Biomedical subjects

C C Hsieh

Publications and source records attributed to C C Hsieh.

At least 217 records · Page 12Linked to original sources

PubMed1991

Risk factors for stomach cancer: a population-based case-control study in Shanghai.

A population-based case-control study of stomach cancer was conducted among the teachers and staff of primary and middle schools in Shanghai. A total of 84 cases of stomach cancer were identified in all schools and 2,676 controls were drawn from the teachers and staff of a randomly selected sample of 40 primary and 15 middle schools. Data were analyzed by a multivariate logistic regression model. The analysis indicated that a positive family history of stomach cancer, cigarette smoking, low consumption of fruits, and low consumption of strong tea were significantly associated with stomach cancer incidence.

Alcohol Drinking↗

PubMed1991

Breast size, handedness and breast cancer risk.

Bra cup size and handedness were studied as possible risk factors for breast cancer. Data for 3918 cases and 11,712 controls from 7 centres were used to examine the association of handedness with laterality of breast cancer; data for 2325 cases and 7008 controls from 4 centres were used to assess the relation of bra cup size to breast cancer risk. There was a suggestive (P about 0.10) association of handedness with breast cancer laterality: odds ratio of a left-handed (or ambidextrous) woman having a left-sided cancer 1.22 (95% CI 0.96-1.56). Handedness may affect the lateral occurrence of breast cancer, although this tumour is in general more common in the left breast, possibly because this breast is usually slightly larger. Premenopausal women who do not wear bras had half the risk of breast cancer compared with bra users (P about 0.09), possibly because they are thinner and likely to have smaller breasts. Among bra users, larger cup size was associated with an increased risk of breast cancer (P about 0.026), although the association was found only among postmenopausal women and was accounted for, in part, by obesity. These data suggest that bra cup size (and conceivably mammary gland size) may be a risk factor for breast cancer.

Adult↗

PubMed1991

Analysis of quantitative data by quantiles in epidemiologic studies: classification according to cases, noncases, or all subjects?

Quantitative exposure data in epidemiologic studies are frequently analyzed by ordered categories. Categorization by quantiles can be based on the distribution of (1) cases, (2) noncases, and (3) all subjects. The advantages of the three schemes in determining quantiles were compared. They were found to give the same power regarding a test for trend over a wide range of study situations. Considerations on the representativeness and the ease of the analysis implementation could dictate the choice of the categorization scheme.

Case-Control Studies↗

PubMed1991

Induced abortions, contraceptive practices, and tobacco smoking as risk factors for ectopic pregnancy in Athens, Greece.

A case-control study of the role of induced abortion and other factors on the subsequent occurrence of ectopic pregnancy was undertaken in 1986-1987 in Athens, Greece, where a similar study 20 years ago found a tenfold risk of ectopic pregnancy among women with one or more illegal induced abortions. Seventy women residents of Athens, consecutively admitted to the major state maternity hospital with a diagnosis of ectopic pregnancy, were individually matched with women with a newly diagnosed pregnancy of the same order as the ectopic index pregnancy. Two control women were found for each of 63 cases, but only one control for each of the remaining seven cases. All cases and controls were interviewed by the same qualified obstetrician. Statistical analysis was undertaken with stratification of individual matched triplets and pairs, as well as through conditional multiple regression procedures. The relative risk of recurrence of an ectopic pregnancy was 6.39 with 95% confidence interval (CI) 1.96-21.04. Miscarriages did not increase the risk of ectopic pregnancy. The relative risk for subsequent ectopic pregnancy among women with one or more induced abortion, compared to women without such abortions, was 1.87 (CI 0.84-4.16) controlling only for the matching factors, and 1.71 (CI 0.69-4.27) when marital status (a possible selection factor) was also accounted for in the conditional logistic regression. There was no evidence for increasing risk with increasing number of induced abortions. Past use of an intrauterine device (IUCD) was associated with a relative risk of 3.89 (0.72-21.02); the relative risk increased with the duration of use of the IUCD.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗

PubMed1991

[Three elderly cases of renal cell carcinoma with pancreatic metastasis].

Three elderly patients, (an 80-year-old female, 78-year-old female and 78-year-old male) suffering from renal cell carcinoma with pancreatic metastasis were reported. In all cases, renal cell carcinoma had been diagnosed previously. Pancreatic tumors were revealed by computed tomography and ultrasonic study during subsequent admission in all cases. In the first case, laparotomy and histological examination proved that pancreatic tumor was metastatic from renal cell carcinoma. In the other cases, according to their clinical course and other laboratory data, we considered the pancreatic tumors to be metastatics from renal cell carcinoma though histological diagnosis was not obtained.

Aged↗

PubMed1991

Occupation and gastric cancer in Spain.

The association between occupational exposure and stomach cancer was investigated in a multicenter case-referent study conducted in Spain on 354 histologically confirmed cases and 354 hospital referents, matched by age, gender, and residence. An increased risk of gastric cancer was found for coal mining workers [odds ratio (OR) 11.8], but the number of workers was small, and therefore the 95% confidence interval (95% CI) was wide (95% CI 1.36-103). An increased risk was observed for wood and furniture workers (OR 1.76), construction workers (OR 1.68), and glass and ceramic workers (OR 2.18), but none of these risks were statistically significant. According to an occupation-exposure linkage system an increased risk was found for occupations associated with exposure to silica and mineral dust (OR 1.80, 95% CI 0.90-3.59). All of the OR estimates were adjusted for the confounding factors socioprofessional status and dietary habits. The possibility of a causal association between stomach cancer and coal and mineral dust is supported by the results.

Adult↗

PubMed1991

Endocardial cushion defect in a fetus: with intrauterine cytomegalovirus infection and growth retardation: report of an autopsy case.

We describe one case of endocardial cushion defect during the second trimester when a consultative fetal echocardiography was undertaken for fetal intrauterine growth retardation with oligohydramnios. Positive cytomegalovirus IgM in cord blood and cytomegalovirus DNA particles in the amniotic fluid were found incidentally. The relationship between possible intrauterine cytomegalovirus infection and the endocardial cushion defect in this case is not clear.

Adult↗

PubMed1991

Analysis of birth weight and gestational age in Taiwan.

Appropriate interpretation of monitored fetal growth throughout pregnancy in individual patients and populations is dependent upon the availability of adequate standards. Previously published standards either were based on small samples, data decades old or were characteristic of foreign subpopulations. We have reviewed the data on a series of 46,575 singleton live births at Chang Gung Memorial Hospital from 1979 to 1989. The ratio of males to females was 1.08. The fetal growth pattern in the third trimester of pregnancy approximates a sigmoid curve. Fetal growth was most rapid from the 32nd to the 37th week of gestation with an average increase of 240 g per week. The birth weight declined beyond 42 weeks' gestation. There were significantly greater weight gains amongst male fetuses as compared to female fetuses from the 34th to the 42nd week of gestation. The mean birth weight recorded at 40 weeks' gestation in male and female newborns was 3,381 g and 3,262 g, respectively. Comparing the birth weight of term pregnancies using our data, with those of a previous, two-decade old report (1945-1967) by Chen, we found that birth weight were slightly higher in this study. The derived fetal growth curves are useful for clinical, public health, and investigational purposes.

Adult↗

PubMed1991

Peripartum cardiomyopathy: report of a case.

Peripartum cardiomyopathy is defined as the development of heart failure during the later part of pregnancy or during the first three to six postpartum months, without an obvious underlying cause or prior evidence of cardiac disease. We present one case of peripartum cardiac failure which occurred in a 25-year-old primigravida with twin gestation. The patient underwent an emergency Cesarean section followed by successful medical treatment. An endomyocardial biopsy was performed 12 days after delivery and the pathological changes were consistent with the diagnosis of peripartum cardiomyopathy.

Adult↗

PubMed1991

[Emergency obstetric hysterectomy: report of fifteen cases].

From June 1978 to June 1990, there were 41,989 deliveries, 13,396 cesarean sections and 15 emergency obstetric hysterectomies at Taipei Chang Gung Memorial Hospital. The incidence of emergency obstetric hysterectomy is 36/100,000 deliveries. The mean age of patients is 31.7 years old. The indications for hysterectomy were placental disorder (60.0%), uterine atony (26.7%), and uterine rupture (13.3%). The present series showed that 14 cases had total abdominal hysterectomy, while only one case had a subtotal hysterectomy. Total hysterectomy should generally be performed unless maternal instability mandates a more expeditious subtotal hysterectomy. The most common postoperative complication included unknown fever and urinary tract infection. For those four cases of post-cesarean hysterectomy, conservative treatment was tried but failed. All cases presented with hypotension (less than 80/60 mmHg), tachycardia (greater than 100 times/min) and with a mean hemoglobin of 9 mg% during the observation period. In these patients, blood loss, operating time and length of hospitalization was increased when compared with a group of 7 patients undergoing cesarean hysterectomy. In patients with placenta accreta, who are candidates for cesarean hysterectomy, initial hypotension, tachycardia and shock developed during cesarean section. It must be emphasized that conservative aggressive measures to control obstetric hemorrhage remain the mainstay of therapy, but emergency hysterectomy played the life-saving role with which every practitioner of obstetrics must be familiar and keep in mind.

Adult↗

PubMed1991

Changing trends of forceps delivery in Chang Gung Memorial Hospital.

Two hundred and fifty-five patients underwent forceps deliveries in Chang Gung Memorial Hospital from January 1, 1985 to June 30, 1990. There was neither maternal nor perinatal mortality related to this procedure during this period; and the perinatal outcome was good without sequela. In the past three years, cesarean section took the place of forceps delivery in some cases with acute fetal distress and malposition. As a result, maternal problems became the most common indication for forceps delivery during that period. Fourth degree laceration of the perineum was the major maternal complication, occurring in 22.4% of total forceps deliveries. Postpartum voiding problems continued to be another complication after forceps delivery, accounting for 7.0%. Either fourth degree laceration of the perineum or postpartum voiding difficulty could be prevented to a certain extent if the forceps were handled delicately in an experienced hand and there was early diagnosis with prompt management of voiding dysfunction.

Adult↗

PubMed1990

Age at menarche, age at menopause, height and obesity as risk factors for breast cancer: associations and interactions in an international case-control study.

The importance of age at menarche, age at menopause, height, and obesity as risk factors for breast cancer, and the possible interactions among these factors in breast cancer causation were investigated in a data set collected in the late 1960's, in an international multicenter case-control study. Multiple logistic regression procedures were used to model data from 3,993 breast cancer cases and 11,783 controls from 7 study centers representing the range of international variation of breast cancer incidence. Height and obesity (measured through the weight/height2 index) were independent risk factors for breast cancer among post-menopausal but not pre-menopausal women; post-menopausal women taller by 10 cm had a 12% higher risk of breast cancer (95% confidence interval, CI, 3-21%) and post-menopausal women of average height (say 158 cm) had an 11% higher risk of breast cancer (CI 7-16%) when they were heavier by 10 kg (and, therefore, more obese by 4 kg/m2). Age at menarche was a risk factor among both pre-menopausal and post-menopausal women, a delay of 2 years corresponding to a 10% reduction in breast cancer risk (CI 6-15%). Age at menopause was also a breast cancer risk factor, women with menopause at each 5 year age difference having a 17% higher risk of breast cancer (CI 11-22%). There is evidence of an interaction (deviation from the logistic regression-postulated multiplicativity) between obesity and age at menarche, implying that the protective effect of late menarche may not apply to overweight women or that late menarche may become detrimental in obese women. The estimated relative risk coefficients, when applied to average risk factor levels observed among control women, can explain only a small fraction of the difference in breast cancer incidence between Boston and Tokyo.

Adult↗

PubMed1990

The severity of pedestrian injuries in children: an analysis of the Pedestrian Injury Causation Study.

We reanalyzed data from the Pedestrian Injury Causation Study (PICS) for 1035 urban pedestrian injuries to children and youth less than 20 years of age. Analysis of variance with the Injury Severity Score (ISS) as the dependent variable was used to evaluate variables describing the characteristics of the pedestrian, the vehicle, the driver, and the circumstances under which the collision occurred. The mean injury severity score was 5.6. Nearly 80% of pedestrians had a minor injury, 13% moderate, and 7% severe; 4.5% of these pedestrian were killed. Multivariate analysis revealed that vehicle travel speed greater than 30 mph, pedestrian age less than 5 years, time of day either early morning or late afternoon, residential zone, type of road including collectors and major roads, and center travel lanes were associated with greater severity of injury. Attempts by the driver to avoid the collision by braking or other avoidance maneuvers were associated with reduced injury severity. Even on local streets and in residential zones, nearly 20% of children were struck by vehicles exceeding 30 mph, and these children were injured much more severely than children struck by more slowly moving vehicles.

Accidents, Traffic↗

PubMed1990

Prevalence of mottled enamel after 12 years of water fluoridation in Chung-hsing New Village.

The prevalence of mottled enamel (dental fluorosis) was investigated among children, aged 6 to 15 years, in Chung-hsing New Village and in Tsao-tun Village. The drinking water in Chung-hsing New Village has been fluoridated for 12 years at a level of 0.6 ppm, while the drinking water in Tsao-tun contains a negligible level of 0.08 ppm. The degree of mottled enamel was assessed by using Dean's Index and the Community Fluorosis Index (CFI), the latter being derived from Dean's Index for the purpose of comparison. In Dean's Index, 6 classes based on the severity of the mottling, are identified: normal, questionable, very mild, mild, moderate, and severe. The results showed that children in Chung-hsing had whiter teeth than those in Tsao-tun Village. In the fluoridated group, 5.8% of children fell into the "very mild" mottling category, as compared to 0.9% in Taso-tun, the control area. For the "mild" class, the rate was 1.9% for Chung-hsing New Village and 0.4% for Tsao-tun. With only one exception in Tsao-tun, none of the children in the two groups showed mottling in the "moderate" or "severe" classes. The Community Fluorosis Index (CFI) was 0.15 for the Chung-hsing group, indicating that the occurrence of mottled enamel is very low when compared with data from fluoridation programs in other countries. It is concluded that in Taiwan, a 0.6 ppm fluoride concentration in drinking water, which has previously been reported to be effective in prevention of dental caries, is associated with only negligible mottling of enamel. Even when mottling does occur, the degree is very mild and only small chalky spots can be seen on the teeth.

Adolescent↗

PubMed1990

Prevalence of cesarean section in Chang Gung Memorial Hospital, 1984-1989.

This study was undertaken to estimate the cesarean delivery rate in Chang Gung Memorial Hospital (CGMH) and to determine whether the reasons for the rising rate have changed during the past 6 years. Since 1984, 43% of the rise in the cesarean rate was due to repeat cesareans, 29% due to dystocia, and 15% due to fetal distress. At the same time, the cesarean delivery rates due to abnormality of position and placentation dropped by 2% in either condition. The rate of cesarean delivery among those with a previous cesarean was 98%. In the future, if the number of vaginal deliveries after cesarean increases, then the overall cesarean delivery rate will decrease or stabilize.

Cesarean Section↗

PubMed1989

Epidemiology of pancreas cancer (1988).

This article reviews the epidemiology of cancer of the pancreas, both descriptive and analytical, at all times cognizant of the problems of misdiagnosis, particularly underdiagnosis, of this lethal disease that continue to hinder epidemiological studies. Pancreas cancer is consistently reported to occur more frequently in men than in women, in blacks than in whites, and in urban rather than rural population groups. In some countries, the mortality rates continue to rise, whereas in others, declining levels of disease can be seen among members of younger birth cohorts. Although some of these patterns can be explained by variation in pancreas cancer risk factors, many cannot. Analytical studies consistently demonstrate that cigarette smoking increases the risk of cancer of the pancreas, and this appears, at the present time, to be the only clearly demonstrated risk factor for pancreatic cancer. Although the association with disease risk and coffee consumption, alcohol consumption, occupational exposures, diabetes, pancreatitis, and other factors requires clarification, it appears likely that the most fruitful research area in the coming years may involve exploration of pancreatic cancer risk and nutritional practices.

Adult↗

PubMed1989

Perinatal outcome of chorionic villus sampling versus amniocentesis.

This study assesses the relative risks of first trimester transcervical chorionic villus sampling (CVS) versus midtrimester amniocentesis performed between April 1986 and March 1988. The most common indication for prenatal diagnosis was advanced maternal age. We discovered 5.1% chromosomal aberrations in CVS compared to 1.0% in amniocentesis. Bleeding was the most frequent early complication, and only 1 case had major hemorrhage with subsequent spontaneous abortion. The fetal loss rate (gestational age less than 28 weeks) was 4.5% in CVS versus 1.2% in amniocentesis, which was not significantly different from the background fetal loss rate reported in normal pregnancies after an 8-week gestational age. Three cases of fetal loss after CVS were probably procedure-related; 1 case had spontaneous abortion and 2 cases had chorioamnionitis. Therefore, we considered that the causal relationship between CVS and the infection was highly probable. The clinical pregnancy outcome indicated that there were no differences in overall perinatal mortality, Apgar score, body weight, body length, gestational age at delivery, intrauterine growth retardation, placenta weight and placental disorders between the CVS group and the amniocentesis group. The pregnancies did not reveal any specific effects of the prenatal diagnostic procedure, but a long-term pediatric follow-up is needed.

Abortion, Spontaneous↗

PubMed1989

Influence of water fluoridation on the eruption of permanent teeth in Chung-Hsing New Village, Taiwan.

Along with an evaluation of the effects of 12 years' water fluoridation in the prevention of caries, the present study was conducted to explore the influence of water fluoridation on the eruption of permanent teeth. The survey was carried out in fluoridated Chung-Hsing New Village and the control town of Tsao-Tun from October to December, 1984. Dental examinations were performed on 3,459 children Chung-Hsing New Village and 4,610 in Tsao-Tun, at ages ranging from 3 to 15 years. The results showed that in general, the mean tooth eruption time of girls was earlier than that of boys, and that teeth in the lower jaw emerge sooner than their homologues in the upper jaw, except for premolars. In both fluoridated and control areas the order of tooth eruption was very similar except for the teeth of girls in the upper jaw. The eruption sequence was first premolar, canine then second premolar in the girls of Chung-Hsing New Village, while first premolar, second premolar then canine in those of Tsao-Tun. By comparing the eruption time of permanent teeth in the children of fluoridated and control areas, it was found that they were very alike in general, the only difference being observed in the premolars of the sexes. The premolars of the children in the fluoridated area emerged in the oral cavity 2.5 to 4.5 months later than did their counterparts in the control area.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗