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Biomedical subjects

R S Lin

Publications and source records attributed to R S Lin.

At least 19 recordsLinked to original sources

Addressing Taiwan's high incidence of cervical cancer: factors associated with the Nation's low compliance with Papanicolaou screening in Taiwan.

BACKGROUND: Despite cervical cancer being the leading female cancer, women in Taiwan have received fewer screening examinations for this disease than populations in Western countries. METHODS: Randomly selected telephone questionnaire interviews with women aged 20 years and over were conducted to investigate the factors associated with the subject's cancer screening practices. RESULTS: Among 1021 respondents, 51.6% self-reported no Papanicolaou (Pap) examination received within their lifetime. The multivariate logistic regression analysis revealed that, in addition to marital status, cancer knowledge was the most significant factor associated with screening practice compliance. Compared with women with correct answers for 22-28 cancer knowledge questions, the odds ratios (OR) for non-compliance were 1.4 (95% confidence interval (CI)=1.0-2.0) for women with 17-21 correct answers and 2.3 (95% CI=1.6-3.4) for women with less than 17 correct answers. Women aged 40-49 years had the best cancer knowledge scores. Unmarried women were at an elevated risk for no Pap examination (OR=7.6, 95% CI=5.2-11.3). CONCLUSIONS: Women in Taiwan should be targeted for intervention to promote cancer knowledge and screening compliance.

Adult↗

Diet, vegetarian food and prostate carcinoma among men in Taiwan.

In a case-control study in a veterans hospital in Taiwan, we compared 237 histology-confirmed prostate carcinoma cases with 481 controls, frequency matched by age, for their consumption of vegetarian food, namely soybean products, rice, wheat protein and other vegetables. The multivariable logistic regression analysis showed a significant association with such food (odds ratio (OR)=0.67, 95% confidence interval (CI)=0.47, 0.94). This beneficial effect presented for men with body mass index (BMI) < or =25 kg m(-2) (OR=0.50, 95% CI=0.32, 0.76) but not for men with greater BMI. The OR of prostate carcinoma for men with BMI < or =25 kg m(-2) was 1.74 (95% CI=1.21, 2.51), compared with men with higher BMI (>25 kg m(-2)). Other significant risk factors associated with the disease included higher income (OR=2.40, 95% CI=1.07, 5.42), physical activity (OR=1.75, 95% CI=1.08, 2.83), being married (OR=2.49, 95% CI=1.40, 4.43) and coffee consumption (OR=1.88, 95% CI=1.07, 3.30). Stratified analysis also showed that the consumption of fish/shellfish had an adverse association for men with higher BMI. This study suggests that the intake of the low fat local vegetarian food has a protective effect against prostate carcinoma for thin men in this study population.

Adenocarcinoma↗

Peripheral blood cells among community residents living near nuclear power plants.

Information about hematopoieses as a result of exposure to very low levels of radiation is scarce. To investigate the human hematopoietic effect of very low level radiation exposure, measurements of peripheral blood components were performed among 3602 men and women, aged 35 and above, living in a community near two nuclear power installations in Chinshan, Taiwan. The radiation level that each individual was exposed to was represented by a surrogate level, '1/D2(1i) + 1/D2(2i)', a transformed distance from each individual's residence to the two power plants D1 and D2. In addition to comparing average hematology measurements, multiple regression analyses were done to include age, gender, smoking, drinking status and the surrogate radiation exposure level as independent variables. Univariate and bivariate analyses showed that the hematology measurements had significant associations with age, gender, smoking or drinking. The multiple regression analyses revealed that significant positive associations with '1/D2(1i) + 1/D2(2i)' were found for hemoglobin, hematocrit, platelet, white blood cell and red blood cell. The platelet count might increase for 208.7 x 10(3)/microl if the exposure from the nuclear plants increased by one exposure unit. This type of association implies that those who lived closer to the nuclear power installation had a higher blood cell count; we suspect that this could be a type of radiation hormesis.

Adult↗

Coronary heart disease risk factors in urban bus drivers.

The purpose of this study was to determine the risk factors for coronary heart disease (CHD) in 2297 bus drivers and skilled workers from the Taipei Municipal Bus Administrative Bureau. Data for this study were compiled from the medical records of annual physical examinations for bus drivers and skilled workers conducted at Taipei Municipal Chronic Disease Hospital during the period from July 1998 to June 1999. The results showed that, after adjustment for age, hypertension rates for bus drivers (56.0%, 986/1361) were significantly greater than for skilled workers (30.6%, 164/536). All age groups demonstrated a similar difference. Significant differences were also noted in body mass index, serum cholesterol, serum triglyceride and ischemic heart disease between bus drivers and skilled workers. Among bus drivers, the prevalence of obesity was 9.6%, hypercholesterolemia 34.0%, hypertriglyceridemia 69.4% and ischemic heart disease 1.7%. By contrast, among skilled workers, the prevalence of obesity was only 4.6%, hypercholesterolemia 29.9%, hypertriglyceridemia 30.6% and ischemic heart disease 0.9%. These findings suggest that exposure to the occupation of driving a bus may carry an increased risk of CHD and that drivers who develop signs of cardiovascular illness should be transferred to non-driving occupations within the company.

Adult↗

Drug-resistant tuberculosis in Taipei, 1996-1999.

OBJECTIVES: To determine the trends, patterns, and risk factors associated with drug-resistant tuberculosis, we conducted a hospital-based retrospective study in Taipei. METHODS: Clinical and bacteriologic data were routinely collected from 453 patients with a diagnosis of tuberculosis who were treated at Taipei Municipal Chronic Disease Hospital from January 1996 through December 1999 for whom drug-susceptibility testing was done. RESULTS: Resistance to at least one drug was identified in 154 (34%) out of the 453 patients, and 34 (7.5%) patients were resistant to at least isoniazid and rifampin. Among the 199 patients with recurrent tuberculosis, 98 (49.2%) had isolates that showed resistance to at least one drug. Among the 254 new patients, 56 (22.0%) had isolates that were drug resistant. For all 453 patients, resistance to rifampin was most common (17.4%), followed by resistance to isoniazid (13.9%), streptomycin (13.7%), ethambutol (8.2%), and kanamycin (3.5%). A history of previous tuberculosis therapy (odds ratio = 9.4; 95% CI, 2.9-28) and being born outside of Taiwan (odds ratio 3.3; 95% CI, 1.1-34) were significant risk factors for multidrug resistance. CONCLUSIONS: Our data suggest that the Taipei tuberculosis control program should be rapidly strengthened by expanded use of directly observed therapy and more careful bacteriologic and clinical follow-up, particularly in cases of recurrence and in persons born outside of Taiwan in tuberculosis endemic areas. Our results also indicate that the regular measuring of rates of drug resistance and the monitoring and guiding of tuberculosis treatment programs could increase the therapeutic response rate and prevent the appearance of newly acquired resistance in patients with tuberculosis. In addition, with high rifampin resistance (17.4%), the regulated market for rifampin is essential in Taiwan.

Adult↗

Pinworm control and risk factors of pinworm infection among primary-school children in Taiwan.

Longitudinal pinworm (Enterobius vermicularis) infection rates were estimated at a mass screening for first-grade children during 1991-1996; children were provided medication at the screening. This campaign was able to decrease the infection rates for the 1991 cohort from 16.3% to 0.6%. A case-control study was further conducted for the investigation of risk factors among fourth-graders. Cases comprised 429 children with at least one infection between September 1996 to June 1999, and controls were 280 randomly selected uninfected classmates. Parents were asked to complete a questionnaire survey to report students' personnel hygiene habits. The case-control study revealed that significant factors associated with the infection included playing on the floor (odds ratio [OR], 2.5), nail biting (OR, 2.1), failure to wash hands before meals (OR, 1.7) and living in nonapartment dwellings (OR, 1.6). Girls were at a higher, but not significant, risk (OR, 1.4), than boys. In conclusion, inadequate personal hygiene increases the risk for pinworm infection. The mass screening-medication campaign can be adapted to countries with a similar parasitic problem.

Case-Control Studies↗

Components of insulin resistance syndrome in a community-based population assessed by log-linear models.

BACKGROUND AND PURPOSE: To investigate the clustering of insulin resistance syndrome with hyperinsulinemia, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, hypertension, and obesity, we conducted this cross-sectional study and analyzed the patterns of conditional independence among these five elements. METHODS: Fasting insulin, lipid profiles, blood pressure, and anthropometric data from 2165 Taiwanese older than 35 years in the Chin-Shan community were examined. The cut-off points of these five factors (all binary variables) were defined. The hierarchical log-linear regression with nested effects model was applied to fit this higher-order contingency table of five variables, and likelihood ratio (chi2) statistics were used to test the goodness of fit. RESULTS: Hyperinsulinemia was independently correlated with obesity (odds ratio [OR] 5.7, 95% confidence interval [CI] 4.5-7.3), low HDL (OR 2.3, 95% CI 1.8-2.9), and hypertriglyceridemia (OR 1.6, 95% CI 1.2-2.2). Hypertriglyceridemia was significantly associated with low HDL (OR 3.6, 95% CI 2.7-4.8), and non-significantly associated with hypertension (OR 1.3, 95% CI 0.9-1.7) and obesity (OR 1.1, 95% CI 0.8-1.6). In persons with normal triglyceride levels, hypertension was positively associated with obesity (OR 2.8, 95% CI 2.1-3.7) and low HDL (OR 2.0, 95% CI 1.5-2.8). Analyses from forward and backward selection methods gave similar results. Graphical models with conditional independence relationships among these five variables were demonstrated. CONCLUSIONS: The components of insulin resistance syndrome have intricate relationships. Hyperinsulinemia was most related to obesity, and hypertriglyceridemia was most related to low HDL.

Adult↗

Role of urbanization and air pollution in adolescent asthma: a mass screening in Taiwan.

BACKGROUND AND PURPOSE: The prevalence of asthma in school children in Taiwan is increasing. This study used mass screening among middle school children in Taiwan to determine the prevalence of asthma and related factors. METHODS: Data were collected from parents using a self-reported questionnaire and from children using the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire. Six study teams conducted the survey nationwide in 1995-1996, with the assistance of middle school nurses and teachers. RESULTS: Among the 1,018,031 students at 795 middle schools who returned questionnaires, 8.5% had a history of asthma (ranging in prevalence from 4.2% to 13% in 25 areas). The prevalence of asthma was higher in boys than in girls (10.0% vs 7%) and was highest in more urbanized areas (11.2%), followed by moderately urbanized areas (7.4%) and less urbanized and rural areas (6.5%). Controlling for age, family smoking, family incense burning, and parental education level, multivariate logistic regression models indicated that children living in an area with heavy air pollution were more likely to have asthma than those in an area with no or light pollution (odds ratio, OR = 2.01 and 95% confidence interval, CI = 1.94-2.09 based on parental ranking of pollution level, or OR = 1.30 and 95% CI = 1.18-1.42 based on pollution level reported by the Environmental Protection Administration). CONCLUSIONS: Adolescent asthma in Taiwan is most prevalent in the most urbanized areas and decreases in prevalence in less urbanized areas. This study also found that higher parental education level and higher area air pollution were associated with higher adolescent asthma prevalence.

Adolescent↗

TSG101 expression in gynecological tumors: relationship to cyclin D1, cyclin E, p53 and p16 proteins.

Recent studies have shown that in vitro steady-state expression of the tumor susceptibility gene TSG101 is important for maintenance of genomic stability and cell cycle regulation. To determine the contribution of TSG101 expression in neoplastic formation, expression of TSG101 protein levels were evaluated in primary ovarian and endometrial adenocarcinoma tumors. Expression of TSG101 was also examined in various tumor cell lines (PA-1, AN3CA, HeLa, HS578T, HCT116). Full-length TSG101 protein was detected in these tumors and cell lines indicating that intragenic deletions were not characteristic of TSG101. In addition, TSG101 protein levels were compared with aberrations of prominent cell cycle regulatory molecules such as cyclin D1, cyclin E, p16 and p53. Reduced TSG101 protein was observed in 36% (8/22) of ovarian and 17% (1/6) of endometrial adenocarcinoma. Aberrant levels of p53, p16, cyclin D or E were comparable to published studies indicating that the clinicopathological distribution of these cases did not favor advanced stage tumors. Altogether, these findings suggest that a down-regulation of TSG101 is associated with tumorigenesis in a subgroup of gynecological tumors.

Adenocarcinoma↗

Chin-Shan Community Cardiovascular Cohort in Taiwan-baseline data and five-year follow-up morbidity and mortality.

A cohort consisting of 3602 residents (82.8% of the target population) aged 35 years and older was established in 1990 in the Chin-Shan Community, a suburb 20 miles outside of metropolitan Taipei, Taiwan. The long-term objective was to investigate the prospective impact on cardiovascular health in a society undergoing transition from a developing to a developed nation. This article presents the study design, selected baseline risk factors of cardiovascular diseases (CVD), and CVD events at the 5-year follow-up evaluation with an emphasis on sociodemographic differences. The multivariate logistic regression analyses revealed that white-collar individuals were more likely than blue-collar workers to have dyslipidemia including high-density lipoprotein cholesterol (HDL-C) levels <35 mg/dl [odds ratio (OR) = 1.7, 95% confidence interval (CI) = 1.2-2.4] and low-density lipoprotein cholesterol (LDL-C) levels >/=160 mg/dl (OR = 1.3, 95% CI = 1.0-1.7). However, they were at slightly lower risk for stroke and CVD/sudden death, and at moderately higher risk for coronary artery disease and diabetes, although both these trends were not significant. Men were more likely than women to have HDL-C levels <35 mg/dl (OR = 1.8, 95% CI = 1.4-2.2), but they were less likely to have LDL-C levels >/=160 mg/dl (OR = 0.7, 95% CI = 0.6-0.8). The risk of CVD/sudden death was higher for men than for women during the follow-up period (OR = 1.9, 95% CI = 1.3-2.9). This could be due to risk factors such as a much higher prevalence of tobacco (61.9% vs. 4.5%) and alcohol (43.7% vs. 6.4%) use in men. In conclusion, individuals of higher socioeconomic status have a higher prevalence of dyslipidemia but slightly lower 5-year incidence of CVD events.

Adult↗

Tuberculosis transmission in the family.

OBJECTIVE: To evaluate the risk of tuberculosis (TB) transmission from family members with infectious TB to other family members, and to examine whether household contact investigations had an impact on tuberculosis patterns. DESIGN: Under the direction of the Taipei Municipal Chronic Disease Hospital, 12 full-time public health nurses recruited the household contacts of TB patients. Chest X-ray examination was recommended for adult contacts. Child contacts received the Mantoux tuberculin skin test, and radiography was recommended if the results were positive. SETTING: Family contacts of all TB index patients who attended one of 29 hospitals in Taipei, from July 1993 through June 1996. The medical records of index patients were obtained from the National Tuberculosis Registry. RESULTS: During the study period, the families of 3903 index patients, comprising 11873 contacts, were investigated. Among these, 4595 received radiography, for a response rate of 38.7%. Of these, 284 had active pulmonary disease: 188 (66.3%) had minimal disease, 79 (27.8%) had moderately advanced disease, and only 17 (5.9%) had far advanced disease. Overall, the index patients had more advanced TB: only 1261 (32.3%) had minimal disease, while 2022 (51.8%) had moderately advanced disease and 620 (15.9%) had far advanced disease. CONCLUSIONS: These data show a relatively high risk of intrafamily TB transmission. Our findings also show that family contact investigations may help to diagnose TB in earlier stages. Such an approach should greatly reduce the number of new TB cases and speed eradication of the disease.

Adolescent↗

Occupational exposures of pharmacists and pharmaceutical assistants to 60 Hz magnetic fields.

We carried out the study to assess, using field surveys and personal dosimetry, the potential exposure of pharmacists and pharmaceutical assistants to 60 Hz magnetic fields in a medical center of Taiwan. Field surveys were conducted twice in the pharmacy where two workers were randomly selected and solicited to wear personal dosimetry instruments for a full-shift assessment of personal exposure. We used an EMDEX II for on site measurements and did not consider any specific instrument or equipment for health care services as potential sources of magnetic field. The results showed that the average magnetic flux densities for the selected areas were between 0.63 mill-Gauss (mG) and 2.23 mG, while the full-shift time-weighted-average exposure for the two selected workers was 4.98 mG and 6.54 mG, respectively. Both inadequate consideration for the field survey of the temporal variability in magnetic flux densities over the workday and that the monitored workers spent almost half of the full-shift working in places outside of the study areas may have contributed to such discrepancy in results between field survey and personal dosimetry. This study suggests that the potential for elevated exposure to 60 Hz magnetic fields in health care settings does exist, and that using job title as a surrogate for magnetic fields exposure classification might entail certain degrees of misclassification. Although limited in its scope and sample size, the study presented here seems to demonstrate the inadequacy of using stationary workplace measurements for the assessment of personal occupational exposure to 60 Hz magnetic fields.

Allied Health Personnel↗

Serum leptin and leptin receptor isoforms in omental adipose tissue of nondiabetic women undergoing gynecologic surgery for benign disease.

BACKGROUND AND PURPOSE: Leptin is important in the regulation of fat mass and body weight. Adipose tissue not only secretes leptin but also serves as a site of action for leptin. This study was designed to examine the relationships among tissue expression of leptin receptors, serum leptin, and body mass index. METHODS: Omental adipose tissue and fasting blood samples were obtained from 57 nondiabetic women who underwent surgery for either myoma of the uterus or ovarian cyst. Tissue RNA was extracted using Trizol reagent and serum leptin concentrations were determined with commercial kits. The leptin receptor isoforms in tissues were quantified using real-time Taqman technology. RESULTS: Three leptin receptor isoforms, Ob-Rb, HuB219.1, and HuB219.3, were found in human omental adipose tissue. The amounts of HuB219.1 and HuB219.3 mRNA relative to that of Ob-Rb were 1314.2 and 16.7, respectively. Higher body mass index was significantly correlated with an increase in serum leptin concentration and a decrease in leptin receptor HuB219.1 isoform in omental fat, even after adjustment for age and menopausal status. There was no direct association between serum leptin concentration and tissue HuB219.1 mRNA level. CONCLUSIONS: HuB219.1 is the major isoform of leptin receptor expressed in human omental adipose tissue. Our findings suggest that the shorter leptin receptor isoforms in human omental adipose tissue might play an important role in body weight control. Further studies on the inter-relationship between leptin concentrations and multiple leptin receptor isoforms are needed to elucidate the exact mechanism of obesity.

Adipose Tissue↗

Risk factors for prostate carcinoma in Taiwan: a case-control study in a Chinese population.

BACKGROUND: Although prostate carcinoma remains a rare disease among Chinese men, its incidence is on the rise. The authors conducted a hospital-based case-control study to identify risk factors for prostate carcinoma in northern Taiwan. METHODS: Patients at a selected veterans hospital or 2 military hospitals who were newly diagnosed with prostate carcinoma between August 1995 and July 1996 were included as cases (n = 90). Controls (n = 180) were comprised noncancer patients who were treated in emergency rooms and departments other than those of urology and cardiology at the same hospitals; controls were matched to cases by age (+/-5 years) and admission date (+/-4 months). Subjects were interviewed in person to elicit information regarding sociodemographic characteristics, life-style, diet, height, and weight. RESULTS: Cases and controls were similar in terms of age and the majority of sociodemographic characteristics. However, cases tended to have received more education and were less likely to have blue-collar jobs than controls. The consumption of pork was moderately higher for cases than for controls, although this difference was not statistically significant. Cases were more likely than controls to engage in exercise (odds ratio [OR] = 2.16; 95% confidence interval [CI] = 1.18-3.96) and to have a body mass index > or = 24.75 kg/m2 at ages 40-45 years (OR = 2.00; 95%CI = 1.05-3.82). In addition, cases were less likely to cook vegetables with pork lard (OR = 0.47; 95%CI = 0.24-0.91). CONCLUSIONS: The higher frequency of exercise and lower use of pork lard for cooking among cases reported in the current study suggest that cases tended to have relatively affluent life-styles compared with controls. Because less affluent families are likely to consume more vegetables than meat, these preliminary findings indicate that vegetable intake appears to have a protective effect.

Adult↗

Association between indoor and outdoor air pollution and adolescent asthma from 1995 to 1996 in Taiwan.

The study aim was to estimate the contribution of indoor and outdoor air pollution to the 1-year prevalence of adolescent asthma after personal susceptibility and other potential risk factors were taken into account. A large-scaled cross-sectional study was conducted among 165,173 high school students aged 11 to 16 years in the different communities of Kaohsiung and Pintong in Taiwan, from October 1995 to June 1996. Each student and his/her parents participating in the study completed a video and a written International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire about symptoms of wheezing and allergies, passive smoking, and demographic variables. After adjustment for potential confounders, adolescents exposed to cigarette smoking (odds ratio = 1.29, 95% confidence interval (CI), 1.17-1.42) and environmental tobacco smoke (odds ratio = 1.08, 95% CI, 1.05-1.12) were found to suffer from asthma at an increased frequency. We observed a statistically significant association between outdoor air pollution and asthma, after controlling for potential confound variables. Total suspended particulate, nitrogen dioxide, carbon monoxide, ozone, and airborne dust particles all displayed an independent association with asthma, respectively. There were no selection biases in this community-based study, which provides evidence that passive smoking and long-term, high average outdoor air pollution are independent risk factors of asthma.

Adolescent↗

Lipoprotein (a) level in the population in Taiwan: relationship to sociodemographic and atherosclerotic risk factors.

To examine the lipoprotein(a) (Lp(a)) level in the Taiwanese population and its association with cardiovascular risk factors, 1703 men and 1899 women aged 35 years and above were enrolled in a community-based study cohort established between 1990 and 1991. The distributions of Lp(a) levels were skewed to the right, and females were more likely than males to have Lp(a) levels greater than 30 mg/dl (14.3% versus 11.6%, P < 0.05). The Lp(a) level increased with age. Socioeconomic status did not seem to have consistent influence on the level of Lp(a). Smoking and alcohol use also had no effect on Lp(a) levels. Multivariate analysis indicated that older age and high level of low-density-lipoprotein cholesterol corresponded to an elevated Lp(a) level, while hypertriglyceridemia, low high-density-lipoprotein cholesterol level, obesity and high insulin resistance corresponded to a lower Lp(a) level. In univariate analysis, hyperinsulinemia was negatively associated with Lp(a) level (-0.107, P < 0.01) only in males. In females, use of oral contraceptive lowered Lp(a) levels, but menopause did not change Lp(a) levels. We also found that different correlation patterns existed for selected coagulation profiles between sexes. There was a significant correlation between Lp(a) and fibrinogen levels in males (0.154, P < 0.001) but not in females (0.007, P > 0.05). These data provided clues for investigating atherosclerotic risk factors and coagulation parameters for the Taiwanese population.

Adult↗

Climate, traffic-related air pollutants, and asthma prevalence in middle-school children in taiwan.

This study compared the prevalence of asthma with climate and air pollutant data to determine the relationship between asthma prevalence and these factors. We conducted a nationwide survey of respiratory illness and symptoms in middle-school students in Taiwan. Lifetime prevalences of physician-diagnosed asthma and of typical symptoms of asthma were compared to air monitoring station data for temperature, relative humidity, sulfur dioxide, nitrogen oxides, ozone, carbon monoxide, and particulate matter with aerodynamic diameter [less than/equal to] 10 microm (PM(10)). A total of 331,686 nonsmoking children attended schools located within 2 km of 55 stations. Asthma prevalence rates adjusted for age, history of atopic eczema, and parental education were associated with nonsummer (June-August) temperature, winter (January-March) humidity, and traffic-related air pollution, especially carbon monoxide and nitrogen oxides, for both girls and boys. Nonsummer temperature, winter humidity, and traffic-related air pollution, especially carbon monoxide and nitrogen oxides, were positively associated with the prevalence of asthma in middle-school students in Taiwan.

Adolescent↗