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Ming-Hsien Lin

Publications and source records attributed to Ming-Hsien Lin.

11 recordsLinked to original sources
PubMed2006

Nutritional status and clinical outcomes among institutionalized elderly Chinese in Taiwan.

Nutrition is an important issue in institutional care, and is related to clinical outcomes in many aspects. Although Taiwan is marching to an aged society, related studies were lacking. Elderly residents in two long-term care facilities (LTCF) were enrolled for study. Nutritional status including anthropometric measurements and laboratory examinations was assessed every 3 months for 12 months. Age, sex-matched community-dwelling elderly participating in the annual health check-up was randomly selected as the control subjects. In total, 66 subjects in LTCF and 870 age, sex-matched community-dwelling elderly were enrolled. Body mass index, serum levels of albumin, and total cholesterol were significantly poorer in LTCF residents than the community-dwelling elderly. Triceps skinfold thickness, hemoglobin, serum albumin, and total cholesterol were progressively deteriorated among the institutionalized elderly during the 6-month follow-up. Thirteen subjects of the study group had been hospitalized during the follow-up. Body mass index, triceps skinfold thickness, mid-arm circumference, serum albumin at screening were significantly poorer and unintentional weight loss within 6 months was significantly greater in subjects who had been hospitalized. By using multivariate logistic regression model, only weight loss >5% within 6-month follow-up was the significant independent predictive factors to hospitalization. In conclusion, nutritional status of institutionalized elderly Chinese was significantly poorer than the community-dwelling elderly. Nutritional markers were progressively deteriorated in LTCF residents during the follow-up period. Unintentional weight loss >5% within 6 months was the only significantly independent predictive factor for hospitalization among the institutionalized elderly Chinese.

Aged↗
PubMed2006

Hyponatremia among the institutionalized elderly in 2 long-term care facilities in Taipei.

BACKGROUND: Hyponatremia is common in the institutionalized elderly, and syndrome of inappropriate antidiuretic hormone secretion was deemed the most important etiologic factor. The purpose of this study was to evaluate the prevalence and etiologic factors of hyponatremia among institutionalized elderly and to explore its association with nutritional status. METHODS: Subjects in 2 private long-term care facilities (LTCFs) participated in this study. Periodic nutritional evaluations, including anthropometric measurements and serial laboratory examinations, were performed every 6 months. When hyponatremia was identified, serum osmolality, serum levels of cortisol, thyrotropin, antidiuretic hormone, urine osmolality, and electrolyte profile were done instantly. Water loading tests were performed for subjects with euvolemic, hypo-osmolar hyponatremia. Nutritional status (i.e. hemoglobin, serum albumin, serum total cholesterol, body mass index [BMI], and mean body weight loss within 6 months) was compared between hyponatremic and normonatremic subjects during hyponatremic episodes and at follow-up (6 months later). RESULTS: In total, 67 (mean age = 77.2 +/- 8.8 years, M/F = 45/22) LTCF residents were enrolled. The prevalence of hyponatremia was 31.3% (21/67) during the 6-month period, and 62.5% of these cases were related to reset osmostat. In addition, BMI was similar between hyponatremic and normonatremic subjects during hyponatremic episodes (19.1 +/- 3.2 vs 20.5 +/- 4.0 kg/m2, p = 0.16), but became significantly lower in hyponatremic subjects 6 months later (18.5 +/- 3.2 vs 20.8 +/- 4.2 kg/m2, p = 0.027). However, the mean body weight loss during the 6-month follow-up was similar (3.0% vs 0.8%, p = 0.25). Furthermore, hemoglobin and serum levels of albumin were similar between groups during hyponatremic episodes and at follow-ups, but serum levels of total cholesterol were significantly lower in hyponatremic subjects on both occasions (166.9 +/- 30.5 vs 190.2 +/- 38.2 mg/dL, p = 0.016 during hyponatremic episodes and 153.6 +/- 29.4 vs 182.8 +/- 35.5 mg/dL, p = 0.003 at follow-up). CONCLUSION: About a third of LTC-dwelling elderly would experience hyponatremia during the 6-month period, and 62.5% of them were due to reset osmostat. The relationship between hyponatremia and undernutrition deserves further investigation.

Aged↗
PubMed2006

Asymptomatic bacteriuria among the institutionalized elderly.

BACKGROUND: Urinary tract infections (UTI) are the most common type of infection among residents of long-term care facilities (LTCFs). The presence of asymptomatic bacteriuria among LTCF residents brings challenges to onsite health professionals. The aim of this study was to explore the prevalence and related factors of aymptomatic bacteriuria among the institutionalized elderly in Taiwan. METHODS: In 2002, residents of 2 private LTCFs participated in this study. History taking, anthropometric measurements, and urine and blood samplings were performed by experienced research staff. Urine bacterial culture was performed by a standard procedure; subjects with symptoms indicating UTI were excluded. Repeated urine bacterial culture was performed 1 week after screening tests. Bacteriuria was defined as 1 or more organisms isolated from 2 consecutive urine specimens (> or =10(5) CFU [colony-forming units]/mL). Asymptomatic bacteriuria was defined as identical microorganisms isolated from 2 urine culture specimens taken at 1-week intervals from a subject who was free of UTI symptoms. The presence of asymptomatic bacteriuria and its related factors, such as age, sex, nutritional status, and long-term placement of urinary catheter, were evaluated. RESULTS: A total of 64 institutionalized Chinese elderly (mean age, 76.2 +/- 9.1 years; male:female, 48:16) were collected. The prevalence of asymptomatic bacteriuria was 57.8% (37/64), and was not associated with age, sex, functional status, long-term foley catheter, or previous UTI history. The most commonly isolated organisms were Escherichia coli (29.7%), Klebsiella pneumoniae (21.6%), Providentia stuartii (16.2%), and Pseudomonas aeruginosa (13.5%). Moreover, 21.6% of them showed multiple organisms. Nutritional status (body mass index, serum levels of albumin, total cholesterol, total lymphocyte count, and hemoglobin) was similar between subjects with or without bacteriuria (p > 0.05). CONCLUSION: Asymptomatic bacteriuria is common among Chinese residents in LTCFs. Escherichia coil was the most commonly cultured bacterium. Presence of asymptomatic bacteriuria was not associated with age, sex, functional status, catheter indwelling, previous history of UTI, or nutritional status of residents in LTCFs.

Aged↗
PubMed2006

Association of insulin resistance and hematologic parameters: study of a middle-aged and elderly Chinese population in Taiwan.

BACKGROUND: Chronic inflammation is a common feature related to changes in hematologic parameters in insulin resistance. The aims of this study were to explore the relationship between hematologic parameters and insulin resistance, and to establish a gerontologic profile for following studies. METHODS: Residents aged over 40 years in 3 major townships in I-Lan County participating in the Adult Health Examination were invited for the study. Diagnosis of diabetes mellitus (DM) was done according to American Diabetes Association criteria. Insulin resistance was measured by homeostasis model assessment (HOMA-IR), and subjects with the highest tertile of HOMA-IR were defined as being insulin resistant. Hematologic parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin, and platelet count were measured for comparisons. RESULTS: A total of 857 subjects (mean age, 64.6 +/- 11.2 years; male/female, 373/484) participated in this study. Their mean body mass index (BMI) was 24.5 +/- 3.7 kg/m2, and 42.4% of them were obese and 21.8% were overweight. The overall prevalence of DM was 15.4% (7.7% were previously diagnosed and 7.7% were newly diagnosed), and impaired fasting glucose was 7.2%. Trend analyses confirmed that age, BMI, HOMA-IR, WBC and platelet counts were significantly increased as glycemic metabolism exacerbated (p = 0.007, < 0.001, < 0.001, < 0.001 and 0.025, respectively). Compared with insulin-sensitive subjects, insulin-resistant subjects were more likely to be females (70.2% vs. 49.7%, p < 0.001), and had significantly higher BMI (26.2 +/- 3.9 kg/m2 vs. 23.7 +/- 3.3 kg/m2, p < 0.001), HOMA-IR (3.6 +/- 3.5 vs. 0.7 +/- 0.3, p < 0.001), WBC count (6686.9 +/- 1889.2/mm3 vs. 5942.9 +/- 1740.4/mm3, p < 0.001), and platelet count (243.5 +/- 70.9 x 10(3)/mm3 vs. 231.0 +/- 62.2 x 10(3)/mm3, p = 0.011), but not age (64.5 +/- 11.0 years vs. 64.6 +/- 11.4 years, p = 0.93) or RBC count (4.6 +/- 0.6 M/mm3 vs. 4.6 +/- 0.6 M/mm3, p = 0.76). When age and sex were controlled, HOMA-IR significantly correlated with WBC count (gamma = 0.23, p < 0.001) and platelet count (gamma = 0.09, p = 0.007). However, by multiple logistic regression, female gender, overweight and obesity, and elevated WBC count were all found to be independent risk factors of insulin resistance, but age, RBC and platelet counts were not. CONCLUSION: Elevated WBC count but not RBC count was significantly associated with insulin resistance and glycemic metabolism. The relationship between platelet count and insulin resistance deserves further investigations.

Aged↗
PubMed2006

Pigmented malignant hidroacanthoma simplex mimicking irritated seborrheic keratosis.

Pigmented variant of malignant hidroacanthoma simplex (PMHS) is very rare. We are aware of only two reported cases, all arising in pigmented hidroacanthoma simplex (HS). We report the third case of PMHS arising in a pigmented HS. A 71-year-old-woman presented with a well-demarcated pigmented hyperkeratotic tumor on the right knee resembling irritated seborrheic keratosis. Histopathologic examination of the excised tumor revealed intraepidermal proliferation of atypical polygonal poroid cells forming large, sharply demarcated nests with colonization of dendritic melanocytes. In addition, there were focal changes of a benign pigmented HS and syringofibroadenoma. The key diagnostic features of ductal structures and intracytoplasmic lumina were highlighted by carcinoembryonic antigen and epithelial membrane antigen immunostaining. PMHS should be differentiated from irritated seborrheic keratosis, melanoacanthoma, Bowen's disease and malignant melanoma both clinically and pathologically.

Acrospiroma↗
PubMed2005

Metabolic characteristics and insulin resistance of impaired fasting glucose among the middle-aged and elderly Taiwanese.

Impaired fasting glucose (IFG), a newly defined category of glycemic metabolism, has gained extensive attentions after the introduction of the diagnostic criteria of diabetes mellitus (DM) by the American Diabetes Association. To explore the metabolic characteristics of IFG, we conducted this prospective community-based study among people aged more than 40 years residing in three major townships of I-Lan, an agricultural county in Taiwan. People attending the annual health examinations in community health stations were recruited for study. Experienced research staff recorded the past medical history, performed comprehensive physical examinations, and drew blood for further laboratory tests for each subject. Insulin resistance was evaluated by homeostasis model assessment (HOMA), and the renal hemodynamics was evaluated by estimated glomerular filtration rate (GFR). In total, 824 subjects (mean age=64.4+/-11.3 years, M:F=366:458) participated this study, the overall prevalence of DM was 15.3% (8.7% previously undiagnosed), and the prevalence of IFG was 7.2%. Lipid profiles including serum levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride of subjects with IFG were basically indistinguishable from subjects with DM. Insulin resistance was significantly associated with the progression of glycemic metabolism (HOMA-IR of subjects with normal fasting glucose, IFG, and DM were 1.12+/-1.24, 1.88+/-1.64, 4.47+/-5.12, P<0.001). However, the prevalence of metabolic syndrome was similar among subjects of IFG and DM (86.4 versus 85.6%). The prevalence of overt proteinuria was significantly increased as the glycemic metabolism progressed. The mean GFR was slightly increased in subjects with IFG, which may represent hyperfiltration in this category. In conclusion, metabolic characteristics of IFG were complex. Lipid profile and prevalence of metabolic syndrome of IFG were indistinguishable from DM, but renal hemodynamics and prevalence of overt proteinuria were intermediate between NFG and DM. To prevent or delay the onset of type 2 DM, aggressive lifestyle modifications should be engaged in our clinical practice for subjects with IFG.

Adult↗
PubMed2003

A phase II trial of gemcitabine in the treatment of advanced bile duct and periampullary carcinomas.

BACKGROUND: Gemcitabine is a novel nucleoside analogue with clinical anticancer activity in several malignancies. From September 1998 to April 2000, we treated patients with advanced bile duct and periampullary carcinomas with gemcitabine alone. METHODS: Gemcitabine 1,000 mg/m(2)/day was administered in 200 ml of normal saline as a 30-min intravenous infusion on day 1 weekly for 3 weeks, followed by a 1-week rest. RESULTS: A total of 24 consecutive patients (15 men, 9 women), with a median age of 59.5 years (range 40-72 years), were enrolled. All patients were evaluable for response: 1 patient achieved complete remission (CR); 2 patients had partial remission (PR); 8 patients remained stable (SD), and 13 patients had progressive disease (PD). The overall response rate (CR + PR) was 12.5% with a 95% confidence interval (CI) of 2.7-32.4%. The median progression-free survival (PFS) was 2.5 months (95% CI 1.6-5.5 months), and the median overall survival (OS) was 7.2 months (95% CI 3.8-8.9 months). Patients with disease control (CR + PR + SD) had better PFS and OS than those with PD. There were no treatment-related deaths. Few patients encountered grade 3/4 toxicity. CONCLUSION: Chemotherapy with gemcitabine demonstrated notable activity and was associated with a well-tolerable toxicity profile in patients with advanced biliary tract malignancies.

Adult↗
PubMed2003

EBER-1 positive diffuse large cell lymphoma presenting as lupus nephritis.

Approximately one-third of membranous glomerulonephritis (MGN) cases in adults are associated with systemic diseases, including systemic lupus erythematosus (SLE) or malignancies. Malignancy-associated glomerulonephritis is rarely found in non-Hodgkin's lymphoma (NHL). Epstein-Barr virus (EBV) has been postulated to contribute to the pathogenesis of both SLE and NHL. We described a 37-year-old woman with nephrotic syndrome who presented with clinical features of SLE and renal-biopsy revealed lupus MGN. The patient also suffered from concomitant progressive lymphadenopathy and NHL (diffuse large B-cell type) was demonstrated by neck lymph node biopsy. Serologic studies demonstrated EBV infection and specific EBV antigens were present on lymph node and metastatic sites. We offer a discussion regarding the complex relationships between SLE, NHL, MGN and EBV.

Acute Kidney Injury↗
PubMedDate not supplied

Childhood functional abdominal pain and Helicobacter pylori infection.

BACKGROUND/AIMS: Like functional gastrointestinal disorders in adults, the exact etiology of childhood functional abdominal pain (FAP) is unclear. Among those proposed etiologies, chronic Helicobacter pylori (HP) infection plays an important role. Therefore, we conducted this study to investigate the relationship of childhood FAP and chronic HP infection. METHODOLOGY: From 1998 to 2000, pediatric patients referred to our outpatient department under the impression of recurrent abdominal pain were carefully evaluated, and only subjects with FAP were recruited for study. Endoscopic examinations for rapid urease test and histology were performed in each patient, and [13C]-urea breath test was also performed in each patient. Twelve months later, all the procedures were repeated again for follow-up study. Status of FAP and HP infection of each subject was re-evaluated again for further comparisons. RESULTS: In total, 135 patients participated in the primary survey, and 114 of them were successfully followed 12 months later. The results of primary endoscopic examinations were as follows: 43.7% normal results, 19.3% esophagitis, 15.6% gastroduodenitis, 13.3% peptic ulcer diseases (PUD), and 7.4% nodular gastritis. The overall prevalence of HP infection was 23.7% (32/135) at the primary survey. At the follow-up study, 77 (67.5%) patients still suffered from FAP. Persistence of FAP was noted among 59 of 84 (70.2%) non-HP infected patients, and in 13 (86.7%) of the 15 HP-infected, non-eradicated patients in the follow-up study, which did not show statistical significance (P=0.13). CONCLUSIONS: Aside from subjects with PUD, 72.7% of FAP children suffered from similar symptoms during the 12-month follow-up, and HP infection status did not significantly influence the disease courses.

Abdominal Pain↗