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Biomedical subjects

Ching-Hua Lin

Publications and source records attributed to Ching-Hua Lin.

13 recordsLinked to original sources

Carpal tunnel syndrome in male visual display terminal (VDT) workers.

BACKGROUND: The association between working at a video display terminal (VDT) and development of carpal tunnel syndrome (CTS) is not well-established. The study surveyed the prevalence of CTS symptoms, explored the risk factors and evaluated the clinical application of hand diagrams, physical tests and electrodiagnosis among male VDT workers. METHODS: A cross-sectional study was performed in an information and communication technology company. Three-forty questionnaires were completed and 82 volunteers participated in the physical examination and nerve conduction study. The personal and occupational risk factors for CTS were analyzed. RESULTS: The prevalence of CTS symptoms was 3.8% among 340 subjects, while prolonged median motor distal latency (>4.2 msec) was disclosed in 3.7% of a subgroup receiving examination. Classic/probable CTS symptoms was associated with high body mass index (>28 kg/m(2), odds ratio = 4.1, P = 0.029) and moderate job seniority (3-5 years, odds ratio = 4.6, P = 0.023). Prolonged median motor distal latency was associated with older age (>35 years old). We did not observe correlation between CTS symptoms, abnormal NCS, positive Tinel's sign or Phalen's test. CONCLUSION: The prevalence of CTS symptoms was not high among the group of male VDT workers studied. Job seniority, but not specific tasks, was associated with CTS symptoms. More reliable and valid methods to quantify the ergonomic exposure are needed to establish the association of VDT tasks and CTS.

Adult↗

Exhaled carbon monoxide level as an indicator of cigarette consumption in a workplace cessation program in Taiwan.

BACKGROUND: Smoking cessation programs are critical to the safety and health of workers. Exhaled carbon monoxide (CO) is an effective indicator of smoking in clinics and hospitals. Its application in the community and workplace, however, remains limited. This study assessed whether exhaled CO concentration can be used as an objective indicator of the amount of daily cigarette consumption among smokers in the workplace in Taiwan. METHODS: A total of 150 workers from a chemical manufacturer in Taiwan were included; there were 27 nonsmokers and 123 current smokers. The number of cigarettes smoked daily by each subject was reported, and exhaled CO concentration was measured in each subject using the Micro CO meter (Micro Medical Ltd, Chatham, Kent, UK). RESULTS: Exhaled CO levels were associated with the number of cigarettes consumed daily, with a correlation coefficient of 0.73 (p < 0.01) and an adjusted R-square (simple linear regression model) of 0.44. The mean exhaled CO level of nonsmokers was 4.2 ppm (95% confidence interval, 3.3-5.1). A reading of > 6 ppm had a sensitivity of 84% and specificity of 85% in detecting workplace smoking. CONCLUSION: Exhaled CO level can be used as an objective, noninvasive indicator to determine the smoking status of an individual in the workplace.

Adult↗

Comparison of time to rehospitalization among schizophrenic patients discharged on typical antipsychotics, clozapine or risperidone.

BACKGROUND: The purpose of this study was to compare the time to rehospitalization of schizophrenic patients who were discharged from a psychiatric hospital while being treated with typical antipsychotics, clozapine or risperidone. We also assessed other possible predictors of time to rehospitalization. METHODS: The study monitored the rehospitalization status of all the schizophrenic patients who were discharged from a psychiatric hospital between July 1, 2001 and June 30, 2002 while they were taking typical antipsychotics (n=272), clozapine (n=61) or risperidone (n=49). Rehospitalizations were tracked over a 2-year period using the Kaplan-Meier method. Risk factors associated with rehospitalization were examined by the Cox proportional hazards regression model. RESULTS: No significant differences in time to rehospitalization were observed among the groups in the first or second year after discharge. Age at onset of schizophrenia was a risk factor for time to rehospitalization over the 1- and 2-year periods. CONCLUSION: This study demonstrated that atypical antipsychotics did not lengthen the time to rehospitalization. The earlier the age at onset of schizophrenia, the shorter is the time to rehospitalization. Some other factors thought to impact rehospitalization need to be further assayed.

Adult↗

Saved by a material safety data sheet.

BACKGROUND: We present the case of a young female laboratory worker who developed acute hepatic encephalopathy. OBJECTIVE: To show that knowledge of occupational exposures to causative agents can alter therapeutic management. METHODS: Although the patient was in a deep coma, her family members examined the workplace material safety data sheet, revealing exposure to chloroform. Since most chemical-induced hepatitis is self-limiting, a scheduled liver transplantation was postponed. RESULTS: The patient recovered. Subsequent air sampling suggested that the patient had been exposed to chloroform at a concentration of more than 15 ppm for 2 weeks. CONCLUSION: Our case report demonstrates the importance of obtaining an occupational history and how the patient's family can be important in this process.

Adult↗

Association analysis of brain-derived neurotrophic factor Val66Met polymorphisms with Alzheimer's disease and age of onset.

Because of a decrease in central brain-derived neurotrophic factor (BDNF) levels in Alzheimer's disease (AD) and the important role of BDNF in neuronal survival, BDNF may represent a candidate gene conferring susceptibility to AD. Recently, a functional BDNF Val66Met polymorphism has been associated with AD in an Italian population. In the present study, we investigated a possible role of this BDNF polymorphism in the susceptibility of AD or AD onset in a Chinese population. Comparing AD patients and controls, the distribution of the BDNF genotypes and alleles did not differ significantly. The onset age was not significantly different comparing the three BDNF genotype groups. Our negative findings suggest that it is unlikely that the BDNF Val66Met polymorphism plays a major role in the pathogenesis of AD in the Chinese population and do not support previous findings that homozygosity for the 66Val allele confers an increased risk for AD. Further studies with genetic variations in BDNF relating either to AD-associated depression or to the AD treatment response are suggested.

Age of Onset↗

Association study of adrenergic beta3 receptor (Trp64Arg) and G-protein beta3 subunit gene (C825T) polymorphisms and weight change during clozapine treatment.

Weight gain, a common adverse effect of clozapine, may impair health and affect patient compliance during treatment with this agent. The aim of this study was to investigate the relationship between genetic variants of the adrenergic beta3 receptor (ADRB3) and the G-protein beta3 subunit (GNB3) and clozapine-induced body weight change (BWC). Eighty-seven treatment-resistant schizophrenic patients were weighed before and after 4 months of clozapine treatment, with the subjects gaining an average of 2.6 kg in body weight. No statistically significant relationship was demonstrated for the investigated ADRB3 Trp64Arg and the GNB3 C825T polymorphisms in terms of BWC post-treatment, suggesting these two polymorphisms do not play a significant role in clozapine-induced BWC. Further exploration of other genetic variants implicated in clozapine-induced BWC is important, however, in order to predict and reduce clozapine-associated weight gain.

Adolescent↗

Predictive factors for QTc prolongation in schizophrenic patients taking antipsychotics.

BACKGROUND AND PURPOSE: The rate-corrected electrocardiographic QT (QTc) interval may significantly increase in schizophrenic patients taking antipsychotics. QTc prolongation is a risk factor for development of arrhythmia. The objective of this study was to assess the predictors of QTc prolongation in schizophrenic patients taking antipsychotic medication. METHODS: Electrocardiograms were obtained from 138 controls and 412 schizophrenic inpatients taking antipsychotics. QTc prolongation was defined as a mean value of 2 standard deviations above the controls. Predictors were analyzed with a logistic regression model. RESULTS: Based on data obtained from controls, QTc prolongation was defined as a QTc greater than 421 ms. Logistic regression analysis showed that significant predictors for QTc prolongation were: female gender (odds ratio, 3.355 [95% CI, 1.767-6.371]); increased age (1.040 [1.011-1.069]); and increased doses of some antipsychotics, including clozapine (1.006 [1.003-1.008]), chlorpromazine (1.003 [1.002-1.005]), thioridazine (1.007 [1.003-1.011]), and sulpiride (1.001 [1.001-1.002]). CONCLUSIONS: Predictors of the QTc prolongation in schizophrenic patients taking antipsychotic medications were female gender, old age, and treatment with clozapine, chlorpromazine, thiroridazine, or sulpiride.

Antipsychotic Agents↗

Brain-derived neurotrophic factor (BDNF) Val66Met polymorphisms in Parkinson's disease and age of onset.

Given the implications with respect to neuronal survival and the decreased level of the protein in the striatal region in Parkinson's disease (PD), brain-derived neurotrophic factor (BDNF) may be a candidate gene conferring susceptibility to PD. In a recent study of a Japanese population, a functional BDNF Val66Met polymorphism was associated with PD, however, an analogous investigation of a western population did not replicate this finding. In the present study of a Chinese sample, we have investigated the associations between the BDNF polymorphism and susceptibility to PD and PD onset age. The distribution of the BDNF genotypes and alleles did not differ significantly comparing PD patients and controls. Further, the onset age was not significantly different comparing the three BDNF genotype groups. Thus, our negative findings suggest that it is unlikely that the BDNF Val66Met polymorphism plays a major role in the pathogenesis of PD in the Chinese population. Other BDNF genetic variants, and the association of these variants with PD symptomatology or treatment response, may merit further investigation.

Age of Onset↗

No association of tumor necrosis factor alpha gene polymorphisms with schizophrenia or response to clozapine.

Tumor necrosis factor alpha (TNF-alpha), a potent immunomodulator and proinflammatory cytokine, has been implicated in schizophrenia pathogenesis and clozapine response. Two studies have established an association between schizophrenia and the TNF-alpha gene -308G/A polymorphism; however, both increased and decreased -308A allele frequency have been reported in two analogous investigations. The present study examined the hypothesis that the TNF-alpha gene -308G/A polymorphism confers susceptibility to schizophrenia in 205 patients with schizophrenia compared with 192 controls. A subgroup of 99 clozapine-treated schizophrenia patients was also tested for the genetic effects of this polymorphism, as evidenced by clinical manifestation, and clozapine-related therapeutic outcome and body-weight change. The results of these investigations suggest that the TNF-alpha gene -308G/A variants do not play a major role in susceptibility to, clinical manifestations for, or clozapine response in, schizophrenia.

Adult↗

An association study of a brain-derived neurotrophic factor Val66Met polymorphism and clozapine response of schizophrenic patients.

A growing body of evidence suggests the involvement of brain-derived neurotrophic factor (BDNF) in both antipsychotic action and schizophrenia pathogenesis. The present study tested the hypothesis that the BDNF-gene Val66Met polymorphism is associated with schizophrenia and clozapine's therapeutic response. To identify any genetic predisposition to schizophrenia, we studied the BDNF-gene Val66Met polymorphism in 93 schizophrenic patients and 198 normal controls. Statistical analysis was used to test the association between this polymorphism and clozapine response the schizophrenic group. A trend (P=0.055) was demonstrated between genetic predisposition and Val66Met genotypes in 93 schizophrenic patients, especially for those with good response to clozapine (P=0.023). No significant difference in clozapine therapeutic response was demonstrated comparing the three Val66Met-genotype subgroups. Our finding suggests that this BDNF-gene Val66Met polymorphism may be related to schizophrenia pathogenesis in patients responsive to clozapine treatment.

Adult↗

Genetic variant of the histamine-1 receptor (glu349asp) and body weight change during clozapine treatment.

Clozapine treatment frequently causes body weight gain that may impair health and may affect patient compliance. While the histamine-1 (H1) receptor may play a major role in the mechanism of the clozapine-induced body weight change, we tested the relationship between the genetic variant (Glu349Asp) of the H1 receptor and the clozapine-induced body weight change. Eighty-eight schizophrenic patients treated with clozapine were included in this study. Analysis of body weight change after 4 months of clozapine treatment showed no relationship with the H1 genotype. Further exploration of the other H1 genotypes and the antipsychotic-induced body weight change may help in the understanding of the mechanisms of antipsychotic-induced body weight gain and in the choice of patient's antipsychotic regimens.

Adolescent↗

Dopamine D2 receptor and N-methyl-D-aspartate receptor 2B subunit genetic variants and intelligence.

The dopaminergic and glutamate systems have been implicated in cognitive function. We tested the associations between the dopamine D2 receptor (DRD2) and N-methyl-D-aspartate receptor 2B subunit (GRIN2B) gene variants and intelligence quotient (IQ). Subjects with the DRD2 A1/A1 genotype had a significantly higher mean performance IQ than A2/A2 carriers, while no significant differences in IQ scores were determined for the three GRIN2B genotype groups. These results suggest that genetic variants of the DRD2 gene may play a role in cognitive function. Considering the major role played by the dopaminergic system in general cognitive function, genetic variants of the dopamine receptors and those involved in metabolism and modulation of reuptake should be tested to improve gene-based prediction of general cognitive function.

Adult↗