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Biomedical subjects

A T Cheng

Publications and source records attributed to A T Cheng.

At least 19 recordsLinked to original sources
PubMed1999

Community-based molecular epidemiology of HTLV type I in Taiwan and Kinmen: implication of the origin of the cosmopolitan subtype in northeast Asia.

To understand the possible origin and dissemination of HTLV-I infection in northeast Asia, community-based molecular epidemiological studies were conducted on the Kinmen Islands (off the coast of Fukien Province, China) and in Taiwan. A total of 3831 Taiwanese from 3 townships (Pu-Li, Chu-Dung, and Pu-Tze) and 993 aborigines from 4 tribes in Taiwan participated in this study. The prevalence rates of HTLV-I infection in adult residents from Pu-Li, Chu-Dung, and Pu-Tze were 0.82, 1.72, and 1.63%, respectively. None of the aborigines had HTLV-I infection. Previously, 0.73% of the adult population of Kin-Hu, Kinmen were found to have HTLV-I infection. Peripheral blood mononuclear cells were collected from HTLV-I carriers identified both in Taiwan and Kinmen and the HTLV-I LTR sequences were PCR amplified, subcloned, and sequenced for phylogenetic tree analysis. The results showed that all 6 HTLV-I isolates from Kinmen and 13 of 18 (72.2%) isolates from Taiwan were group a (transcontinental) of Cosmopolitan subtype, while 5 of 18 (27.8%) isolates from Taiwan were group b (Japanese) of Cosmopolitan subtype. Since all of the HTLV-I-infected persons were descendants of immigrants from mainland China, the origin of the Cosmopolitan subtype in Taiwan and Kinmen may not have been Japan, as previously theorized, but China, possibly the result of the migration of an infected population in the past several centuries.

Adult↗
PubMed1999

Substance use disorders among adolescents in Taiwan: prevalence, sociodemographic correlates and psychiatric co-morbidity.

BACKGROUND: This paper reports prevalences, sociodemographic correlates and psychiatric co-morbidity of substance use disorders (SUDs) among adolescents in Taiwan. METHODS: A random sample of ninth grade students (N = 774) was selected from an urban, a suburban and a rural community. Two-stage case identification was employed with a brief screening tool and a modified Chinese version of the Kiddie-SADS conducted by child psychiatrists. RESULTS: The overall prevalence of any SUD was 11.0%, with nicotine (96.0%) as the most prevalent substance. The prevalences of SUDs were significantly higher in boys, rural community and classes with poor academic performance. Sixty-two per cent of all SUD cases suffered from other concurrent psychiatric disorders. The most common co-morbid conditions were conduct disorder, attention deficit hyperactivity disorder and mood disorders. CONCLUSIONS: High prevalences of SUDs were found among adolescent school children in Taiwan. Effects of urbanization, selective migration and the availability of substances are possible explanations for the urban-rural difference on the risk for SUDs. Psychiatric co-morbid conditions for SUD among adolescents in Taiwan were similar to those in Western societies.

Adolescent↗
PubMed1998

Prolonged overexpansion of extracellular water in elderly patients with sepsis.

OBJECTIVE: To compare the sequential changes in extracellular water (ECW) expansion in elderly patients receiving intensive care for severe sepsis with those in a similar group of younger patients. DESIGN: Inception cohort study. SETTING: Critical Care Unit and University Department of Surgery in a single tertiary care center. PATIENTS: A consecutive series of 14 patients older than 60 years (n=8) or younger than 40 years (n=6) with severe sepsis who completed sequential measurements of body composition during a 21-day period. MAIN OUTCOME MEASURE: Sequential measurements of body composition including ECW by bromide dilution, total body water by tritium dilution, and fat-free body mass by dual-energy x-ray absorptiometry were performed during 21 days after resuscitation. Excess ECW was estimated from the difference between measured ECW and ECW predicted from fat-free body mass corrected to normal hydration. RESULTS: On the first study day, ECW was overexpanded by 9.05+/-1.87 L (mean+/-SEM) and 10.33+/-1.79 L in the young and elderly groups, respectively (P=.66). Whereas the young group excreted most of this excess ECW by day 5 (P=.008), the elderly group remained overexpanded until day 10 before mobilization of ECW occurred (P=.003). The changes over time of ECW excess were significantly different (P=.02 for group x time interaction). The elderly group required more prolonged inotropic (P=.009) and ventilatory (P=.004) support and remained in intensive care longer (P=.008) than the young group. CONCLUSIONS: The period of ECW expansion is more prolonged in elderly patients with sepsis and contributes to a poorer outcome from critical illness. This new finding is of fundamental importance to the treatment of elderly patients recovering from severe sepsis.

Adult↗
PubMed1998

Search for mutations near the alternatively spliced 8-amino-acid exon in the GABAA receptor gamma 2 subunit gene and lack of allelic association with alcoholism among four aboriginal groups and Han Chinese in Taiwan.

The alternatively spliced 8-amino-acid exon for the GABAA receptor gamma2 subunit gene (GABRC2) has been postulated to mediate behavioral actions of alcohol. A rapid search for splice-junction mutations near the 8-amino-acid exon using restriction enzymes which normally recognize sequences near or in the exon gave negative results among 217 alcoholics in four aboriginal groups (Ami, Atayal, Bunun and Paiwan) and Han Chinese in Taiwan. The role of the GABRC2 gene in alcoholism was further assessed by a comparison of allelic frequencies revealed by a NciI RFLP between case and control groups. No significant association of alcohol dependence with GABRC2 alleles was observed. These results suggest that the GABRC2 gene probably does not play an essential role in predisposition to alcoholism in the sample population.

Alcoholism↗
PubMed1998

Alcohol use disorders among the Yami aborigines in Taiwan. An inter-ethnic comparison.

BACKGROUND: Alcohol use disorders (AUDs) among the Yami aborigines in Taiwan were investigated and compared with four other taiwanese aboriginal groups. METHOD: A sample survey was conducted using a semi-structured clinical interview for AUDs among 252 subjects, aged 15 and above, from two Yami villages on Orchid Island. RESULTS: The prevalences of DSM-III-R and DSM-IV alcohol use disorders were 13.1% and 10.3% by one year, and 17.5% and 15.2% by lifetime, respectively, with a male excess. The risk for AUDs in Yami men was significantly associated with a lower educational level, a non-married status, and the length of stay in mainland Taiwan. A protective effect of Christian belief was evident for lifetime risk for AUDs. CONCLUSIONS: The lower prevalences of AUDs in Yami than in other aboriginal groups in Taiwan might be explained by social isolation of the former, and differences in drinking tradition, availability of alcohol, biological vulnerability, and the extent of acculturation between these groups.

Adolescent↗
PubMed1998

Self-reported flushing and genotypes of ALDH2, ADH2, and ADH3 among Taiwanese Han.

The aims of this study are to investigate whether self-reported facial flushing postalcohol consumption (PAC) among subjects with ALDH2*1/*1 can be attributed to ADH2 or ADH3 and whether the prediction of ALDH2 genotype can be improved by examining the combination of flushing and other accompanying reactions of PAC sensitivity. Fifty-eight subjects of Han ancestry in Taiwan were interviewed for alcohol-sensitivity reactions and their blood samples were genotyped for ALDH2, ADH2, and ADH3. For subjects with ALDH2*1/*1 (n = 46), 70% reported to have no flushing PAC and 30% reported flushing PAC. When subjects with ALDH2*1/*1 had ADH2*1/*1 (n = 11), all reported to have no flushing; otherwise, 35% (for ADH2*1/*2, n = 17) and 44% (for ADH2*2/*2, n = 18) reported flushing. For subjects with ALDH2*1/*1 and at least one ADH2*2 allele, the genotype of ADH3 was not associated with self-reported flushing. PAC flushers with ALDH2*1/*1 (50%) were more likely to report nausea than those with ALDH2*1/*2 (8%). The probability of ALDH2*1/*1 given flushing reported was 0.29, while the probability of ALDH2*1/*1 given both flushing and nausea reported was 0.71. The results indicate that self-reported flushing is determined by both ALDH2 and ADH2 and that prediction of ALDH2 genotype on the basis of self-reported flushing and nausea can help identify subjects at increased risk for alcoholism.

Adult↗
PubMed1998

Schizophrenia: conceptual change in modern psychiatry.

Schizophrenia is perhaps the most devastating mental illness that psychiatrists must treat. Its chronic course with deteriorating consequences has been the focus of study throughout this century. This paper reviews the concept of schizophrenia, from fundamental Kraepelinian theory of 'dementia praecox' to biological correlates and explanation. Its causes, however, remain obscure and there were no appreciable changes in its treatment modality. A 'bio-psycho-social' model of care is emphasized, aiming at the prevention of deterioration of symptoms, functional impairment, disability and social handicap.

Humans↗
PubMed1997

Polymorphisms and intron sequences flanking the alternatively spliced 8-amino-acid exon of gamma2 subunit gene for GABAA receptors.

Gamma-amminobutyric acid (GABA) is a major inhibitory neurotransmitter. Two alternatively spliced forms of the gamma2 subunit of GABAA receptor (gamma2L and gamma2S), which differ by an exon of eight amino acids, show different sensitivities to modulatory effects of ethanol on receptor activities. A 2.7 kb DNA fragment and an 1.7 kb DNA fragment covering respectively the introns upstream and downstream from the 8-amino-acid exon were obtained through PCR-amplification of human genomic DNA using primers derived from cDNA sequences. Total sequencing of these fragments showed a composite 4.2 kb segment containing the 8-amino-acid exon and consensus sequences for RNA splice junctions. Restriction fragment length polymorphisms (RFLP) based on NciI restriction digestion were found among Chinese in Taiwan. This RFLP provides a useful DNA marker for allelic association or linkage analyses of the role of GABAA receptors in predisposition to alcoholism or other neuropsychiatric disorders.

Alternative Splicing↗
PubMed1997

Dopamine D2 receptor gene and alcoholism among four aboriginal groups and Han in Taiwan.

Previous studies examining the putative association between DRD2 TaqI A1 and alcoholism have produced conflicting results. Major critiques of such studies include potential confounding arising from population admixture by inappropriate selection of controls, failure to screen out substance abusers from controls, and the failure to assess the severity of alcoholics. To address these issues, we compared the allelic frequency of two polymorphisms of DRD2, TaqI A and NcoI, among severe alcoholics and their ethnically matched nonalcoholic controls within four major aboriginal groups and Han (Chinese) in Taiwan. The sample of alcoholics and controls examined for the five groups included 36 and 31 (Atayal), 24 and 23 (Ami), 58 and 58 (Bunun), 35 and 35 (Paiwan), and 50 and 66 (Han). A borderline association between TaqI A1 and alcoholism among the Ami (P = 0.08) and an association between NcoI N1 and alcoholism among Han (P = 0.01) were found. Results of haplotype analysis further confirm that the frequency of haplotype A1N1 was higher in alcoholics than in controls for the Ami (P = 0.01) and Han (P = 0.03). If controls with tobacco abuse were excluded from the analysis, the results remained unchanged. Severity in medical complications of alcohol dependence with withdrawal symptoms was not associated with higher prevalence of DRD2 TaqI A1 or NcoI N1 alleles. The absence of an association between DRD2 and alcoholism among the three aboriginal groups suggests either a higher rate of phenocopies among aboriginal alcoholics or genetic heterogeneity in the susceptibility to alcoholism.

Alcoholism↗
PubMed1997

Alcohol dehydrogenase and aldehyde dehydrogenase genotypes and alcoholism among Taiwanese aborigines.

Previous population association studies have indicated that certain alleles of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) genes may reduce the risk of alcoholism in Oriental populations. In this report we determined the genotypes for three genes, ADH2, ADH3, and ALDH2 among subjects with alcohol dependence (n = 159) and ethnically matched normal controls (n = 149) for the four largest aboriginal groups (Atayal, Ami, Bunun, and Paiwan) in Taiwan. The ethnicity matching used in this study was feasible because there are still few intergroup marriages between these aboriginal groups. On a group level, the rare frequencies of ALDH2*2, the inactive allele of ALDH2, among these aborigines may account partially for their vulnerability to alcohol use disorders. On an individual level, however, the genotypes controlling alcohol metabolism did not account for intragroup differences in vulnerability to alcoholism except in the case of ADH2 for the Ami ethnic group.

Adult↗
PubMed1997

Histopathologic changes after pericardial patch tracheoplasty.

Pericardial patch tracheoplasty has been used for surgical correction of long-segment congenital tracheal stenosis caused by complete tracheal rings in infants. The case histories of 2 infants with descriptions of the histopathologic changes in their respective tracheas are presented. Complete reepithelialization of the graft site with ciliated pseudostratified columnar epithelium was found, suggesting the likelihood of normal mucociliary flow in the trachea. The pericardial patches were replaced by mature scar tissue in the graft site, establishing a functional tracheal lumen. Wound healing in the trachea is reviewed. Obstruction by exuberant granulation tissue is an ongoing concern. Pericardium continues to be an important option as graft material for tracheal reconstruction in infants with long-segment congenital tracheal stenosis.

Abnormalities, Multiple↗
PubMed1997

Incidence of first onset alcoholism among Taiwanese aborigines.

BACKGROUND: An initial prevalence survey of mental disorders among 993 subjects aged 15 and above randomly drawn from four major Taiwanese aboriginal groups (the Atayal, Ami, Bunun and Paiwan) was conducted from 1986 to 1988. The incidence of alcoholism was investigated in a follow-up survey from 1990 to 1992. METHODS: Both surveys employed a semi-structured clinical interview with satisfactory reliability for case identification, and DSM-III-R as the diagnostic criteria for alcohol use disorders. The estimation of incidence rates of first onset alcoholism (alcohol abuse or dependence) was based on person-years at risk of 499 subjects who did not have any lifetime diagnosis of such morbidity at phase I. RESULTS: The follow-up rate was 99.6% and only four subjects among the survivors were not found. The age-standardized annual incidence rates of alcoholism ranged from 2.8 to 4.9% among the four aboriginal groups, and the rank order of rates was consistent with that of prevalences among these groups. The incidence rates of alcoholism were the highest among adolescents and young adults in men, and among the middle-aged in women. CONCLUSIONS: High rates of first onset alcoholism among the Taiwanese aborigines indicate an interaction of sociocultural and biological factors in the development of such morbidity.

Adolescent↗
PubMed1997

Personality disorder and suicide. A case-control study.

BACKGROUND: The relationships between personality disorders and suicide were investigated among two aboriginal groups and the Han Chinese in East Taiwan. METHOD: Biographical reconstructive interviews were conducted for consecutive suicides from each of the three ethnic groups (116 suicides in total), 113 of whom were matched with two controls for age, gender, and area of residence. RESULTS: In all three groups, a high proportion of suicides suffered from ICD-10 personality disorder before suicide (46.7-76.7%), and the most prevalent category was emotionally unstable personality disorder (F60.3) (26.7-56.7%). The risk for suicide was mainly significantly associated with F60.3, comorbidity among personality disorders, and comorbidity of personality disorder with other psychiatric disorders, particularly severe depression. CONCLUSION: The main category of personality disorder significantly associated with the risk of suicide is F60.3 in ICD-10. The risk is highest for a comorbidity of this category and severe depression.

Adult↗
PubMed1996

Alcoholism, hepatitis B and C viral infections, and impaired liver function among Taiwanese aboriginal groups.

Viral hepatitis and alcoholism prevail in four major Taiwanese aboriginal groups. To study the relative importance of the acquisition of hepatitis B virus or hepatitis C virus infection and alcoholism to the presence of impaired liver function in these groups, the authors conducted a semistructured clinical interview for alcoholism and test for seromarkers for viral hepatitis among 993 cohort members enrolled in 1990-1992 in an ongoing prospective study (Taiwan Aboriginal Study Project). The subjects' blood specimens were tested for serum alanine aminotransferase/aspartate aminotransferase levels and for the presence of hepatitis B surface antigen and anti-hepatitis C virus antibody. The prevalence of a combination of an alanine aminotransferase level of > 35 IU/liter and an aspartate aminotransferase level of > 40 IU/liter, implying impaired liver function or advanced liver disease, was 4.3% overall. Univariate and multiple logistic regression analysis showed that, rather than chronic hepatitis B virus infection, hepatitis C virus infection and alcoholism were the two dominant risk factors that signalled the risk of liver damage among these Taiwanese aborigines. In addition, these two contributing factors were able to act synergistically to cause impaired liver function.

Alcoholism↗
PubMed1996

Association of monoamine oxidase A alleles with alcoholism among male Chinese in Taiwan.

OBJECTIVE: The role of monoamine oxidase (MAO) in alcoholism was assessed by genetic association studies separately in five ethnic groups in Taiwan. METHOD: Restriction fragment length polymorphisms (RFLP) and dinucleotide repeat polymorphisms (DNRP) were used to determine MAOA and MAOB alleles in male alcoholic patients and nonalcoholic comparison subjects among Han Chinese and four aboriginal groups. RESULTS: Significant associations of alcohol dependence with MAOA alleles (RFLP and DNRP) were found among the Han Chinese, but not among the aboriginal groups. No significant association with MAOB DNRP alleles was found in any group. CONCLUSIONS: Genetic heterogeneity may underlie alcoholism among different ethnic groups in Taiwan, and MAOA mutations may play a role in susceptibility to alcoholism among Han Chinese.

Alcoholism↗
PubMed1996

Alcohol-metabolising genes and alcoholism among Taiwanese Han men: independent effect of ADH2, ADH3 and ALDH2.

BACKGROUND: Previous population association studies have indicated that certain alleles of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) may reduce the risk of alcoholism in Asian populations. The association of ALDH2 and ADH2 with the development of alcoholism was found to be independent of each other and has been replicated in different Asian populations, while the effect of ADH3 is less studied. METHOD: We genotyped the alcohol metabolism genes among Han men with alcohol dependence (n = 46) and their ethnically matched normal controls (n = 63) in Taiwan. Multiple logistic regression was then applied to assess the contribution of ADH3 to alcoholism by controlling the effect of ALDH2 and ADH2. RESULTS: The results of multivariate analyses demonstrated that the odds ratios for an increment of one allele of ADH2*1, ADH3*2 and ALDH2*1 in the development of alcoholism were 4.18, 3.82, and 6.89, respectively. CONCLUSIONS: These findings clearly indicate that all three alcohol-metabolising genes contribute to susceptibility to alcoholism.

Adult↗
PubMed1995

Mental illness and suicide. A case-control study in east Taiwan.

BACKGROUND: As part of the Taiwan Aboriginal Study Project, a case-control study of suicide among two aboriginal groups and the Han Chinese was carried out in East Taiwan. METHODS: Biographical reconstructive interviews were conducted for consecutive suicides from each of the three ethnic groups (a total of 116 suicides), 113 of whom were matched with two controls for age, sex, and area of residence. RESULTS: In all three groups, a high proportion of suicides suffered from mental illness before committing suicide (97% to 100%). The two most prevalent psychiatric disorders were depression and alcoholism, and the most common comorbid pattern was depression with substance use disorders. The risk for suicide was significantly associated with all of these psychiatric conditions, previous suicide attempts, and a family history of suicide and depression. Fifty-one percent of all suicides had consulted medical professionals in the previous month. CONCLUSION: Despite the widely different rates of depressive illness and alcoholism in different cultures previously reported, the psychiatric antecedents of suicide are the same in the West and the East.

Adolescent↗