huang,
Tai-Cheng Lai,
Tsu-Nai Wang,
Cheng-Che E Lan,
Sharon Tsai,
Wen-Yi Lin,
Ming-Tsang Wu
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ABSTRACT: Genetic variants in alcohol dehydrogenase-1B (ADH1B) and aldehyde dehydrogenase-2 (ALDH2) genes modulate acetaldehyde removal upon alcohol ingestion. Although these genetic vulnerabilities have been linked to higher esophageal squamous cell carcinoma (ESCC) risks, it is unclear whether they also determine the time of malignancy presentation. The purpose of this investigation was to unravel genotoxic effects of the two alcohol-metabolizing genes with regard to alcohol and tobacco consumption on the age at ESCC diagnosis and tumor dissemination. ADH1B/ALDH2 genotyping was performed on lymphocyte DNA specimens taken from 406 consecutively registered incident patients with pathology-proven ESCC. To fully utilize individual genetic and survival information, survival analyses and gene-longevity applied approaches were introduced. Among heavy drinkers, the ADH1B Arg/Arg (55 years) and ALDH2 Glu/Lys genotypes (54 years) were found to confer a 15 and 16 years earlier carcinoma diagnosed age than His/His and Glu/Glu nondrinkers (both 70 years), respectively. For drinkers, 1-year age advancement was, separately, associated with a 0.977 and 0.953-fold stepwise reduced likelihood of being ADH1B Arg homozygote and ALDH2 Lys variant. Noticeably elevated hazard-ratio (HR) for drinkers of ADH1B slow-form genotype and ALDH2 inactive-form allele were identified in smokers (HR = 2.3-2.6), but no in nonsmokers. In smokers, appreciably higher cumulative cancer onset risks were correspondingly recognized from the age of 45 and 49 upward among any + Lys allele and Arg/Arg + Glu/Glu combined-ADH1B/ALDH2-genotype drinkers than nondrinkers. In conclusion, consumption of tobacco and alcohol, coupled with genetic susceptibilities associated with acetaldehyde elimination, as modulated by ADH1B and ALDH2 genotypes, determines a substantial magnitude of tumorigenetic effect on earlier age ESCC diagnosis.
International Journal of Cancer 03/2009; 125(5):1134-42. · 5.44 Impact Factor
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ABSTRACT: To compare the concentrations of visfatin in the plasma with those in follicular fluid of women undergoing controlled ovarian stimulation and to discover their correlation to the number of oocytes retrieved. Further, to examine whether FSH or hCG affects the expression of visfatin and whether visfatin affects COX-2 expression in cultured granulosa luteal (GL) cells.
A clinical and in vitro study.
University hospital.
Women subjected to IVF procedures were enrolled in the study.
Plasma and follicular fluid visfatin levels were analyzed using ELISA. HCG, FSH, PGE2 and visfatin were added to cultured GL cells.
Enzyme immunoassay and RT-PCR were performed.
There was no correlation between follicular fluid and plasma visfatin levels (r = 0.443). The number of oocytes retrieved was significantly correlated to follicular visfatin levels in multiple linear regression analysis (r = 0.891, r(2) = 0.794). In vitro experiments on GL cells revealed that hCG and PGE(2) considerably increased visfatin mRNA expression. FSH did not affect visfatin mRNA expression. Treatment with visfatin caused an induction of COX-2 mRNA.
The follicular fluid visfatin concentrations are correlated to the number of oocytes retrieved. Human GL cells produce visfatin, and visfatin synthesis is increased by hCG and PGE2 treatment. Visfatin can induce expression of COX-2 mRNA in GL cells.
Fertility and sterility 03/2009; 93(6):1844-50. · 3.97 Impact Factor
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ABSTRACT: The Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has recently introduced the prehypertension category of blood pressure status that needs monitoring and intervention. This study aimed to assess the prevalence of prehypertension and its associated risks in rural Taiwan.
From community-based cross-sectional data of 6204 adults (2650 men and 3554 women) who received general health examination in the Chi-Shan district in rural Taiwan, collected between 2002 and 2007, we analyzed and compared the blood pressure and demographic, metabolic, and behavior characteristics of prehypertensive and normotensive subjects. Multiple logistic regression methods were used to identify risk factors for prehypertension.
Within the study population, 3354 had hypertension, 1875 had prehypertension, and 975 had normal blood pressure. The prehypertensive subjects were older, had higher body mass index (BMI), and had higher blood glucose, total cholesterol, triglycerides, and uric acid levels than did the normotensive group. Multivariate logistic regression analysis revealed that BMI was the strongest predictor of prehypertension in both men and women (OR=1.102, 95% CI=1.054-1.152, P<0.001; and OR=1.121, 95% CI=1.085-1.159, P<0.001, respectively).
The prevalence of prehypertension is high among adults in rural Taiwan and it was associated with many risk factors for further hypertension and cardiovascular disease. Early lifestyle modifications, such as healthy diet, optimal weight control, and exercise are recommended interventions.
International journal of cardiology 02/2009; 144(2):269-73. · 7.08 Impact Factor
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Huang-Ming Hu,
Chao-Hung Kuo, Chien-Hung Lee,
I-Chen Wu,
Ka-Wo Lee,
Jang-Ming Lee,
Yih-Gang Goan,
Shah-Hwa Chou,
Ein-Long Kao,
Ming-Tsang Wu,
Deng-Chyang Wu
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ABSTRACT: Overexpression of Cyclooxygenase-2 (COX-2) was observed in many types of cancers, including esophageal squamous cell carcinoma (ESCC). One functional SNP, COX-2 -1195G/A, has been reported to mediate susceptibility of ESCC in Chinese populations. In our previous study, the presence of Helicobacter pylori (H. pylori) was found to play a protective role in development of ESCC. The interaction of COX-2 and H. pylori in gastric cancer was well investigated. However, literature on their interaction in ESCC risk is scarce. The purpose of this study was to evaluate the association and interaction between COX-2 single nucleotide polymorphism (SNP), H. pylori infection and the risk of developing ESCC.
One hundred and eighty patients with ESCC and 194 controls were enrolled in this study. Personal data regarding related risk factors, including alcohol consumption, smoking habits and betel quid chewing, were collected via questionnaire. Genotypes of the COX-2 -1195 polymorphism were determined by PCR-based restriction fragment length polymorphism. H. pylori seropositivity was defined by immunochromatographic screening test. Data was analyzed by chi-squared tests and polytomous logistics regression.
In analysis adjusting for the covariates and confounders, H. pylori seropositivity was found to be inversely association with the ESCC development (adjusted OR: 0.5, 95% CI: 0.3 - 0.9). COX-2 -1195 AA homozygous was associated with an increased risk of contracting ESCC in comparison with the non-AA group, especially among patients with H. pylori seronegative (adjusted OR ratio: 2.9, 95% CI: 1.2 - 7.3). The effect was strengthened among patients with lower third ESCC (adjusted OR ratio: 6.9, 95% CI 2.1 - 22.5). Besides, H. pylori seropositivity conveyed a notably inverse effect among patients with COX-2 AA polymorphism (AOR ratio: 0.3, 95% CI: 0.1 - 0.9), and the effect was observed to be enhanced for the lower third ESCC patients (AOR ratio: 0.09, 95% CI: 0.02 - 0.47, p for multiplicative interaction 0.008)
H. pylori seropositivity is inversely associated with the risk of ESCC in Taiwan, and COX-2 -1195 polymorphism plays a role in modifying the influence between H. pylori and ESCC, especially in lower third esophagus.
BMC Gastroenterology 02/2009; 9:37. · 2.42 Impact Factor
