Publications by authors named "Ming Hung Lin"

22 Publications

  • Page 1 of 1

The pharmaceutical practice of mask distribution by pharmacists in Taiwan's community pharmacies under the Mask Real-Name System, in response to the COVID-19 outbreak.

Cost Eff Resour Alloc 2020 19;18:45. Epub 2020 Oct 19.

Department of Pharmacy and Master Program, Tajen University, Pintung, 90741 Taiwan.

Background: Pharmacists hold to their promise to foster, implement and promote the health of the population and to prevent disease, given their knowledge, skills, and proximity to the locals. The objective of this study was to foster equality and cost-effectiveness in the distribution and sale of masks to all Taiwanese citizens, in response to the COVID-19 pandemic.

Methods: All 6336 special community pharmacies participating in the NHI (National Health Insurance) served as mask-selling sites. Access to masks by citizens was determined and controlled, based on the weekly rationing of the number of purchasable masks per citizen and the last digit of their NHI card number. Masks were available on different weekdays for holders of cards ending with odd and even numbers, except on Sundays, when everyone was eligible to buy a mask.

Results: Implementing the program has provided equal access to masks for all citizens across Taiwan. It has stabilized the pricing of masks and mitigated the public's anxiety of a perceived likely market shortage.

Conclusion: The community pharmacy-based approach to the distribution of prevention face masks to citizens represents a new and innovative engagement of pharmacists in public health promotion and protection initiatives. Community pharmacies can greatly improve the efficiency, reliability, and cost-saving of the distribution of public health resources to local communities, especially in the face of an epidemic.
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http://dx.doi.org/10.1186/s12962-020-00239-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7570415PMC
October 2020

Secondhand smoke effects on rhinoconjunctivitis and sleep quality in an adolescent asthma study.

Ann Allergy Asthma Immunol 2020 12 12;125(6):717-719. Epub 2020 Aug 12.

Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan; College of Public Health, China Medical University, Taichung, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.anai.2020.08.014DOI Listing
December 2020

Risk of mental illness after the diagnosis of occupational injury or disease: a retrospective cohort study.

Int Arch Occup Environ Health 2021 Jan 18;94(1):55-68. Epub 2020 Jun 18.

Department of Health Services Administration, China Medical University, Taichung, 40402, Taiwan.

Objectives: As studies on mental disorders in victims of occupational injury or disease are limited, this study aims to evaluate the risk of, and factors associated with, the development of mental illness in patients with occupational injury or disease using insurance claims data from Taiwan.

Methods: This retrospective cohort study analyzed insurance records in Taiwan to identify 18,285 adults who experienced occupational injury or disease in 2002-2013 and 18,285 adults without occupational injury or disease who were matched by propensity score. The risks of mental disorders during a follow-up period of up to 2 years were estimated and compared between the two cohorts.

Results: After controlling for other variables, the odds of mental illness in patients with occupational injury or disease was significantly higher compared to patients without occupational injury or disease. Additional factors associated with higher odds of mental disorders included female gender, age ≥ 30 years (vs. 20-29 years), Charlson comorbidity index ≥ 1, occupation category of labor union member, soldier, insured by social security, religious group member (vs. private or government employee), lower premium-based monthly salary (≤ 576 US$), treatment at a district hospital or clinic (vs. medical center), treatment at a publically-owned or consortium-owned hospital (vs. private hospital), and central or southeast geographic location (vs. Taipei). The main types of mental illness were anxiety disorder (2.79%) and other psychoses (3.29%).

Conclusion: The risk of mental illness slightly increased during the 2-year period after the diagnosis of occupational injury or disease.
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http://dx.doi.org/10.1007/s00420-020-01558-xDOI Listing
January 2021

Occupational health and safety hazards faced by healthcare professionals in Taiwan: A systematic review of risk factors and control strategies.

SAGE Open Med 2020 18;8:2050312120918999. Epub 2020 May 18.

Department of Pharmacy and Master Program, Tajen University, Pingtung, Taiwan.

Background: Healthcare professionals in Taiwan are exposed to a myriad of occupational health and safety hazards, including physical, biological, chemical, ergonomic, and psychosocial hazards. Healthcare professionals working in hospitals and healthcare facilities are more likely to be subjected to these hazards than their counterparts working in other areas.

Objectives: This review aims to assess current research literature regarding this situation with a view to informing policy makers and practitioners about the risks of exposure and offer evidence-based recommendations on how to eliminate or reduce such risks.

Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses review strategy, we conducted a systematic review of studies related to occupational health and safety conducted between January 2000 and January 2019 using MEDLINE (Ovid), PubMed, PMC, TOXLINE, CINAHL, PLOS One, and Access Pharmacy databases.

Results: The review detected 490 studies addressing the issue of occupational health and safety hazards; of these, 30 articles were included in this systematic review. These articles reported a variety of exposures faced by healthcare professionals. This review also revealed a number of strategies that can be adopted to control, eliminate, or reduce hazards to healthcare professionals in Taiwan.

Conclusion: Hospitals and healthcare facilities have many unique occupational health and safety hazards that can potentially affect the health and performance of healthcare professionals. The impact of such hazards on healthcare professionals poses a serious public health issue in Taiwan; therefore, controlling, eliminating, or reducing exposure can contribute to a stronger healthcare workforce with great potential to improve patient care and the healthcare system in Taiwan. Eliminating or reducing hazards can best be achieved through engineering measures, administrative policy, and the use of personal protective equipment.

Implications: This review has research, policy, and practice implications and provides future students and researchers with information on systematic review methodologies based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy. It also identifies occupational health and safety risks and provides insights and strategies to address them.
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http://dx.doi.org/10.1177/2050312120918999DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235655PMC
May 2020

Sleepiness and injury risk in emergency medical service workers in Taiwan.

PLoS One 2020 24;15(2):e0229202. Epub 2020 Feb 24.

Department of Health Services Administration, China Medical University, Taichung, Taiwan.

Background: Insufficient sleep is a common health and safety risk factor in high-impact workplaces where workers are required to take rotating shifts. However, studies on sleepiness-related risks and incidents, particularly among emergency medical services (EMS) workers are limited.

Objective: This study sought to investigate the prevalence of sleepiness and related workplace incidents among EMS workers.

Methods: This study utilized a cross-sectional survey design on a convenient sample of 500 EMS workers from 41 EMS squads across Taiwan. Data were collected using structured online questionnaires on workplace sleepiness and related safety incidents based on the Epworth Sleepiness Scale (ESS) and a modified 25-item EMS Safety Inventory respectively.

Results: With a response rate of 79.8% (n = 399), 36.9% of the respondents were identified as having mild daytime sleepiness, while 39.2% of the respondents were identified as having excessive daytime sleepiness. Multivariate analysis indicated that not only was working on rotating shifts the main cause of the high ESS scores among EMS workers, but also that higher ESS scores increased their risk of sustaining a workplace injury. Furthermore, ill-at-work incidents were associated with an increased risk of workplace-related injuries.

Conclusion: Overall, the findings indicated a correlation among working on rotation shifts, the prevalence of sleepiness, and a higher risk of workplace injury among EMS workers.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0229202PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039431PMC
June 2020

Stroke risks in women with dysmenorrhea by age and stroke subtype.

PLoS One 2019 12;14(11):e0225221. Epub 2019 Nov 12.

Department of Health Service Administration, China Medical University, Taichung, Taiwan.

Background: Dysmenorrhea and stroke are health problems affecting women worldwide in their day-to-day lives; however, there is limited knowledge of the stroke risk in women with dysmenorrhea, and there have been no studies assessing the specific distribution of stroke subtypes. This case-control study assessed stroke subtypes by age and the role of comorbidities in women with dysmenorrhea.

Methods And Findings: Data obtained between 1997 and 2013 from Taiwan's health insurance database identified 514 stroke cases and 31,201 non-stroke controls in women with dysmenorrhea aged 15-49 years. Proportional distributions of subtypes and odds ratios (ORs) of stroke associated with comorbidities by age and subtype were measured. We found that the stroke risk in dysmenorrheal patients increased with age, and that hypertension was nine-fold more prevalent in the stroke cases than in the controls and was associated with an adjusted OR of 4.53 (95% confidence interval (CI) = 3.46-5.92) for all stroke cases. Moreover, the proportion of hemorrhagic stroke was greater than that of ischemic stroke in younger dysmenorrheal patients between 15-24 years old (50.5% vs. 11.4%), whereas this was reversed in those aged 30-49 years old (16.1% vs. 21.0%). Overall, 25.3% of the stroke cases consisted of transient cerebral ischemia and 31.3% were other acute but ill-defined cerebrovascular diseases, in which the prevalence increased with age for both types of strokes. Hypertension was the comorbidity with the highest OR associated with each subtype stroke; diabetes, hyperlipidemia, arrhythmia, and thyroid disease were also comorbidities that were significantly associated with ill-defined cerebrovascular diseases.

Conclusions: The stroke type varies by age in dysmenorrheal patients, and hypertension is the most important comorbidity associated with all types of stroke; therefore, more attention for stroke prevention must be paid to women with dysmenorrhea, particularly when combined with comorbidities.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0225221PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6850544PMC
March 2020

Capsaicin Targets tNOX (ENOX2) to Inhibit G1 Cyclin/CDK Complex, as Assessed by the Cellular Thermal Shift Assay (CETSA).

Cells 2019 10 18;8(10). Epub 2019 Oct 18.

Division of Urology, Department of Surgery, An Nan Hospital, China Medical University, Tainan 70965, Taiwan.

Capsaicin (8-methyl--vanillyl-6-noneamide), which is an active component in red chili peppers, is used as a chemopreventive agent that shows favorable cytotoxicity against cancer cells. Accumulating evidence indicates that capsaicin preferentially inhibits a tumor-associated NADH oxidase (tNOX, ENOX2) that is ubiquitously expressed in cancer but not in non-transformed cells. This attenuates cancer cell growth by inducing apoptosis. The capsaicin-mediated inhibition of tNOX was recently shown to prolong the cell cycle. However, the molecular events underlying this regulation have not yet been investigated. In the present study, we used a cellular thermal shift assay (CETSA) to detect "target engagement" of capsaicin and its consequent impact on cell cycle progression. Our results indicated that capsaicin engaged with tNOX and triggered the proteasomal degradation of tNOX, which leads to the inhibition of NAD-dependent SIRT1 deacetylase. Ultimately, the acetylation levels of c-Myc and p53 were enhanced, which suppressed the activation of G1 cyclin/Cyclin-dependent kinase complexes and triggered cell cycle arrest in cancer cells. The results obtained when tNOX was overexpressed in non-cancer cells validated its importance in cell cycle progression. These findings provide the first molecular insights into the regulatory role of tNOX and the anti-proliferative property of capsaicin in regulating the cell cycle of bladder cancer cells.
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http://dx.doi.org/10.3390/cells8101275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830080PMC
October 2019

Capsaicin attenuates cell migration via SIRT1 targeting and inhibition to enhance cortactin and β-catenin acetylation in bladder cancer cells.

Am J Cancer Res 2019 1;9(6):1172-1182. Epub 2019 Jun 1.

Division of Urology, Department of Surgery, An Nan Hospital, China Medical University Tainan 70965, Taiwan.

We have studied the chemopreventive property of capsaicin, a major active component in chili pepper, and found that it exhibited apoptotic activity against various lines of cancer cells. Interestingly, accumulating data has revealed that, in addition to cytotoxicity, capsaicin also plays regulatory role on cell migration and invasion. However, its effect on cell migration is paradoxical and not completely understood. Here, we set out to elucidate the molecular events underlying capsaicin-inhibited cell migration in bladder cancer cells. Our results show that the capsaicin-reduced cell migration was associated with down-regulation of sirtuin 1 (SIRT1) deacetylase, possibly through proteasome-mediated protein degradation. More importantly, we employed a cellular thermal shift assay (CETSA) to demonstrate that there was a direct binding between capsaicin and SIRT1. The engagement with capsaicin and protein degradation diminished the deacetylase of SIRT1, which in turn, enhanced acetylation of cortactin and β-catenin to decrease MMP-2 and MMP-9 activation, resulting in cell migration impairment in bladder cancer cells.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6610058PMC
June 2019

Associations between urate-lowering therapy and the risk of type 2 diabetes mellitus.

PLoS One 2019 7;14(1):e0210085. Epub 2019 Jan 7.

Department of Public Health, China Medical University, Taichung, Taiwan.

Background: Gout is independently associated with increased risk of type 2 diabetes mellitus (T2DM). Urate-lowering therapy (ULT) might be beneficial in lowering the risks of T2DM. Therefore, we conducted a nested case-control study to evaluate the associations between ULT and T2DM.

Methods: This study retrieved the data of 29,765 gout patients from the period of 1998-2010 by using data from Taiwan's National Health Insurance Research Database. Controls (n = 59,530) were matched at a 1:2 ratio by age, sex, and region. Multivariate Cox proportional hazards regression were performed to examine the dose-dependent relationship between ULT and T2DM.

Results: The adjusted Hazard ratio (HR) for the association of T2DM with allopurinol or benzbromarone exposure was 1.17 (95% confidence interval (CI) 1.07-1.28) and1.09 (95% CI 1.03-1.15), respectively. The HR for the cumulative allopurinol dose was 0.87 (95% CI 0.71-1.07) for patients with dose ≤1.3 mg/day and was 1.31 (95% CI 1.13-1.52) for those with a dose >15.2 mg/day. Similarly, the HR for the cumulative benzbromarone dose was 0.85(95% CI 0.75-0.96) for patients with a dose ≤1.3 mg/day and 1.42 (95% CI 1.30-1.55) for patients with a dose>9.4 mg/day, respectively. Moreover, the average exposure dose of >100 mg/day for allopurinol and >100 mg/day for benzbromarone was associated with a 1.28-fold (95% CI 1.11-1.48) and 1.47-fold (95% CI 1.23-1.76) T2DM risk respectively. The HR for patients in aged >50 years group with cumulative dose ≤1.3 mg/day of allopurinol or benzbromarone had lower risk of T2DM (HR = 0.74, 95% CI 0.58-0.94 for allopurinol; HR = 0.79, 95% CI 0.69-0.90 for benzbromarone).

Conclusion: Gout patients with prolonged ULT and a high dose of ULT were associated with a significant increase in T2DM risk. Although gout patients with age greater than 50 years and a lower dose of ULT may be beneficial in lowering T2DM risk, further clinical studies need to be confirmed these associations.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210085PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322774PMC
September 2019

Aminomethylation of heliomycin: Preparation and anticancer characterization of the first series of semi-synthetic derivatives.

Eur J Med Chem 2018 Jan 19;143:1553-1562. Epub 2017 Oct 19.

Institute of Biomedical Sciences, National Chung Hsing University, Taichung, 40227, Taiwan; Graduate Institute of Basic Medicine, China Medical University, Taichung, 40402, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, 40402, Taiwan; Department of Biotechnology, Asia University, Taichung, 41354, Taiwan. Electronic address: https://dragon.nchu.edu.tw.

A series of 4-aminomethyl derivatives of heliomycin 1 was prepared using the Mannich reaction. The modification significantly improved aqueous solubility of the initially poorly soluble antibiotic. Testing the antiproliferative efficacy revealed a potent activity of heliomycin as well as its new derivatives on a panel of mammalian tumor cells including drug resistant variants. In contrast to 1 the new derivatives 7a, 7l, 7p generated a high level of ROS associated with induction of apoptosis in T24 bladder cancer cells. Introduction of 4-aminomethyl moiety increased the affinity to DNA and the ability to inhibit topoisomerase 1 making 7p the most promising candidate for further preclinical evaluation. Thus, aminomethylation is the first-in-class successful transformation of the antibiotic 1 resulting in an improved water solubility of derivatives and promising properties in search of novel anticancer drug candidates.
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http://dx.doi.org/10.1016/j.ejmech.2017.10.055DOI Listing
January 2018

Investigating spousal concordance of diabetes through statistical analysis and data mining.

PLoS One 2017 17;12(8):e0183413. Epub 2017 Aug 17.

Department of Public Health, China Medical University, Taichung, Taiwan.

Objective: Spousal clustering of diabetes merits attention. Whether old-age vulnerability or a shared family environment determines the concordance of diabetes is also uncertain. This study investigated the spousal concordance of diabetes and compared the risk of diabetes concordance between couples and noncouples by using nationally representative data.

Methods: A total of 22,572 individuals identified from the 2002-2013 National Health Insurance Research Database of Taiwan constituted 5,643 couples and 5,643 noncouples through 1:1 dual propensity score matching (PSM). Factors associated with concordance in both spouses with diabetes were analyzed at the individual level. The risk of diabetes concordance between couples and noncouples was compared at the couple level. Logistic regression was the main statistical method. Statistical data were analyzed using SAS 9.4. C&RT and Apriori of data mining conducted in IBM SPSS Modeler 13 served as a supplement to statistics.

Results: High odds of the spousal concordance of diabetes were associated with old age, middle levels of urbanization, and high comorbidities (all P < 0.05). The dual PSM analysis revealed that the risk of diabetes concordance was significantly higher in couples (5.19%) than in noncouples (0.09%; OR = 61.743, P < 0.0001).

Conclusions: A high concordance rate of diabetes in couples may indicate the influences of assortative mating and shared environment. Diabetes in a spouse implicates its risk in the partner. Family-based diabetes care that emphasizes the screening of couples at risk of diabetes by using the identified risk factors is suggested in prospective clinical practice interventions.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183413PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560637PMC
October 2017

Capsaicin Inhibits Multiple Bladder Cancer Cell Phenotypes by Inhibiting Tumor-Associated NADH Oxidase (tNOX) and Sirtuin1 (SIRT1).

Molecules 2016 Jun 28;21(7). Epub 2016 Jun 28.

Institute of Biomedical Sciences, National Chung Hsing University, Taichung 40227, Taiwan.

Bladder cancer is one of the most frequent cancers among males, and its poor survival rate reflects problems with aggressiveness and chemo-resistance. Recent interest has focused on the use of chemopreventatives (nontoxic natural agents that may suppress cancer progression) to induce targeted apoptosis for cancer therapy. Capsaicin, which has anti-cancer properties, is one such agent. It is known to preferentially inhibit a tumor-associated NADH oxidase (tNOX) that is preferentially expressed in cancer/transformed cells. Here, we set out to elucidate the correlation between tNOX expression and the inhibitory effects of capsaicin in human bladder cancer cells. We showed that capsaicin downregulates tNOX expression and decreases bladder cancer cell growth by enhancing apoptosis. Moreover, capsaicin was found to reduce the expression levels of several proteins involved in cell cycle progression, in association with increases in the cell doubling time and enhanced cell cycle arrest. Capsaicin was also shown to inhibit the activation of ERK, thereby reducing the phosphorylation of paxillin and FAK, which leads to decreased cell migration. Finally, our results indicate that RNA interference-mediated tNOX depletion enhances spontaneous apoptosis, prolongs cell cycle progression, and reduces cell migration and the epithelial-mesenchymal transition. We also observed a downregulation of sirtuin 1 (SIRT1) in these tNOX-knockdown cells, a deacetylase that is important in multiple cellular functions. Taken together, our results indicate that capsaicin inhibits the growth of bladder cancer cells by inhibiting tNOX and SIRT1 and thereby reducing proliferation, attenuating migration, and prolonging cell cycle progression.
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http://dx.doi.org/10.3390/molecules21070849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6272932PMC
June 2016

Melatonin Supplementation for Children With Atopic Dermatitis and Sleep Disturbance: A Randomized Clinical Trial.

JAMA Pediatr 2016 Jan;170(1):35-42

Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan8Graduate Institute of Immunology, College of Medicine, National Taiwan University, Taipei, Taiwan9Department of Medical Research, National Taiwan University Hospital.

Importance: Sleep disturbance is common in children with atopic dermatitis (AD), but effective clinical management for this problem is lacking. Reduced levels of nocturnal melatonin were found to be associated with sleep disturbance and increased disease severity in children with AD. Melatonin also has sleep-inducing and anti-inflammatory properties and therefore might be useful for the management of AD.

Objective: To evaluate the effectiveness of melatonin supplementation for improving the sleep disturbance and severity of disease in children with AD.

Design, Setting, And Participants: This randomized clinical trial used a double-blind, placebo-controlled crossover design to study 73 children and adolescents aged 1 to 18 years with physician-diagnosed AD involving at least 5% of the total body surface area. The study was conducted at the pediatric department of a large tertiary care hospital in Taiwan from August 1, 2012, through January 31, 2013. Forty-eight children were randomized 1:1 to melatonin or placebo treatment, and 38 of these (79%) completed the cross-over period of the trial. Final follow-up occurred on April 13, 2013, and data were analyzed from January 27 to April 25, 2014. Analyses were based on intention to treat.

Interventions: Melatonin, 3 mg/d, or placebo for 4 weeks followed by a 2-week washout period and then crossover to the alternate treatment for 4 weeks.

Main Outcomes And Measures: The primary outcome was AD severity evaluated using the Scoring Atopic Dermatitis (SCORAD) index, with scores ranging from 0 to 103 and greater scores indicating worse symptoms. Secondary outcomes included sleep variables measured by actigraphy, subjective change in sleep and dermatitis, sleep variables measured by polysomnography, nocturnal urinary levels of 6-sulfatoxymelatonin, and serum IgE levels.

Results: After melatonin treatment among the 48 children included in the study, the SCORAD index decreased by 9.1 compared with after placebo (95% CI, -13.7 to -4.6; P < .001), from a mean (SD) of 49.1 (24.3) to 40.2 (20.9). Moreover, the sleep-onset latency shortened by 21.4 minutes after melatonin treatment compared with after placebo (95% CI, -38.6 to -4.2; P = .02). The improvement in the SCORAD index did not correlate significantly with the change in sleep-onset latency (r = -0.04; P = .85). No patient withdrew owing to adverse events, and no adverse event was reported throughout the study.

Conclusions And Relevance: Melatonin supplementation is a safe and effective way to improve the sleep-onset latency and disease severity in children with AD.

Trial Registration: clinicaltrials.gov Identifier: NCT01638234.
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http://dx.doi.org/10.1001/jamapediatrics.2015.3092DOI Listing
January 2016

Risk of lingual plate perforation for virtual immediate implant placement in the posterior mandible: A computer simulation study.

J Am Dent Assoc 2015 Oct;146(10):735-42

Background: This study sought to determine which factors are correlated to a higher risk of lingual plate perforation (LPP) when placing a virtual implant in the area of the anticipated extraction site of the posterior mandible.

Methods: Computed tomographic images of 300 patients (1,279 teeth) were analyzed in regard to the shape of the mandible (convergent, parallel, or undercut type), dimensional parameters of lingual concavity (angle, height, depth) and its relation to the inferior alveolar canal (zones A, B, C), distance from root apex to inferior alveolar canal, and probability of LPP. The odds ratio of variables was determined by multiple logistic regression modeling.

Results: The overall probability of LPPs on virtual implant placement was 3.1%. This perforation was most commonly observed at the second molar and with a U-type ridge. After adjusting cofounders, a concave point located in zone A is 17.34 times more likely to have a LPP than one in zone C. The probability of LPPs was reduced by 34% for every 1-millimeter increase in distance from root apex to inferior alveolar canal on virtual implant placement of posterior mandible region.

Conclusions: Three-dimensional cone-beam computed tomographic imaging is essential for planning immediate implant placement in the anticipated extraction sites of the posterior mandible region as proved by anatomic findings that can only be understood from preoperative imaging analysis.

Practical Implications: Presurgical cross-sectional images can be analyzed to identify anatomic features relative to the lingual concavities in the posterior mandible region, which can help to avoid unpleasant complications, specifically when performing immediate implant procedures.
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http://dx.doi.org/10.1016/j.adaj.2015.04.027DOI Listing
October 2015

Risk assessment of inferior alveolar nerve injury for immediate implant placement in the posterior mandible: a virtual implant placement study.

J Dent 2014 Mar 3;42(3):263-70. Epub 2014 Jan 3.

Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan. Electronic address:

Objectives: To investigate the prevalence and morphological parameters of lingual concavity, and whether these factors are related to a higher risk of inferior alveolar nerve (IAN) injury when performing an immediate implant surgery in posterior mandible region.

Methods: The CBCT images from 237 subjects (1008 teeth) were analysed the shape of the mandibles (C, P, U type), dimensional parameters of lingual concavity (angle, height, depth), and its relation to inferior alveolar canal (IAC) (A, B, C zone), RAC (distance from root apex to IAC) and probability of IAN injury. Multiple logistic regression modelling to determine the odds ratio of variables that made an important contribution to the probability of IAN injury and to adjust for confounding variables.

Results: The U type ridge (46.7%) and the most concave point located at C zone (48.8%) are most prevalent in this region. The mandibular second molar presents highest risk for IAN injury than other tooth type (p<0.001), which were 3.82 times to occur IAN injury than the mandibular second premolar. The concave point located at A zone and B zone were 7.82 and 3.52 times than C zone to have IAN damage, respectively. The probability of IAN injury will reduce 26% for every 1mm increase in RAC (p<0.001).

Conclusions: The tooth type, morphological features of lingual concavities, and RAC are associated with risks of IAN injury during immediate implant placement.

Clinical Significance: Pre-surgical mapping of the IAC and identification of its proximity relative to the lingual concavity in the posterior mandible regions may avoid unpleasant complications, specifically when performing immediate implant procedures.
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http://dx.doi.org/10.1016/j.jdent.2013.12.014DOI Listing
March 2014

Association of time-location patterns with urinary cotinine among asthmatic children under household environmental tobacco smoke exposure.

Environ Res 2013 Jul 23;124:7-12. Epub 2013 Apr 23.

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Introduction: Environmental tobacco smoke (ETS) is a hazardous component of indoor air, and may increase the risk of respiratory diseases, atherosclerosis and otitis media in children. In this study, we explored the relationship between time inside the house, ETS exposure and urinary cotinine level, and also determined the association of time inside the house on asthma phenotypes when children exposed to ETS.

Methods: A total of 222 asthmatic children and 205 non-asthmatic controls were recruited in the Genetic and Biomarker study for Childhood Asthma (GBCA). Structured questionnaires and time-location pattern questionnaires were administered by face-to-face interview. Urinary cotinine was measured by liquid chromatography tandem mass spectrometry (LC/MS/MS). The level of household ETS exposure was assessed using the cotinine/creatinine ratio (CCR).

Results: In general, urinary cotinine and CCR were higher in subjects exposed to household ETS than those who never had ETS at home. A significant positive relationship was found between average time inside the house and urinary CCR in asthmatic children with current ETS at home (β=0.278, p=0.02). After adjustment for age and gender, average time inside the house was positively related to severe wheeze in asthmatic children with household ETS within 1 month (OR: 1.26, 95%: 1.02-1.64).

Conclusions: Our study suggests that the major source of ETS exposure for children is due to longer period of exposures among children living with adult smokers at home. Home-smoking restrictions that effectively prevent children from being exposed to ETS would be worthwhile.
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http://dx.doi.org/10.1016/j.envres.2013.03.002DOI Listing
July 2013

Combining prostrate-specific antigen and Gleason score increases the diagnostic power of endorectal coil magnetic resonance imaging in prostate cancer pathological stage.

J Chin Med Assoc 2013 Jan 23;76(1):20-4. Epub 2012 Nov 23.

Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.

Background: The proper use of endorectal coil MRI (eMRI) images provide detailed information for the real extent of locally prostate cancer invasion and involvement of pelvic lymph nodes. This study evaluated the accuracy of endorectal coil magnetic resonance imaging (eMRI) results, combining the preoperative prostate-specific antigen (PSA), and the biopsy Gleason score to improve the diagnostic accuracy of prostate cancer (PCa) with organ-confined disease (OCD) or extracapsular extension (ECE)/seminal vesicle invasion (SVI).

Methods: Between 2001 and 2007, 94 PCa patients received eMRI testing during presurgical evaluation and underwent radical prostatectomy. As a part of routine patient workup, serum PSA level and Gleason score after pathology examination were recorded. The eMRI images were used to help assess patient PCa staging status regarding OCD or ECE/SVI. These stage assessments as evaluated through the use of MRI were compared with the final specimen pathological stage after the patients underwent radical prostatectomy.

Results: Of the total 94 patients in our study, 65 had stage pT2, 12 had stage pT3a, and 17 had stage pT3b PCa. In patients with clinical stage T2 PCa, the Gleason score significantly improved the discriminative ability of eMRI to successfully predict PCa at the OCD stage. Otherwise, in cases of clinical stage T3 PCa, accurate determination of PSA levels significantly improved eMRI predictive ability to assess ECE or SVI staging.

Conclusion: In clinical stage T2 PCa patients, integrating the biopsy Gleason score improved the discriminative ability to assess OCD PCa staging. Additionally, combining the preoperative PSA levels of clinical T3 prostate cancer cases with Gleason scores significantly improved the sensitivity and accuracy of eMRI diagnosis to distinguish ECE from SVI.
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http://dx.doi.org/10.1016/j.jcma.2012.09.005DOI Listing
January 2013

Recommendations on bioanalytical method stability implications of co-administered and co-formulated drugs by Global CRO Council for Bioanalysis (GCC).

Bioanalysis 2012 Sep;4(17):2117-26

Advion Bioanalytical Laboratories, Quintiles, NY, USA.

An open letter written by the Global CRO Council for Bioanalysis (GCC) describing the GCC survey results on stability data from co-administered and co-formulated drugs was sent to multiple regulatory authorities on 14 December 2011. This letter and further discussions at different GCC meetings led to subsequent recommendations on this topic of widespread interest within the bioanalytical community over the past 2 years.
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http://dx.doi.org/10.4155/bio.12.192DOI Listing
September 2012

4th Global CRO Council for Bioanalysis: coadministered drugs stability, EMA/US FDA guidelines, 483s and carryover.

Bioanalysis 2012 Apr;4(7):763-8

The Global CRO Council for Bioanalysis (GCC) was formed in September 2010. Since then, the representatives of the member companies come together periodically to openly discuss bioanalysis and the regulatory challenges unique to the outsourcing industry. The 4th GCC Closed Forum brought together experts from bioanalytical CROs to share and discuss recent issues in regulated bioanalysis, such as the impact of coadministered drugs on stability, some differences between European Medicines Agency and US FDA bioanalytical guidance documents and lessons learned following recent Untitled Letters. Recent 483s and agency findings, as well as issues on method carryover, were also part of the topics discussed.
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http://dx.doi.org/10.4155/bio.12.48DOI Listing
April 2012

Medulloblastoma presenting with pure word deafness: report of one case and review of literature.

Pediatr Neonatol 2011 Oct 2;52(5):290-3. Epub 2011 Oct 2.

Department of Pediatrics, Cardinal Tien Hospital Yonghe Branch, New Taipei City, Taiwan.

Pure word deafness (PWD) is a rare disorder characterized by impaired verbal comprehension sparing discrimination and recognition of nonverbal sounds with relatively normal spontaneous speech, writing, and reading comprehension. Etiologies of this syndrome are varied, and there are rare reports about brain tumor with PWD in children. We report a case of medulloblastoma presented with PWD in a 7-year-old girl. She visited our outpatient clinic because of English dictation performance deterioration. PWD was diagnosed by the otolaryngologist after examinations. Posterior fossa tumor and obstructive hydrocephalus were shown in the magnetic resonance imaging of the brain. The diagnosis of medulloblastoma was then made by pathology.
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http://dx.doi.org/10.1016/j.pedneo.2011.06.009DOI Listing
October 2011

Molecular and functional studies of tilapia (Oreochromis mossambicus) NMDA receptor NR1 subunits.

Comp Biochem Physiol B Biochem Mol Biol 2007 Mar 6;146(3):402-11. Epub 2006 Dec 6.

Department of Life Science, National Tsing Hua University, Hsinchu, Taiwan, Republic of China.

NMDA (N-methyl-d-aspartate) receptor, a subclass of the ionotropic glutamate receptors, participates in synaptic transmission and plays important roles in various higher brain functions in the vertebrate central nervous system. Here, we report the cloning of two NR1 subunits of tilapia (Oreochromis mossambicus). Phylogenetic analysis strongly supports that the two tilapia NR1 genes are paralogous, resulting from a gene duplication event in the teleost lineage. The electrophysiological and pharmacological properties of the tilapia NR1.2 subunit coexpressed with rat NR2B in the Xenopus oocytes are similar to that of the recombinant rat NR1/NR2B. Both tilapia NR1 transcripts are alternatively spliced at the N and C terminal coding regions. The C terminal exons, C1' and C1", originally discovered in the knifefish NR1 gene, are present in the tNR1.1 but not in the tNR1.2. Majorities of the NR1 transcripts expressed in the tilapia and zebrafish brains do not include these alternative splice exons. The splicing patterns of NR1 transcripts differ in various brain subregions. The regional expression patterns of splice variants are not fully preserved between tilapia and zebrafish. Nevertheless, tectum opticum regions of teleost and rat express high levels of NR1 splicing variant with N1 cassette.
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http://dx.doi.org/10.1016/j.cbpb.2006.11.026DOI Listing
March 2007