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Summary: This study is to estimate the lifetime risks of hip fracture in Chinese patients with type 2 diabetes. Introduction: The lifetime risks of hip fracture have not been reported across the age spectrum in male adults and female adults with type 2 diabetes. Methods: A retrospective cohort study was conducted on 25275 men and 27953 women with type 2 diabetes aged 30–100 years old and participated in the National Diabetes Case Management Program in 2002–2004 in Taiwan. Sociodemographic factors, biomarkers, and comorbidity at the baseline and hip fracture events were analyzed with Cox proportional hazards regression models with age as the time scale. Results: Significant differences in the lifetime risks of hip fracture were observed between men and women with type 2 diabetes. The cumulative lifetime incidences (%) of hip fracture at 50, 60, 65, 70, 75, 80, and 85 years old for men were 0.11, 0.40, 0.84, 1.84, 3.82, 8.53, and 16.72, respectively. The corresponding lifetime incidences (%) for women at 50, 60, 65, 70, 75, 80, and 85 years old were 0.05, 0.50, 1.36, 3.89, 9.56, 21.19, and 35.45, respectively. With competing risks, the significant multivariate-adjusted hazard ratio of developing hip fracture included smoking, alcohol drinking, duration of diabetes, type of oral hypoglycemic drugs use (no medication, sulfonylurea only, thiazolidinediones (TZD) only or TZD plus others, other single or multiple oral agents, insulin use, insulin plus oral hypoglycemic drug use), loop diuretics use, use of corticosteroids, normal weight or underweight, hyperlipidemia, and chronic obstructive pulmonary disease. Conclusions: The gender differences in lifetime hip fracture risk were significant. Thiazolidinediones and insulin use are factors with the greater magnitude of strength of association among those significantly associated with hip fracture. [ABSTRACT FROM AUTHOR]

Patients with diabetes have higher rates of depression than does the general population, but diabetes management mainly aims to maintain glucose stability. For this reason, our study assessed the relationship between 1-year variations in fasting plasma glucose (FPG) and risk of depression in Chinese patients with type 2 diabetes (T2D). This retrospective cohort study was conducted on 32,829 patients aged ≥ 30 years who were diagnosed with T2D and who participated in the National Diabetes Case Management Program in Taiwan. Their 1-year FPG variation as a predictor was determined by coefficient of variation (CV), whereas depressive events were analyzed by Cox's proportional hazards models. During a mean 8.23 years of follow-up, 1041 new cases of depression were diagnosed. When patients were grouped based on quartiles of FPG-CV, incidence rates were 3.23, 3.49, 3.96 and 4.80 per 1000 person-years in the first, second, third and fourth quartile subgroups, respectively. After adjusting for traditional risk factors, baseline fasting glucose and HbA 1c levels, and diabetes complications, FPG-CV was independently linked with incident depression. Hazard ratios of depression for FPG-CV in the fourth vs first quartile subgroups was 1.33 (95% CI: 1.11–1.59), respectively. Patients whose 1-year FPG variations were > 42.6% had an increased risk of depression, thus suggesting that FPG variations may be a predictor of depression in patients with T2D. Also, glucose variation during outpatient visits may be an indicator for individualized diabetes management in clinical practice. [ABSTRACT FROM AUTHOR]

Summary: We investigated the association between blood pressure variability measured by the coefficient of variation (CV) of blood pressure and hip fracture in older persons with diabetes. After excluding patients with acute complications and comorbidities, a positive association with similar magnitude of strength was found between BP variability and hip fracture, compared with that in the original analysis. Introduction: Hypertension is a risk factor of osteoporosis and hip fracture, but studies have yet to investigate whether blood pressure variability measured by the CV of blood pressure can predict hip fracture in older persons with diabetes. Methods: We conducted a retrospective cohort study on 21,160 patients who suffered from type 2 diabetes (age ≥ 50 years) and participated in the National Diabetes Care Management Program in Taiwan. The patients' 1-year variability in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the baseline and subsequent hip fracture incidence for 8.2 years were analyzed. Results: There were 937 recorded incident hip fractures. SBP-CV and DBP-CV were classified based on their tertiles. After multivariate adjustment was conducted, SBP-CV found to be a predictor of hip fracture, and its hazard ratio was 1.18 (95% CI 1.00–1.40) for the third tertile compared with the first tertile. Conclusions: Our study suggests SBP stability is a predictor for hip fracture incidence in older persons with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Background and purpose: No study has established a prediction dementia model in the Asian populations. This study aimed to develop a prediction model for dementia in Chinese type 2 diabetes patients. Methods: The retrospective cohort study included 27 540 Chinese type 2 diabetes patients (aged 50–94 years) enrolled in the Taiwan National Diabetes Care Management Program. Participants were randomly allocated into derivation and validation sets at a 2:1 ratio. Cox proportional hazards regression models were used to identify risk factors for dementia in the derivation set. Steps proposed by the Framingham Heart Study were used to establish a prediction model with a scoring system. Results: The average follow‐up was 8.09 years, with a total of 853 incident dementia cases in the derivation set. The dementia risk score summed up the individual scores (from 0 to 20). The areas under the curve of 3‐, 5‐ and 10‐year dementia risks were 0.82, 0.79 and 0.76 in the derivation set and 0.84, 0.80 and 0.75 in the validation set, respectively. Conclusions: The proposed score system is the first dementia risk prediction model for Chinese type 2 diabetes patients in Taiwan. [ABSTRACT FROM AUTHOR]

Summary: We investigated the association between fasting plasma glucose variability (FPG-CV) and the risk of hip fracture in elderly diabetic patients. Our finding showed a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures. Introduction: Hip fracture is a major health burden in the population and is associated with high rates of mortality and morbidity especially in elderly. It is evident that diabetes mellitus is a risk factor of osteoporosis which is a significant risk factor of hip fracture. However, epidemiological studies exploring the risks of hip fracture among type 2 diabetic patients are limited. Methods: A retrospective study of 26,501 ethnic Chinese older persons enrolled in the National Diabetes Care Management program in Taiwan was conducted; related factors were analyzed with extended Cox proportional hazards regression models to competing risk data on hip fracture incidence. Results: The results show a temporal association between FPG-CV and hip fracture as patients categorized as FPG-CV greater than 25.4 % showed an increased risk in hip fractures, confirming a linear relationship between the two. After multivariate adjustment, the risk of hip fracture increased among patients with FPG-CV of 25.4-42.3 % and >42.3 % compared with patients with FPG-CV of ≦ 14.3 % (hazard ratio, 1.35; 95 % confidence interval 1.14-1.60 and 1.27; 1.07-1.52, respectively). Significant linear trends among various FPG-CV were observed. Conclusions: Thus, the present study demonstrated the importance of glucose stability for fracture prevention in older persons with type 2 diabetes. Future studies should be conducted to explore whether reduction in glucose oscillation in older adults with diabetes mellitus can reduce the risk of hip fracture. [ABSTRACT FROM AUTHOR]

Summary: We studied 472 elders to assess joint association of vitamin D receptor (VDR) variability and physical activity on low handgrip strength (LHS) and osteoporosis (OST). Our findings showed that higher risks of OST were associated with physically inactive elders with some specific VDR variations, highlighting the importance of promotion program for physical activity. Introduction: The aim of this study was to determine the joint association between VDR variability and physical activity on LHS and OST in community-dwelling elders. Methods: Bone mineral density of the lumbar spine (LS), the femoral neck (FN), and the total hip were measured by dual-energy X-ray absorptiometry. Four single-nucleotide polymorphisms (SNPs) (rs7975232, rs1544410, rs2239185, and rs3782905) of the VDR gene were examined in 472 participants. Results: Physical inactivity and each of the four SNPs were jointly associated with a significantly greater risk of LHS in people than that associated with each of the VDR SNPs or low physical activity alone. Physically inactive men with the AG or AA genotype of rs2239185 had a significantly greater risk of overall, LS, and FN OST than those of physically active men with the GG genotype [odds ratio (OR) 3.57, 95 % confidence interval (CI) 1.10-11.65; OR 4.74, 95 % CI 1.43-15.70; and OR 5.06, 95 % CI 1.08-23.71, respectively]. Similarly, physically inactive women with the CG or CC genotype of rs3782905 and the AG or AA genotype of rs1544410 had a significantly greater risk of FN OST than physically active women with the GG genotype (OR 5.33, 95 % CI 1.23-23.06 and OR 5.36, 95 % CI 1.11-25.94, respectively). Conclusions: VDR polymorphisms and physical activity are jointly associated with LHS and OST in elders. Health care programs should promote physical activity among elders as a cost-effective way to prevent LHS and OST, especially in those who may be genetically predisposed. [ABSTRACT FROM AUTHOR]

Eur J Clin Invest 2010; 40 (3): 220–225 Background The previous studies regarding the association between endogenous dehydroepiandrosterone (DHEA) sulphate level and metabolic syndrome are inconsistent. This study aimed to investigate such relationship in elderly Taiwanese men. Materials and methods Five hundred and eighty-five elderly Taiwanese men (mean age 68·7 ± 8·3 years) were enrolled as the baseline cohort population in 2000. In addition to a questionnaire, body mass index (BMI), blood pressure, fasting blood glucose, lipids, albumin and serum DHEA-S levels were measured for each participant. Metabolic syndrome was based on the definition by the America Heart Association/National Heart Lung Blood Institute. Results The prevalence of metabolic syndrome was 33·3%. Using multivariate logistic regression analyses with adjustments for age, smoking, alcohol, physical activities, albumin and BMI, there was a positive relationship between serum DHEA-S level and metabolic syndrome. The highest DHEA-S quartile group had increased risk for metabolic syndrome (odds ratio = 2·68, 95% confidence interval: 1·44–5·01, P < 0·01) compared with the lowest quartile group. The mean serum DHEA-S level increased with increasing number of metabolic syndrome components. Conclusions The prevalence of metabolic syndrome increases with elevated DHEA-S levels among elderly Taiwanese men. Thus, elevated serum DHEA-S level should be treated as an important risk factor for metabolic syndrome in elderly men. [ABSTRACT FROM AUTHOR]

XRCC1 plays a central role in mammalian DNA repair processes. Two polymorphisms of XRCC1, rs1799782 (Arg>Trp at codon 194) and rs25487 (Arg>Gln at codon 399), are common in the Han Chinese population. Our objective was to analyze the relationship between these two functional single-nucleotide polymorphisms (SNPs) and systemic lupus erythematosus (SLE) in the Taiwanese Han Chinese population. Genotyping was performed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) on 172 SLE patients and 160 normal controls. Our data indicate that the frequency of A/G at codon 399 differed between patients and controls (p=0.01; odds ratio: 1.80; 95% confidence interval: 1.17-2.75), but the allelic frequency analysis did not reveal significant differences. For the SNP at codon 194, there were no differences in either allelic or genotype frequencies between SLE patients and normal subjects. Clinical association studies of SLE symptoms revealed the involvement of the A/G polymorphism at codon 399 in SLE pathogenesis. Our results indicate that a functional SNP at codon 399 of XRCC1 is associated with the development of SLE. [ABSTRACT FROM AUTHOR]

Background The prevalence of the metabolic syndrome (MetS) is high among the elderly. However, evidence that mortality increases with MetS is rare. In this study, we investigated the relationship between MetS, cardiovascular disease (CVD) and all cause mortality in the elderly. Materials and methods A total 10 547 participants, aged 65 years and older, of baseline cohort were recruited from four nationwide Health Screening Centres in Taiwan from 1998 to 1999. The metabolic syndrome was defined according to the America Heart Association/National Heart Lung Blood Institute definition. Cox proportional hazards regression analyses were used to estimate the relative risks (RRs) of CVD and all cause mortality for those with MetS for up to 8 years of follow-up. Results The baseline prevalence of MetS was 50·1% (45·6% in men and 54·4% in women, respectively). A total of 1312 participants died; of these, 300 participants died from CVD. Adjusted for age, gender, smoking, total cholesterol and estimated glomerular filtration rate, the RRs for CVD and all cause mortality among participants with MetS were 1·48 (95% confidence interval = 1·16–1·90) and 1·16 (1.03–1.30), respectively, for participants compared to those without MetS. The mean RRs for CVD, however, ranged from 1·21 to 5·31 among different combinations of MetS components. Conclusion The elderly with MetS, compared to those without MetS, had a higher CVD and all cause mortality in Taiwan. Furthermore, different combinations of MetS components posed different risks to the mortality, which deserves further research in the future. [ABSTRACT FROM AUTHOR]

Background Microalbuminuria and the metabolic syndrome (MetS) have both been linked to chronic kidney disease and cardiovascular disease. This study investigated the association between urinary albumin-to-creatinine ratio (ACR) and MetS and its components. Materials and methods A total of 2311 subjects aged 40 years and over were recruited in 2004 in a metropolitan city in Taiwan. The biochemical indices, such as fasting glucose levels, urinary albumin, urinary creatinine and anthropometric indices, were measured. We defined microalbuminuria as a urinary ACR ranging from 30 to 300 mg g−1 creatinine. MetS was defined using the American Heart Association and the National Heart, Lung and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) definitions. The relationship between MetS and microalbuminuria was examined using multiple logistical regression analysis. Results Subjects with microalbuminuria had higher age, body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose, triglycerides, total cholesterol (TCHOL)/high-density lipoprotein cholesterol (HDL-C) ratio, prevalence of diabetes mellitus and hypertension and lower HDL-C than subjects with normoalbuminuria. After adjusting for age and BMI, microalbuminuria was associated with the individual components of MetS, except in central obesity in women and elevated fasting glucose in men. After adjusting for age, BMI, smoking and alcohol consumption status, multiple logistical regressions revealed that microalbuminuria is strongly associated with MetS in both genders and according to both definitions. The odds ratio of having MetS using the AHA/NHLBI and IDF definition was 1·76 (1·16–2·67) and 1·73 (1·06–2·83) in men and 2·19 (1·38–3·50) and 2·09 (1·24–3·51) in women, respectively. Conclusions Microalbuminuria was strongly associated with MetS and its components. There is an increased likelihood of having MetS if subjects have microalbuminuria. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the prevalence of metabolic syndrome in older people in Taiwan. Methods: This was a hospital-based, cross-sectional study. We retrospectively analysed subjects receiving self-referred health examination at one medical centre in Taiwan from 2000 to 2004. In all, 696 older people without any acute illness were enrolled in this study, 352 men (50.6%) and 344 women (49.4%). The mean age was 70.2 ± 4.6 years (age range 65–87). Metabolic syndrome was estimated according to the criteria proposed by National Cholesterol Education Program Adult Treatment Panel III in 2001 and by International Diabetes Foundation in 2005, with the cut-off values of the waist circumference greater than or equal to either 90 or 80 cm for men or women, respectively. Results: Among this group, 94% of the individuals presented with at least one condition of metabolic syndrome. The prevalence of metabolic syndrome defined by National Cholesterol Education Program Adult Treatment Panel III was 44.1% and was higher in women than in men (52.6 vs 35.8%, P < 0.001). Defined by International Diabetes Foundation, the prevalence was also 44.1% and was higher in women than in men (55.5 vs 33.0%, P < 0.001). Conclusion: The prevalence of metabolic syndrome remains relatively high in Taiwanese older people. [ABSTRACT FROM AUTHOR]

Objective:To investigate the relationship between the metabolic syndrome and its related factors among non-diabetic pre- and post-menopausal women in North Taiwan.Design:A cross-sectional study in a medical center in North Taiwan.Subjects:Five hundred and ninety-four, non-diabetic middle-aged women (age range=40–64 years, mean=48.9±5.4 years) were recruited.Measurements:The fasting plasma glucose, insulin, lipids levels and anthropometric indices were measured. The homeostasis model assessment was applied to estimate the degree of insulin resistance (HOMA-IR). Metabolic syndrome was defined by using the National Cholesterol Education Panel (NCEP) criteria and modified NCEP criteria (waist circumference >80 cm).Results:The prevalence of metabolic syndrome was 6.2% using NCEP criteria, and 8.9% using modified NCEP criteria. Post-menopausal women had a higher prevalence of metabolic syndrome and its individual components compared to pre-menopausal women except hyperglycemia and low HDL-C. In multiple logistic regression analysis with adjustment for age and menopausal status, both BMI and HOMA-IR were independently associated with the metabolic syndrome.Conclusion:The prevalence of metabolic syndrome was higher in post-menopausal than pre-menopausal women. Both obesity and insulin resistance may play an important role in the development of metabolic syndrome among the middle-aged women in North Taiwan.International Journal of Obesity (2006) 30, 912–917. doi:10.1038/sj.ijo.0803240; published online 24 January 2006 [ABSTRACT FROM AUTHOR]

BACKGROUND: The increased health risks associated with obesity have been found to occur in Asians at lower body mass indices (BMIs). To determine the optimal cut-off values for overweight or obesity in Taiwan, we examined the relationships between four anthropometric indices and cardiovascular risk factors. METHODS: The data were collected from four health-screening centers from 1998 to 2000 in Taiwan. Included were 55 563 subjects (26 359 men and 29 204 women, mean age = 37.3 ± 10.9 and 37.0± 11.1 y, respectively). None had known major systemic diseases or were taking medication. Individual body weight, height, waist circumference (WC), and a series of tests related to cardiovascular risk (blood pressure, fasting plasma glucose, triglycerides, total cholesterol, low- and high-density lipoprotein cholesterol) were assessed and their relationships were examined. Receiver operating characteristic (ROC) analysis was used to find out the optimal cut-off values of various anthropometric indices to predict hypertension, diabetes mellitus and dyslipidemia. RESULTS: Of the four anthropometric indices we studied, waist-to-height ratio (WHtR) in women was found to have the largest areas under the ROC curve (women=0.755, 95% Cl 0.748-0.763) relative to at least one risk factor (ie hypertension or diabetes or dyslipidemia). The optimal cut-off values for overweight or obesity from our study in men and women showed that BMIs of 23.6 and 22.1 kg/m², WCs of 80.5 and 71.5 cm, waist-to-hip ratios (WHpR) of 0.85 and 0.76, and WHtR of 0.48 and 0.45, respectively, may be more appropriate in Taiwan. CONCLUSIONS: WHtR may be a better indicator for screening overweight- or obesity-related CVD risk factors than the other three indexes (BMI, WC and WHpR) in Taiwan. Our study also supported the hypothesis that the cut-off values using BMI and WC to define obesity should be much lower in Taiwan than in Western countries. [ABSTRACT FROM AUTHOR]

Examines the relationships between four anthropometric measurements and cardiovascular risk factors in Taiwan. Collection of data from four nationwide health screen centers in Taiwan from 1998 to 1999; Measurement of individual body weight, height, waist circumference, and cardiovascular risk factors.

A feeding trial was conducted to investigate the effects of dietary lipid level on growth and body composition of juvenile river chub, Zacco barbata (Regan). Juvenile river chub with 0.26 g body weight were given five isoenergetic and isonitrogenous purified diets containing 0–20% lipids in 5% increments for 8 weeks. The dietary lipid source was a 1:1 (w/w) mixture of menhaden fish oil and soybean oil. There was no significant difference on weight gain, feed conversion ratio, or protein efficiency ratio, among fish fed different experimental diets (P > 0.05). Body fat contents of both initial fish and fish fed the diet containing 20% dietary lipid were significantly greater than those fed other diets (P < 0.05). The percentage of total n-3 fatty acids in the body lipids of fish at the beginning of the trial was 12.34%. This value decreased to 3.83% by the end of the trial for fish fed a control diet with no supplemented lipid. Similar trends were observed in linoleic acid contents that were 6.11% and 3.09%, respectively, for initial fish and the fish fed the control diet for 8 weeks. However, the absolute amount of these fatty acids stayed the same in the initial and in the control group. Meanwhile, as dietary lipid level increased, the percentages of these fatty acids in body lipids of fish at the end of the trial also increased. [ABSTRACT FROM AUTHOR]

Data from P-waves and from S-waves generated by P-S conversion on reflection from airgun shots recorded along four lines of ocean bottom seismometers were used to construct 2-D velocity sections near the Yuan-An Ridge, off southwest Taiwan. The locations of the ocean bottom seismometers were determined to high accuracy by an inversion based on the shot traveltimes. Traveltime inversion and forward modeling of multicomponent wide-angle seismic data result in detailed P-wave (Vp) and S-wave (Vs) velocities of hydrate-bearing sediment layers. The inversion indicates a relatively high P-wave velocity beneath topographic ridges which represent a series of thrust-cored anticlines develop in the accretionary wedge. S-wave velocities of the sediments over the entire section, down to 400m below seafloor, range from 320 to 570ms−1. We suggested the lateral variation in Vp/Vs profiles in the hydrate-affected zones may be related to the migration conduit of gas-rich fluid and a characteristic of hydrate content. We model Vp using equations based on a modification of Wood's equation to estimate the gas hydrate saturation. The hydrate saturation varies from 5% at the top ~200m below the seafloor to 10-15% of pore space close to the bottom simulating reflector (BSR) in the survey area. [ABSTRACT FROM AUTHOR]

A matched case-control study was used to determine pathogens and risk factors associated with gastroenteritis in a Taipei Emergency Department. Viruses (40.0%) were the leading cause of gastroenteritis, with noroviruses the most prevalent (33.2%). Bacteria were found in 26.0% of all cases, mostly suspected diarrheagenic E. coli (22.2%), followed by Salmonella spp. (5.4%) and Vibrio parahaemolyticus (4.2%). Giardia lamblia was identified in 16.4% of all cases. Statistical significance was noted for seven risk factors: taking antacids before gastroenteritis (OR = 3.91; 95% CI, 2.13, 7.15), other household members with gastroenteritis (OR = 5.18; 95% CI, 2.09, 12.85), attending a banquet (OR = 1.93; 95% CI, 1.25, 2.98), eating out (OR = 2.35; 95% CI, 1.30, 4.23), drinking bottled water (OR = 1.72; 95% CI, 1.07, 2.75), eating honey peaches (OR = 3.26; 95% CI, 1.24, 8.58), and eating raw oysters (OR = 3.24; 95% CI, 1.02, 10.28). Eating out was identified as the highest risk behavior, as measured by population attributable risk fraction (PAR) (50.9%). Respective PAR values for drinking bottled water, attending a banquet and taking antacids before illness were 19.7%, 19.6% and 17.6%. Of these, additional research on bottled water appears to be the highest priority, because this is the first time it has been identified as a risk factor for gastroenteritis. [ABSTRACT FROM AUTHOR]

We investigated the association between blood pressure variability measured by the coefficient of variation (CV) of blood pressure and hip fracture in older persons with diabetes. After excluding patients with acute complications and comorbidities, a positive association with similar magnitude of strength was found between BP variability and hip fracture, compared with that in the original analysis., Introduction: Hypertension is a risk factor of osteoporosis and hip fracture, but studies have yet to investigate whether blood pressure variability measured by the CV of blood pressure can predict hip fracture in older persons with diabetes., Methods: We conducted a retrospective cohort study on 21,160 patients who suffered from type 2 diabetes (age ≥ 50 years) and participated in the National Diabetes Care Management Program in Taiwan. The patients' 1-year variability in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the baseline and subsequent hip fracture incidence for 8.2 years were analyzed., Results: There were 937 recorded incident hip fractures. SBP-CV and DBP-CV were classified based on their tertiles. After multivariate adjustment was conducted, SBP-CV found to be a predictor of hip fracture, and its hazard ratio was 1.18 (95% CI 1.00-1.40) for the third tertile compared with the first tertile., Conclusions: Our study suggests SBP stability is a predictor for hip fracture incidence in older persons with type 2 diabetes.

Background: Selenium is an essential trace element with antioxidant property. Decreased serum selenium concentration with aging had been found in previous report. In this study, we aim to investigate the association between serum selenium and the inflammatory cytokine interleukin-6 in the elderly living in long-term care facilities in Taiwan., Materials and Methods: A total of 336 subjects aged 65 years and older (range of age: 65 - 101 years) were recruited from eight long-term care facilities in 2002-2003. Baseline characteristics, anthropometric indices, and biochemical data were obtained. Selenium deficiency was defined as serum selenium concentration < 80 μg/L. Multiple logistic and linear regression analyses were used to examine the relationships between selenium deficiency and interleukin-6 (divided into quartiles)., Results: The prevalence of selenium deficiency was 35.6% in men and 43.2% in women, respectively. After adjusting for potential confounders using multiple logistic regression analysis, interleukin-6 quartiles were significantly associated with selenium deficiency. Compared to the interleukin-6 quartile I, the adjusted odds ratios of having selenium deficiency for interleukin-6 quartile II, III, IV were 1.00(0.50~2.01), 1.24 (0.62~2.50), and 2.35(1.15~4.83), respectively. The increasing odds ratios for selenium deficiency in higher interleukin-6 quartiles revealed dose-response effects (p < 0.05). Moreover, multiple linear regression analysis showed that serum selenium was significantly inversely associated with interleukin-6 after adjusting for potential confounders., Conclusions: Serum selenium was inversely associated with inflammatory cytokine interleukin-6 among elderly living in long-term care facilities in Taiwan. Monitoring serum selenium should be considered in these institutionalized elderly.

Defects in dopaminergic transmission play important roles in the disturbance of synaptic plasticity and even in advanced cognitive behavior. However, the relationship between genes involved in the regulation of dopamine levels and predisposition for Alzheimer s disease (AD) remains unclear. The potential association of dopamine-modulating gene polymorphisms with AD was evaluated. We performed a case-control study with 120 patients and 86 healthy controls. Two catechol-O-methyltransferase (COMT) single-nucleotide polymorphisms (SNPs) (rs2020917 and rs4646312), two dopamine D4 receptor (DRD4) SNPs (rs3758653 and rs916455), and four dopamine transporter (DAT1) SNPs (rs2937639, rs6347, rs12516948 and rs11133762) were investigated. The T allele at the DRD4 SNP (rs3758653) was found to be significantly associated with AD. Our results also showed that haplotype frequencies, observed from the analyzed SNPs, were distributed significantly differently in AD patients vs control subjects. Moreover, a strong association was observed between the A allele at rs6347 of DAT1 and moderate stage of dementia. These observations suggest that genetic variations in the dopamine-modulating genes, COMT, DRD4 and DAT1, may contribute to AD pathogenesis in the Taiwanese population.

Background: Varicella zoster infection can be spread by infected healthcare workers (HCWs) to coworkers and patients. A self-reported history of chickenpox infection is sometimes taken as proof of immunity., Aim: To establish the relationship between positive recall history and serological immunity against varicella zoster virus (VZV) amongst healthcare workers in a tertiary hospital in Taiwan., Methods: Between May 2008 and April 2009, all HCWs in a Taiwanese tertiary care hospital were tested for VZV immunoglobulin G (IgG), and completed a self-administered questionnaire to determine their history of varicella infection or vaccination. Those who were seronegative were vaccinated., Findings: All HCWs (N=3733) at the hospital participated in this study. Their mean age was 34.6 years, and the seroprevalence of VZV was 91.1%. Sensitivity, specificity, and positive and negative predictive values of a self-reported history of varicella infection were 82.3%, 48.6%, 96.3% and 14.4%, respectively. Corresponding figures for a history of varicella vaccination were 23.4%, 69.4%, 90.9% and 6.5%, respectively. The recall history of younger HCWs and medical professionals (doctors, nurses and paramedical staff) to varicella had higher sensitivity. However, only the recall history of medical professionals had a significantly higher positive predictive value., Conclusion: A positive recall history of varicella infection and vaccination did not ensure the presence of protective VZV IgG, and a negative history was not predictive of a lack of immunity. For effective prevention of nosocomial infection, VZV IgG status should be documented for all HCWs, and susceptible HCWs should be vaccinated., (Copyright © 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)

Six new compounds, including one nor-neolignan, dehydroxymethylailanthoidol (1), and five butanolides, litseakolide D (2), litseakolide E (3), litseakolide F (4), litseakolide G (5), and isolincomolide D (6), were isolated from the leaves of Litsea acutivena. Their structures were elucidated from spectral analyses. The butanolides (2-6) showed significant cytotoxic activity against P-388, A549, and HT-29 cell lines in vitro.

Motor vehicle emission factors of carbon monoxide (CO) and non-methane volatile organic compounds (NMVOCs) were calculated inside the Chung-Cheng Tunnel of Kaohsiung in Taiwan. The results were compared with those model predictions from the Mobile Taiwan 2.0 model. Individual concentrations of 21 species of NMVOCs were also determined. Photochemical potential of NMVOCs was evaluated by using the maximum incremental reactivity (MIR). Field data showed that the integrated emission factors of CO and NMVOCs for actual fleet were 6.3 and 1.5 g/veh km, respectively. The error range of these factors may be up to 45%. The predicted values by the Mobile Taiwan 2.0 model closely matched the observed data. Concentrations of isopentane, 2-methylpentane, toluene and m,p-xylene were the dominant species of NMVOCs. The ratio of maximum incremental reactivity to NMVOCs concentration was 3.9, similar to those of the studies in the US Fort McHenry and Tuscarora Tunnel.

A p-hydroxyacetophenone-like derivative, (+)-gynunone, and a chromane, together with six known compounds were isolated from the CHCl3 fraction of the roots of Gynura elliptica. Their structures were determined by means of spectral analyses. Among the isolates, 6-acetyl-2,2-dimethylchroman-4-one and vanillin showed anti-platelet aggregation activity induced by arachidonic acid in vitro.

Through continuing studies on the chemical constituents and antiplatelet aggregation principles of the fruit of the Formosan Zanthoxylum integrifoliolum, four new compounds-including two new lignans, (+)-pinoresinol-di-3,3-dimethylallyl ether (1), and (+)-pinoresinol-3,3-dimethylallyl ether (2); zanthonitrile (3), and one new flavonoid, 3,5-diacetyltambulin (4)-and 18 known compounds were isolated from the CHCl3-soluble fraction. Their structures were elucidated on the basis of spectral data and chemical evidence. Among the isolates, including the previously reported isobutylamides, 13 compounds showed strong in vitro antiplatelet aggregation activity, with only (-)-tetrahydroberberine showing weak vasorelaxing effect in high potassium- or norepinephrine-induced contraction of rat aorta.

Radionuclide gastric emptying studies of liquid phases were used to evaluate the gastric motility of healthy Chinese. A total of 53 normal volunteers were included in this study and divided into two groups. Group 1, included 20 males and 8 females (ages: 17-73) who received a meal which consisted of 500ml normal saline containing 500 uCi of Tc-99m phytate. Group 2, included 19 males and 6 females (ages: 27-73) who received a meal which consisted of 500ml 5% glucose solution (25g glucose, 100Kcal) labeled with 500 uCi Tc-99m phytate. Studies were performed with the subjects in the supine position and a gamma camera in a left anterior oblique (LAO) position, while data were collected for 30 minutes after injection of the liquid meal. The gastric emptying time was presented as the half-time (T1/2) for the food to empty from the stomach. The study results showed that the T1/2 was 20.5 +/- 7.2 min in Group 1 and 35.3 +/- 11.7 min in Group 2. We conclude that gastric emptying is slower for a liquid meal with a higher caloric content.