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Jung-Der Wang

Publications and source records attributed to Jung-Der Wang.

At least 19 recordsLinked to original sources
PubMed2007

Quality of life in patients with hepatocellular carcinoma received surgical resection.

BACKGROUND: Hepatocellular carcinoma (HCC) is one the most common malignancies in the world. As the prognosis for HCC patients is poor, the quality of life (QOL) is becoming more important on the outcome assessments. The aim of this study was to evaluate QOL in HCC patients. METHODS: A total of 161 patients with HCC were enrolled at a university hospital. Most of these patients received surgical resections. They were assessed with Taiwan versions of WHOQOL-BREF, EORTC QLQ-C30, and utility measures. The WHOQOL-BREF domain scores for the HCC patients were compared to healthy normative Taiwan population, using general linear models controlling for gender and age. Multiple logistic regressions were applied to explore association between a better QOL and clinical/sociodemographic variables. RESULTS: Compared with healthy people, the HCC patients had reduced QOL in physical domains, but better environmental QOL. After controlling gender, age, education, and employment, duration of HCC more than 1 year was associated with better QOL scores. WHOQOL-BREF could be cross-validated with EORTC QLQ-C30. CONCLUSIONS: Survival over 1 year was associated with better QOL in HCC patients. WHOQOL-BREF could be a valid QOL instrument for the assessments of QOL in HCC patients.

Adult↗
PubMed2006

Predictors of betel quid chewing behavior and cessation patterns in Taiwan aborigines.

BACKGROUND: Betel quid, chewed by about 600 million people worldwide, is one of the most widely used addictive substances. Cessation factors in betel quid chewers are unknown. The present study explores prevalence and the quit rate of betel quid chewing in Taiwan aborigines. Our goal was to delineate potential predictors of chewing cessation. METHODS: A stratified random community-based survey was designed for the entire aborigines communities in Taiwan. A total of 7144 participants were included between June 2003 and May 2004 in this study. Information on sociodemographic characteristics, such as gender, age, obesity, education years, marital status, ethnicity, and habits of betel quid chewing, smoking and drinking was collected by trained interviewers. RESULTS: The prevalence of betel quid chewers was 46.1%. Betel quid chewing was closely associated with obesity (OR = 1.61; 95% CI: 1.40-1.85). Betel quid chewers were most likely to use alcohol and cigarettes together. Quit rate of betel quid chewers was 7.6%. Betel quid chewers who did not drink alcohol were more likely to quit (OR = 1.89; 95% CI: 1.43-2.50). Alcohol use is a significant factor related to cessation of betel quid chewing, but smoking is not. CONCLUSION: Taiwan aborigines have a high prevalence of betel quid chewers and a low quit rate. Alcohol use is strongly association with betel quid chewing. Efforts to reduce habitual alcohol consumption might be of benefit in cessation of betel quid chewing.

Adolescent↗
PubMed2006

Health-related quality of life after laparoscopically assisted vaginal hysterectomy: is uterine weight a major factor?

OBJECTIVE: To assess uterine size, symptom severity, and hemoglobin level as determinants of health-related quality of life (HRQOL) in women subsequently undergoing laparoscopically assisted vaginal hysterectomy (LAVH). METHODS: Sixty-one consecutive women with uterine leiomyoma or adenomyosis undergoing LAVH were studied using a prospective cohort design. The Chinese version of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire was assessed preoperatively. The Taiwan brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and a self-assessment of the perceived health status were assessed preoperatively and 1 day, 1 week, 12 weeks, and 18 months postoperatively. RESULTS: Women with a greater uterine weight did not report a greater severity of symptoms than those with lower uterine weight. Women with more severe symptoms had lower preoperative hemoglobin levels and were usually younger. Their perceived health status and their scores in physical domain of WHOQOL-BREF were also significantly lower, indicating a poorer HRQOL. The mixed-effects model found that a normal (higher) baseline hemoglobin level and a greater symptom severity were associated with a significant improvement of HRQOL in the physical domain of WHOQOL-BREF following LAVH. CONCLUSIONS: Preoperative symptom severity, but not uterine weight, was associated with long-term improvement in HRQOL after LAVH. Women with severe symptoms could be considered for LAVH before development of anemia.

Adenomatoid Tumor↗
PubMed2006

Hepatitis B- and C-related hepatocellular carcinomas yield different clinical features and prognosis.

The purpose of this study was to compare the clinical features and survival in patients with hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) and hepatitis C virus-related hepatocellular carcinoma (HCV-HCC). A total of 2820 HCC patients were included. The mean age of HBV-HCC patients was 52.5+/-13.4 years, while it was 64.8+/-8.7 years in HCV-HCC patients. The male/female ratio was 7.8 in HBV-HCC, while it was 1.7 in HCV-HCC. The mean alpha-fetoprotein level in HBV-HCC was 11,661+/-22,805 ng/mL, while it was 5079+/-15,005 ng/mL in HCV-HCC. The mean tumour size was 6.4+/-4.1 cm in HBV-HCC, while it was 4.6+/-3.1 cm in HCV-HCC. The median survival was 11.1 months in HBV-HCC, while it was 23.9 months in HCV-HCC. Compared with HBV-HCC patients, HCV-HCC patients were older, had a lower male/female ratio, lower white blood cell count, lower serum albumin level, higher serum ALT level, lower serum alpha-fetoprotein level, smaller tumour size and survived longer.

Adult↗
PubMed2006

Estimation of reduced life expectancy from serious occupational injuries in Taiwan.

This study assesses the loss of life expectancy and potential working life in Taiwan, between 1986 and 2000, from various types of occupational accidents resulting in mortality or permanent disability. The databases on occupational mortality and permanent disability were obtained from the Bureau of Labor Insurance, with this information then being linked to national death registry data to construct the survival function. A Monte Carlo simulation method was subsequently used to extrapolate the survival rate for up to 600 months, to derive the life expectancy for different types of occupational accidents leading to permanent disability (n=81,249). Based upon the life table for each calendar year, the life expectancy lost by age-gender cohort was also estimated for cases of mortality (n=20,001). In those cases resulting in permanent occupational disability, variations in the expected years of life lost (EYLL) were demonstrated by different occupational injuries, ranging from 7.4 to 13.6 years per case. The overall EYLL through permanent occupational disability is found to be almost identical to that of occupational mortality, with a ratio of 1.04:1. We conclude that permanent disability resulting from occupational injuries has a significant impact on society as a whole.

Accidents, Occupational↗
PubMed2006

Parental exposure to lead and small for gestational age births.

BACKGROUND: Previous studies about the effect of lead exposure on adverse birth outcomes are still inconsistent and few studies estimate the relationship between parental lead exposure and small for gestational age (SGA) infants. An occupational cohort study to assess whether parental lead exposure would be related to decreased birth weight and shortened gestational ages of their offspring was conducted. Whether higher lead exposure doses would increase risks of low birth weight (LBW), preterm delivery, and SGA births was also investigated. METHODS: A Program to Reduce Exposure by Surveillance System-Blood Lead Levels (Press-BLLS) was established in Taiwan in July 1993. The names of workers exposed to lead was collected from this occupational blood-lead notification database. The birth outcomes of their offspring were determined by linking to the Taiwan birth registration database from 1993 to 1997. Only singleton births whose parental blood-lead concentrations were tested during pregnancy or prior to conception, or within a 1-year span before these two periods were included. RESULTS: Among 1,611 eligible births, 72 births were LBW, 74 were preterm deliveries, and 135 were SGA. Maternal blood-lead concentrations (PbBs) equal to or more than 20 microg/dl had a higher risk of mothering a SGA child (risk ratio (RR) = 2.15; 95% confidence interval (CI), 1.15-3.83). CONCLUSIONS: Additional evidence of the effects of lead on adverse birth outcomes, especially for SGA births is reported. Maternal exposure to lead plays a more important role in the adverse effect on birth outcome than does paternal exposure.

Adult↗
PubMed2006

Use of Coptidis Rhizoma and foetal growth: a follow-up study of 9,895 pregnancies.

PURPOSE: To explore the effect of Coptidis Rhizoma on foetal growth in pregnancy. METHODS: During 1985-1987, each pregnant woman with 26 or more weeks of gestation who came to the Taipei Municipal Maternal and Child Hospital for prenatal care was enrolled and interviewed by three trained interviewers using structured questionnaires to obtain detailed information including the herbal medicines used during pregnancy. Medical histories of diabetes, hypertension, antepartum haemorrhage and medicines used during pregnancy were abstracted from medical records of mothers'. Data of birth weight, gestational duration and characteristics of infants were gathered from the Taiwan national birth registration. A total of 9,895 singleton livebirths were analysed. The variables related to foetal growth included two dichotomous measures: low birth weight (LBW) and small for gestational age (SGA); and one continuous measure: birth weight. Potential risk factors associated with these outcomes were investigated using multiple logistic and linear regression models. RESULTS: After adjustment, pregnant women taking Coptidis Rhizoma during pregnancy had no significantly adverse effect on foetal growth. There was a non-significantly slightly decreased mean of birth weight and increased risk of LBW and SGA babies if the frequency of using Coptidis Rhizoma was more than 56 times. CONCLUSIONS: The usual usage of Coptidis Rhizoma during pregnancy seemed not to increase the adverse risk on foetal growth. Future observations for use of longer than 56 times or a higher cumulated dose were needed to clarify the safety.

Adolescent↗
PubMed2006

Development of active safety surveillance system for traditional Chinese medicine: an empirical study in treating climacteric women.

PURPOSE: Traditional Chinese medicines (TCM) prescribed by doctors are regularly reimbursed by the National Health Insurance (NHI) in Taiwan. The safety of TCM should undergo the same scrutiny that most western medicines do. This study was to monitor adverse events (AEs) associated with a new mixture of TCM, TMN-1, used to treat climacteric symptoms. METHODS: For this multi-center, prospective observational study, we recruited 134 women with climacteric symptoms. During this 12-week study, the subjects made nine visits, took TMN-1 three times a day, and received routine hematologic tests, biochemical tests, and tests for gynecologically relevant hormones at baseline and after 4 and 12 weeks of beginning medication. At every visit, the subjects were asked by questionnaire about any AEs. All AEs were examined through a process of causality assessment (CA) by a research team. RESULTS: In total, we recorded 203 AEs, in order of decreasing incidences--cough, pharyngitis, rhinitis, abdominal pain, abdominal fullness, diarrhea, and pruritus with incidence rates of 2.57, 2.47, 1.88, 1.78, 1.68, 1.58, and 1.58 per 10(3) person-days, respectively. Most AEs were tolerable. Five of the AEs were judged to be "probable" adverse drug reactions (ADRs): Two events of diarrhea and one event each of nausea, abdominal pain, and abdominal fullness. CONCLUSION: This study demonstrates the effectiveness using active safety surveillance to document safety of TCMs. This surveillance system could probably be useful to document the safety of other alternative or complementary medicines.

Adult↗
PubMed2006

Prevalence and risk factors of work-related musculoskeletal disorders in massage practitioners.

INTRODUCTION: Massage practitioners are at high risk for work-related musculoskeletal disorders (WMSDs). We investigated the prevalence and risk factors. METHODS: We randomly selected 161 visually impaired practitioners. Demographics, musculoskeletal symptoms, and working postures were analyzed with multivariate logistic regression. RESULTS: Results indicated that about 71.4% had at least one WMSD in 12 months. Prevalence rates were finger or thumb, 50.3%; shoulder, 31.7%; wrist, 28.6%; neck, 25.5%; arm or elbow, 23.6%; forearm, 20.5%; and back, 19.3%. Working duration >20 years had an adjusted odds ratio (OR) for finger or thumb 4.0-4.5 with 95% confidence interval (CI) 1.5-13.8, client contact >4 h/day (adjusted OR for finger = 3.2, 95% CI=1.3-8.1), and < or =7-kg pulp-pinch strength (adjusted OR for upper extremity = 2.9-3.2, 95% CI=1.2-8.3). Adjusted ORs for lower-back symptoms were 3.1 (95% CI=1.3-7.8) and 3.6 (95% CI=1.4-9.6), respectively, for lack of neutral neck posture and for inappropriate working-table height. CONCLUSION: WMSDs were prevalent among massage practitioners.

Adult↗
PubMed2006

Validating, improving reliability, and estimating correlation of the four subscales in the WHOQOL-BREF using multidimensional Rasch analysis.

OBJECTIVE: This study examined the construct validity, and improved the test reliability and the estimation accuracy for the correlation between domains of the WHOQOL-BREF using multidimensional Rasch analysis. METHOD: A total of 13,083 adults were administered the 28-item WHOQOL-BREF Taiwan version, which consists of 4 subscales (domains). The multidimensional form of the partial credit model was used to examine the fit of the 4 subscales. For comparison, each subscale individually was also fitted to the unidimensional partial credit model. Standard item fit statistics and analysis of differential item functioning (DIF) were used to check model-data fit. RESULTS: After excluding 2 overall items and deleting 7 DIF items, the remaining items of each subscale in the WHOQOL-BREF constituted a single construct. The test reliabilities and correlations between domains obtained from the multidimensional approach, (0.82-0.86) and (0.79-0.89), respectively, were much higher than those obtained from the unidimensional approach, (0.67-0.75) and (0.53-0.65), respectively. CONCLUSION: The 19-item WHOQOL-BREF measures more succinct latent traits than the original design. The multidimensional approach yields not only more accurate estimates for the correlation between domains but also substantially higher reliabilities, than the standard unidimensional approach.

Adult↗
PubMed2006

Development and psychometric properties of the dialysis module of the WHOQOL-BREF Taiwan version.

BACKGROUND: Quality of life (QOL) is now considered to be an important part of the assessment of dialysis patients. The aim of this study was to develop and assess the reliability, validity and sensitivity of the dialysis module of the World Health Organization Quality of Life - Brief (WHOQOL-BREF) Taiwan version [WHOQOL-BREF(TW)] in patients undergoing regular hemodialysis (HD). METHODS: QOL survey was administered to 283 regular HD patients in metropolitan Taipei. The instruments used included: (1) the proposed module - composed of the core part, the WHOQOL-BREF(TW), and the six specific items; (2) the symptom/problem (S/P) scale - composed of 12 items specific for dialysis patients; (3) the utility measure, which was performed with standard gamble (SG) methods; and (4) the rating scale (RS). RESULTS: Based on the six criteria of validity, reliability and variance of the items, four HD-specific items were selected. Reliability study showed that Cronbach's alphas, composite reliability, and test-retest reliability (intraclass correlation at an average retest interval of 4-8 weeks) of the four domains of physical, psychological, social relationship and environment, ranged from 0.74-0.82, 0.79-0.84 and 0.61-0.79, respectively. Validity study showed that all the correlations between an item and its corresponding domain were highly significant (r>0.4, p<0.01) and larger than the correlations between the item and other domains. SG and psychometric measures showed relatively low correlations (0.12-0.26). The module showed the same construct as the WHOQOL-BREF(TW) under confirmatory factor analysis, whereas the exploratory factor analysis showed mild variation. Convergent and discriminant validity were good. Global QOL, physical, psychological and environment domains had some sensitivity to differentiate the severity of the condition of patients receiving HD. Clinical validity was demonstrated in global QOL, physical and psychological domains to have significant correlations with S/P scores. CONCLUSION: Besides broader coverage than the core WHOQOL-BREF(TW), the dialysis module of the WHOQOL-BREF(TW) is a valid, reliable and sensitive QOL instrument for the assessment of HD patients in Taiwan.

Adult↗
PubMed2006

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↗
PubMed2006

Reduced epidermal nerve density among hand-transmitted vibration-exposed workers.

OBJECTIVE: The objective of this study was to evaluate ultrastructural changes of epidermal nerve density (END) in workers exposed to hand-transmitted vibration. METHODS: Ten male subjects with occupational exposure to hand-transmitted tools for 46.9 hours weekly for an average of 6.5 years were included in this study. We performed a skin biopsy from the forearms and compared the END with 10 age- and gender-matched healthy control subjects. RESULTS: Nine of the 10 subjects had abnormally low END. The END of the exposed workers was significantly lower than the control group (4.1 +/- 2.8 vs 9.0 +/- 4.3 fibers/mm, P = 0.005). The difference remained even after one subject with possible undiagnosed diabetes was not included (4.3 +/- 2.9 vs 9.6 +/- 4.2 fibers/mm, P = 0.005). The reduction of END did not correlate with the abnormality of nerve conduction studies or quantitative sensory testing. CONCLUSIONS: The reduction of END suggested the involvement of small-diameter nerve fibers among this population, and such a histologic change might either be independent or precede changes of large myelinated nerve fibers.

Adult↗
PubMed2006

Grand rounds: outbreak of hematologic abnormalities in a community of people exposed to leakage of fire extinguisher gas.

CONTEXT: Although there are ample data on the respiratory effects of exposure to fire extinguisher gas, the potential hematologic effects have not been fully documented. We conducted this study to determine the possible etiologic agent(s) for a decrease in red blood cells among community residents in Taipei, Taiwan, after they were exposed to leakage of mixed fire extinguishants containing bromotrifluoromethane (CF3Br, Halon 1301), bromochlorodifluoromethane (CF2BrCl, Halon 1211), and dichlorodifluoromethane (CCl2F2, CFC-12). CASE PRESENTATION: We studied 117 exposed residents who came into one hospital for physical examinations. We also selected age- and sex-matched referents for comparison from residents who came to the same hospital for health examinations. Nine months after the exposure to mixed fire extinguishants, 91 of the exposed residents came back for a second physical examination. In the first examination of the exposed residents, we found a significant reduction in red blood cell count and hemoglobin and a relationship between dose and response. DISCUSSION: After excluding iron-deficiency anemia, thalassemia, and other possible agents, we suspected that the hematologic effects might have resulted from pyrolytic products of CFC-12 and Halon 1211, which may contain phosgene, among other products. RELEVANCE TO CLINICAL PRACTICE: The acute transient hematologic effects observed in the exposed residents were associated with the incident of leakage of mixed fire-extinguisher gases and were most likely caused by a small amount of pyrolytic products, probably phosgene. Nine months after the exposure, we found a significant improvement in the abnormalities without any specific treatment.

Adult↗
PubMed2006

Herbal medicines used during the first trimester and major congenital malformations: an analysis of data from a pregnancy cohort study.

BACKGROUND: Major congenital malformations place a considerable burden on the affected child, the family and society. Any kind of medicine used during pregnancy might have a harmful impact; therefore, such practice has raised concerns. The objective of the current study was to explore the relationship between the use of herbal medicines by pregnant women during the first trimester of pregnancy and the risk of major congenital malformation in their live born infants. METHODS: This was a cross-sectional analysis of data from a prospective pregnancy cohort, which was established between 1984 and 1987. To assemble the cohort, pregnant women of >or=26 weeks of gestation who came to the Taipei Municipal Maternal and Child Hospital in Taiwan for prenatal care were enrolled in the study and interviewed using a structured questionnaire. Detailed information, including herbal medicine use during different periods of pregnancy, was obtained during the interview. Past medical history, current obstetric data and details on conventional medicines used during pregnancy were abstracted from medical records. Data on birth weight, gestational duration and characteristics of live born infants were gathered from the Taiwan national birth register. Congenital malformation information was obtained from multiple sources: the newborn examination record (1984-7); the national death register (1984-2003); and Taiwan National Health Insurance data (1996-2000). Multiple logistic regression was used to estimate the odds ratio [OR] of major congenital malformation by herbal medicines used during the first trimester. RESULTS: A total of 14,551 live births were analysed. After adjustment for confounding factors, taking huanglian during the first trimester of pregnancy was found to be associated with increased risk of congenital malformations of the nervous system (adjusted OR 8.62, 95% CI 2.54, 29.24). An-Tai-Yin was associated with an increased risk of congenital malformations of the musculoskeletal and connective tissues (adjusted OR 1.61, 95% CI 1.10, 2.36) and the eye (adjusted OR 7.30, 95% CI 1.47, 36.18). CONCLUSION: We found evidence for a possible link between the use of specific herbal medicines during the first trimester of pregnancy and increased risks of specific groups of congenital malformations. We could not investigate whether the adverse effects were related to direct toxicity from the herbal medicines, or were from misuse, contamination or uncontrolled confounding. Nonetheless, we would advise caution regarding use of herbal medicines during pregnancy, and we suggest that further investigation of these findings is warranted.

Abnormalities, Drug-Induced↗
PubMed2006

Respirable dust exposure and respiratory health in male Taiwanese steelworkers.

The objective of this cross-sectional study was to investigate the prevalence and determinants of respiratory symptoms and lung function and their association with occupational dust exposure in Taiwanese steelworkers. The study was conducted on an integrated-steel company in Taiwan from March 1989 to February 1990. After excluding workers in the coke ovens and ex-smokers, we performed physical examinations on 1,339 male workers in the iron making and steel making factories. Subjects were interviewed regarding respiratory symptoms using a Chinese version of the American Thoracic Society respiratory questionnaire and were examined with respect to their lung function using spirometry. Objective dust exposure was measured using personal air sampling with 277 valid samples. Prevalences of cough frequently, chronic cough, phlegm frequently, chronic phlegm, wheezing occasionally, and breathlessness were 11.4%, 9.3%, 14.6%, 11.9%, 2.6%, and 6.5%, respectively. Duration of employment, smoking, subjective dustiness, and past respiratory illnesses can predict these respiratory symptoms. Average respirable dust exposure significantly decreased the forced vital capacity (FVC) and forced expiratory volume in one second (FEVI.0) in smoking workers. In the non-smokers, an effect of respirable dust exposure on FEVl.0/FVC was shown. Since the main ingredients of dust in such a steelworks usually contained mixtures of oxides and silicates other than silica dust, respirable dust exposure in steelworks might impair lung function, especially among smokers.

Adult↗