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Introduction: In real-world practice, most non-small cell lung cancer (NSCLC) patients receiving combined immunochemotherapy are exposed to short-course corticosteroids following immune checkpoint inhibitor (ICI) infusion to prevent chemotherapy-related adverse events. However, whether this early short-course corticosteroid use prevents immune-related adverse events (irAEs) remains unknown. Methods: Between January 1st, 2015, and December 31st, 2020, NSCLC patients who received at least one cycle of ICI with or without chemotherapy were enrolled. Early short-course corticosteroids were defined as corticosteroids administered following ICI injection and before chemotherapy on the same day and no longer than 3 days afterward. The patients were categorized as either "corticosteroid group" or "non-corticosteroid group" depending on their exposure to early short-course corticosteroid. The frequencies of irAEs requiring systemic corticosteroid use and irAEs leading to ICI discontinuation were compared between the two groups, and exploratory survival analyses were performed. Results: Among 252 eligible patients, 137 patients were categorized as "corticosteroid group" and 115 patients as "non-corticosteroid group." The corticosteroid group enriched patients in the first-line setting (n = 75, 54.7%), compared to the non-corticosteroid group (n = 28, 24.3%). Thirty patients (21.9%) in the corticosteroid group and 35 patients (30.4%) in the non-corticosteroid group developed irAEs requiring systemic corticosteroid use (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.35–1.18; p = 0.15). Eight patients (5.8%) in the corticosteroid group, as compared with 18 patients (15.7%) in the non-corticosteroid group, permanently discontinued ICI due to irAEs (OR, 0.34; 95% CI, 0.12–0.85; p = 0.013). Conclusion: Early short-course corticosteroids following each ICI injection may reduce the rate of irAEs that lead to ICIs discontinuation, warranting further investigation of its prophylactic use to mitigate clinically significant irAEs. [ABSTRACT FROM AUTHOR]

Background: The combination of bevacizumab and atezolizumab has been established as a standard first-line systemic treatment for unresectable hepatocellular carcinoma (HCC). We examined the treatment outcomes of patients in Taiwan who received the combination in 2 pivotal clinical trials.Methods: All patients who resided in Taiwan, were enrolled in the IMbrave150 and GO30140 studies, and received bevacizumab and atezolizumab as the first-line systemic therapy for unresectable HCC were included. We extracted and pooled anonymous raw data from the study records.Results: We enrolled 40 patients, with the median age of 62.5 years; 36 (90%) had Barcelona Clinic Liver Cancer stage C disease. The response rate was 37.5%, including 3 (7.5%) complete responses. The disease control rate was 85%. The median duration of response was 21.4 months (95% confidence interval [CI], 16.6-not estimable). The median progression-free survival (PFS) and overall survival (OS) were 8.6 (95% CI, 5.6-18.6) and 24.9 months (95% CI, 14.2-not estimable), respectively. The most common adverse events of all grades were proteinuria (50%) and hypertension (37.5%), the median onset of which were 157 and 127 days, respectively. Bevacizumab and atezolizumab treatment had to be interrupted in 20 (50%) and 13 (32.5%) patients, respectively. Among patients whose treatment duration was ≥6 months, 50% of them had to skip bevacizumab, but no signal of poorer PFS or OS was observed.Conclusion: In Taiwanese patients with advanced HCC, the efficacy and safety outcomes of bevacizumab and atezolizumab treatment were generally consistent with the global intent-to-treat populations. [ABSTRACT FROM AUTHOR]

Background: Several previous studies reported a greater prevalence of dry eye syndrome (DES) among patients with psychiatric diseases. The aim of this study is to investigate the prevalence and risk factors of DES in patients with psychiatric disorders (PD) using nationwide population-based data in Taiwan.Methods: This population-based cohort study retrospectively identified patients with PD from 1997 to 2011. Patients with both PD and DES served as the DES cohort, and PD patients without DES comprised the non-DES cohort. PD was defined as a diagnosis of PD (ICD-9-CM 290-319) made by psychiatrists only, with at least three consecutive outpatient visits or at least one inpatient visit. DES was defined as a diagnosis of DES (ICD-9-CM 375.15) and a prescription for an eye lubricant (anatomical therapeutic chemical code, ATC code: S01XA). The main outcome measures were the prevalence of DES in these patients and associated risk factors.Results: A total of 75,650 patients with PD (3665 in the DES cohort and 71,985 in the non-DES cohort) were included in the final analysis. The majority of patients in the DES group were women (72.6%), compared the non-DES group (57.8%). The mean age of patients in the DES cohort was 62.2 ± 14.9, which was significantly older than those in the non-DES group (50.9 ± 17.5). The patients with DES had a significantly greater likelihood of having dementia, bipolar disorder, depression, and neurotic disorders. Conditional regression analyses revealed that patients with dry eye disease were more likely to have schizophrenia (OR = 1.34), bipolar disorder (OR = 1.9), depression (OR = 1.54), and neurotic disorders (OR = 1.62). In addition, patients with DES were more likely to use 1st generation anti-psychotics (OR = 1.28) and had a lower risk of using 2nd generation anti-psychotics (OR = 0.64).Conclusion: The study demonstrated that among PD patients, DES is highly prevalence in certain subtypes of PD, such as depression, bipolar disorder, and neurotic disorders, after adjusting for the comorbidities. [ABSTRACT FROM AUTHOR]

Purpose. This population-based, retrospective cohort study was to investigate whether metformin is associated with a lower risk of subsequent age-related macular degeneration (AMD) in patients with type 2 diabetes. Methods. Using the Taiwan National Health Insurance Research Database from 2001 to 2013, 68205 subjects with type 2 diabetes were enrolled in the study cohort. Among them, 45524 were metformin users and 22681 were nonusers. The metformin and nonmetformin groups were followed until the end of 2013. Cox regression analyses were used to estimate hazard ratios (HRs) for AMD development associated with metformin use. Confounders included for adjustment were age, sex, and comorbidities (hypertension, hyperlipidemia, coronary artery disease, obesity, diabetic retinopathy, chronic kidney disease, and insulin treatment). Furthermore, propensity score (PS) matching method was used to choose the matched sample, and PS-adjusted Cox regression was performed. Finally, how HRs changed according to metformin treatment duration and dose was also evaluated in the metformin group. Results. After adjusting for confounders, the metformin group had a significantly lower risk of AMD (adjusted HR = 0.54; 95% confidence interval [CI], 0.50–0.58). In the PS-matched sample, the significance remained (adjusted HR = 0.57; 95% CI, 0.52–0.63). In the metformin group, the adjusted HRs for the second (1.5–4 years) and third (≥4 years) tertiles of metformin treatment duration were 0.52 and 0.14, respectively, compared with the first tertile (<1.5 years). We also found significant trends of lower HRs (all p-value for trend <0.05) with increasing total and average doses. Conclusions. Among patients with type 2 diabetes, those who use metformin are at a significantly lower risk of developing AMD relative to individuals who do not use metformin. Also, the trend of a significantly lower AMD risk was found with a higher dose of metformin. [ABSTRACT FROM AUTHOR]

Purpose. To report the epidemiological and clinical data as well as surgical outcomes of canalicular lacerations with Mini-Monoka insertion at a tertiary center in Taiwan and to discuss differences in traumatic pattern, pathogenesis, and surgical outcomes between Taiwan and other countries. Methods. From 2009 to 2018, all 48 patients who underwent canalicular laceration repair with Mini-Monoka stent at a tertiary center in Taiwan were retrospectively analyzed. Demographic and clinical data and surgical outcomes were recorded. Results. The mean age of the 48 patients was 38 years. Single lower canaliculus was involved in 37 (77.1%) patients, upper canaliculus in 10 (20.8%) patients, and both in 1 (2.1%) patient. The most common etiology was motorcycle accident (41.7%), and all traffic accident injuries accounted for 68.75% of cases. Subgroup classification revealed 64.6% of patients (n=31) were categorized in the deep laceration group, and lower anatomical and functional outcomes were noted in deep laceration. The mean follow-up time was 14.5 months. Overall, the anatomical success rate was 87.5%, and the functional success rate was 91.7% after stent removal. Conclusion. Canalicular laceration caused by traffic accidents occurred with a relatively high frequency in Taiwan. Affected patients tended to be middle-aged, and deep laceration accounted for 64.6% of patients. These were contributed by the avulsive eyelid injury mechanism caused by traffic accidents. Furthermore, the deeper lacerated site was located, and the lower anatomical and functional success rates were observed. Early repair after trauma with Mini-Monoka stents achieved good eyelid position (100%) as well as good anatomical (87.5%) and functional (91.7%) success without serious complication. [ABSTRACT FROM AUTHOR]

Metabolic risk factors, such as obesity, fatty liver, high lipidemia, and diabetes mellitus are associated with increased risk for nonviral hepatocellular carcinoma (HCC); however, few nonviral HCC studies have stratified patients according to underlying etiologies. From 2005 to 2011, 3,843 patients with HCC were recruited into the Taiwan Liver Cancer Network. Of these patients, 411 (10.69%) who were negative for hepatitis B virus (HBV), surface antigen, HBV DNA, and anti‐hepatitis C virus (HCV) antibody were classified as non‐HBV non‐HCV (NBNC)‐HCC. Detailed clinical analyses of these patients were compared with age‐ and sex‐matched patients with HBV‐HCC or HCV‐HCC for the associated metabolic risk factors. For this comparison, 420 patients with HBV‐HCC and 420 patients with HCV‐HCC were selected from the 3,843 patients with HCC. Multivariate analyses showed fatty liver (by echography), high triglyceride levels (>160 mg/dL), and diabetes mellitus history to be significantly associated only with NBNC‐HCC and not with the matched patients with HBV‐ or HCV‐HCC. When the patients with HCC were further divided into four groups based on history of alcoholism and cirrhotic status, the group without alcoholism and without cirrhosis exhibited the strongest association with the metabolic risk factors. Based on trend analyses, patients with NBNC‐HCC with or without alcoholism were significantly different from the matched patients with HBV‐ or HCV‐HCC, except for patients with alcoholism and cirrhosis, in having more than two of the above three risk factors. Conclusion: Metabolic risk factors are significantly associated with nonviral HCC, especially for patients without alcoholism in Taiwan. Because the prevalence of viral HCC is decreasing due to the success of universal vaccination and antiviral therapy, strategies for cancer prevention, prediction, and surveillance for HCC will require modification. (Hepatology Communications 2018;2:747‐759) [ABSTRACT FROM AUTHOR]

Objective: This phase II trial investigates the efficacy and safety of low-dose everolimus in combination with cisplatin-fluorouracil chemotherapy in patients with advanced gastric cancer. Methods: Eligible patients with chemotherapy-naïve advanced gastric cancer received low-dose everolimus (10 mg p.o. on days 1, 8 and 15) plus cisplatin and a weekly 24-hour infusion of high-dose 5-fluorouracil and leucovorin (HDFL) chemotherapy (cisplatin 35 mg/m2 intravenous infusion for 24 h on days 1 and 8, 5-fluorouracil 2,000 mg/m2 and leucovorin 300 mg/m2 intravenous infusion for 24 h on days 1, 8 and 15) every 28 days. The primary endpoint was objective response rate (ORR) according to the Response Evaluation Criteria in Solid Tumors version 1.0. Results: Forty patients (19 men; 21 women; median age, 54.1 years; range, 33.7-73.3 years) received a median of 6 (range, 1-30; 95% CI, 4.9-8.0) cycles of study treatment. The ORR was 52.5% (21 confirmed partial response). The median progression-free survival and overall survival were 6.9 (95% CI, 4.9-8.4) and 10.5 (95% CI, 8.6-12.3) months, respectively. Most adverse events were mild. Conclusion: Adding low-dose everolimus to cisplatin-HDFL chemotherapy failed to increase the ORR as in a preplanned statistical assumption but may prolong progression-free survival in treatment-naïve advanced gastric cancer patients. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: This study develops and weights energy conservation and carbon reduction (ECCR) indicators for the hotel industry in Taiwan to create an instrument to help address climate change. Eighteen semi-structured interviews were conducted with senior hotel managers, environmental specialists, and government officials to identify the preliminary ECCR framework. An expert panel then was invited to review the structure of ECCR criteria and the compiled criteria in a structure for item modification. An analytic network process questionnaire survey was employed to determine the relative weights of the criteria. The data analysis reveals seven categories in the ECCR framework: communication and participation, top management commitment, energy, water, waste, building, and purchasing. A total of 32 indicators were identified and prioritized in terms of their relative importance to ECCR contributions. The results of this study suggest that the success of ECCR implementation depends primarily on management support and staff engagement. Hotel operators can improve their environmental management by initiating ECCR practices based on the proposed ECCR indicators. [Copyright &y& Elsevier]

As in most social interactions, affective and referential goals are essential in doctor-patient communication: doctors need to establish a trusting relationship with patients so that they can collect holistic health information from them. Although good rapport should be established early in the greeting stage of the medical interview, exactly how doctors' greetings facilitate patient participation has not yet been fully explored. By examining 44 triadic medical encounters among doctors, elderly patients, and patient companions collected in a teaching hospital in southern Taiwan, we examine three research questions. First of all, what greeting topics are commonly observed? Among these topics, which ones encourage more verbal participation from patients? And, how do they achieve this goal in terms of discourse structure and under the context of Taiwanese geriatric interaction? Three categories of doctors' greeting topics were identified according to the average number of syllables they elicited in response from patients' response: greetings with low response (eliciting 0.46 syllables), mid-response greetings (eliciting 4.8 syllables), and high-response greetings (eliciting 41.1 syllables). We find that low- and mid-response greetings dealing mainly with topics related to the preparatory sequences of the interview, such as seating arrangements and name exchanges (low-response), and the patients' hearing ability or language background (mid-response). High-response greetings, such as those touching on a patient's occupation or medical history, are social-relational (Coupland 1994). These topics extend the conversation structure by developing subtopics and establishing `grounding' (Paek and Horvitz 2000), i.e., background knowledge between doctors and patients. The patient is the expert on, and has exclusive access to, his/her social-relational aspects. We argue that it is the patient who holds the key to high participation and extensibility of topics. Other high-response greeting topics, such as the patient's age and the patient's companions, reflect the unique and complicated relationships between age and health status (Coupland et al. 1991, Giles et al. 1994) and between patients and caregivers. Since social-relational information is as important as biophysical information in evaluating a patient's health, we suggest that doctors facilitate the use of social-relational topics at the greeting stage. This will help doctors establish rapport with patients and encourage patient participation during the medical interview. [ABSTRACT FROM AUTHOR]

The hepatic toxicity of vinyl chloride monomer (VCM) has often been reported, but few studies have assessed insulin resistance or adipose tissue dysfunction. We analyzed the chronic health effects of moderate exposure to VCM on factory workers in Taiwan. Data were collected from personal air samples, urine samples, and immunohistochemical (IHC) examinations of 122 recruited voluntary participants. Air samples were analyzed to assess personal levels of exposure to VCM and ethylene dichloride (EDC). Urine samples were collected from each worker before they started and after they finished their daily shift. Urinary thiodiglycolic acid (TDGA) levels were analyzed using high-performance liquid chromatography-tandem mass spectrometry (HPLC/MS/MS). IHC examinations included liver function and serum adipokine level tests for insulin resistance. Consequently, the participants included for the final analysis were 113. After confounders had been adjusted for, the airborne VCM concentration significantly (P = 0.043) correlated with pre-shift urinary TDGA levels (β = 0.194). A multivariate analysis showed a significant (P = 0.013) inverse correlation between the adiponectin:leptin ratio and the airborne VCM concentration (β = -0.283), which means that exposure to VCM might increase the risk of insulin resistance and adiponectin abnormalities. We hypothesized that pre-shift urinary TDGA levels can be used as exposure biomarkers for the exposure of workers to VCM., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objectives: To investigate a possible association between normal tension glaucoma (NTG) and an increased risk of developing Alzheimer's disease (AD)., Design: Retrospective cohort study., Setting: NTG group and the comparison group were retrieved from the whole population of the Taiwan National Health Insurance Research Database from 1 January 2001 to 31 December 2013., Participants: A total of 15 317 subjects with NTG were enrolled in the NTG group, and 61 268 age-matched and gender-matched subjects without glaucoma were enrolled in the comparison group., Primary and Secondary Outcome Measures: Kaplan-Meier curves were generated to compare the cumulative hazard of AD between the two groups. A multivariable Cox regression analysis was used to estimate the adjusted hazard ratios (HRs) of AD, adjusted for diabetes, hypertension, hyperlipidaemia, coronary artery disease and stroke. Furthermore, risk factors for developing AD among the NTG group were investigated., Results: The mean age of the cohort was 62.1±12.5 years. Patients with NTG had significantly higher proportions of diabetes, hypertension, hyperlipidaemia, coronary artery disease and stroke than the comparisons. Patients with NTG had a significantly higher cumulative hazard for AD than the comparisons (p<0.0001). In the multivariable Cox regression after adjustment for confounders, the NTG group had a significantly higher risk of AD (adjusted HR 1.52; 95% CI 1.41 to 1.63). Moreover, in the NTG group, when we compared the effects of different types of glaucoma eye drops, none of the eye drops used were significant risk factors or protective factors for AD., Conclusions: People with NTG are at a significantly greater risk of developing AD compared with individuals without glaucoma. Among patients with NTG, none of the glaucoma eye drops used significantly changed the risk of subsequent AD., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The emergence of multidrug-resistant (MDR) Escherichia coli (E. coli), particularly E. coli sequence type ST131, is becoming a global concern. Commensal bacteria, an important reservoir of antibiotic resistance genes, facilitate the spread of such genes to pathogenic bacterial strains. The objective of the study is to investigate the fecal carriage of MDR E. coli and ST131 E. coli in community children in Southern Taiwan., Methods: In this prospective study, stool samples from children aged 0-18 years were obtained within 3 days of hospitalization from October 2013 to September 2014. Children with a history of underlying diseases, antibiotic treatment, or hospitalization in the 3 months before specimen collection were excluded. E. coli colonies were selected and tested for antimicrobial susceptibility, and O25b-ST131, multilocus sequence typing, and blaCTX-M gene groups were detected., Results: Among 157 E. coli isolates, the rates of nonsusceptibility to ampicillin, amoxycillin + clavulanate, trimethoprim-sulfamethoxazole, and cefazolin were 70, 65.6, 47.1, and 32.5%, respectively. Twenty-nine (18.5%) isolates were nonsusceptible to ciprofloxacin. MDR E. coli accounted for 58 (37%) of all isolates. Thirteen (8.3%) isolates produced extended-spectrum β-lactamase (ESBL). Furthermore, 26 (16.6%) and 13 (8.3%) isolates were O25b and ST131 positive, respectively. Five (38.5%) of the 13 ESBL-producing E. coli belonged to blaCTX-M group 9, among which were CTXM-14 and 4 (80%) were O25b-ST131 positive. Compared with the non-ESBL and ciprofloxacin-susceptible groups, the ESBL and ciprofloxacin-nonsusceptible groups showed significantly higher rates of O25b-ST131 positivity., Conclusions: The prevalence of the fecal carriage of nonsusceptible E. coli in children was high; among these E. coli, 37% were MDR, 18.5% were nonsusceptible to ciprofloxacin, and 8.3% produced ESBL. O25b-ST131 was the most common ESBL-producing E. coli clonal group present in the feces of children, and the ESBL and ciprofloxacin-nonsusceptible groups showed significantly higher rates of O25b-ST131 positivity.

Aims: The aim was to investigate the circadian and weekly variation in Chinese young patients with acute myocardial infarction (AMI)., Methods: This was a 10-year retrospective cohort study. We studied patients (>18 to <45 years of age) with a first attack of AMI from the emergency departments of 3 university teaching hospitals in Taiwan from January 1, 2001, to December 31, 2010. We analyzed patients in the standard circadian fashion using 6-hour intervals (00:01-06:00, 06:01-12:00, 12:01-18:00, and 18:01-24:00). We also did an analysis by day of week., Results: The database had 505 patients with AMI with complete data. The percentage of total AMIs that occurred in the 6-hour intervals were as follows: 00:01 to 06:00, 30.9%; 06:01 to 12:00, 23.4%; 12:01 to 18:00, 25.9%; and 18:01 to 24:00, 19.8%. The percentage of AMIs between 00:01 and 06:00 was significant higher compared with that in the other three 6-hour intervals (df = 3, χ(2) = 91.7, P < .001). However, there was no significant weekly variation for these patients in the present study., Conclusions: There was a significant circadian variation with a peak from 00:01 to 06:00 in Chinese young patients with AMI. However, there was no significant weekly variation in these patients. The circadian periodicity may create new possibilities for disease prevention and medication prescription., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Purpose: Tumor necrosis factor-α (TNF-α), an important proinflammatory cytokine, exerts a variety of physiologic and pathogenic effects that lead to tissue destruction. Recent laboratory evidence indicates that TNF-α have either protective or adverse effects on primary open angle glaucoma (POAG). Inheritance of the TNF-α (-863) C allele has been associated with an elevated risk of Alzheimer disease. The neuronal injuries associated with Alzheimer disease have several similarities with the optic nerve changes often seen with POAG. In this study we investigated the possible association between the TNF-α (-863) polymorphism and the development of POAG., Methods: A total of 234 patients with POAG were recruited and compared with 230 healthy controls in a Chinese population. Sequence-specific primers with 3' end mismatches were used to identify the presence of specific allelic variants by polymerase chain reaction (PCR) amplification. Patients and controls were genotyped for the A/C polymorphism at position -863 of the TNF-α gene promoter region., Results: The frequency of the TNF-α (-863)A allele (22% versus 30%, respectively; p=0.007) and the carriers of the TNF-α (-863)A allele (37% versus 48%; p=0.017, OR 0.63, 95% CI 0.44-0.92) were lower in POAG patients compared with those in controls. There is a reduced risk of POAG associated with homozygosity for the TNF-α (-863)A allele (AA genotype) compared with that in the control population (AA genotype; 7% versus 11%, respectively, p=0.037; OR 0.5, 95% CI 0.26-0.98)., Conclusions: The TNF-α (-863)A allele polymorphism may be a protective factor in the development of POAG.

Objectives: To assess the ability of mean platelet volume (MPV) to detect acute coronary syndromes (ACS) in Chinese patients within 4&emsp14;h of chest pain onset., Methods: Consecutive adult Chinese patients who arrived at an emergency department (ED) with acute chest pain (onset within 4&emsp14;h) between May and August 2009 were recruited. The MPV was checked for all enrolled patients on arrival at the ED, and further comparisons between the patients in different groups were made., Results: 282 patients (136 men and 146 women) were enrolled and 69 were diagnosed as having ACS (24.5%). As compared with the non-ACS group, the ACS group had significantly higher MPV values (10.8±0.86 fl vs 9.8±0.76 fl, p<0.001). Moreover, we found that the MPV values were higher in patients with acute myocardial infarction (AMI) (n=28) as compared with patients with unstable angina (UA) (n=41) (11.0±0.79 fl vs 10.6±0.87 fl, p=0.027). Multiple logistic regression analysis yielded the fact that the initial MPV was an independent predictor of ACS attack in patients with acute chest pain (OR 8.866). The corresponding area under the receiver operating characteristic curve (ROC) for MPV in predicting ACS in patients with acute chest pain was 0.800 (95% CI 0.736 to 0.864) and the best cut-off value was 10.35 fl (sensitivity 78.3%; specificity 74.6%)., Conclusions: MPV is significantly associated with ACS in patients with acute chest pain and is an early and independent predictor.

To describe the epidemiologic features of work-related eye injuries in Kaohsiung, a hospital-based study was performed. Four hundred and eighty-six patients who were treated at emergency service or were admitted to the ophthalmology ward over a 4-year period were reviewed. Among these, 38.9% of eye injuries in the study were work-related. Male workers had a 3.99 higher odds ratio (OR) than females to suffer from eye injuries (95% confidence interval [CI], 1.99-8.04). Most of the work-related eye injuries occurred in subjects who were 30-49 years old (OR, 3.02, and 95% CI, 1.56-5.82, when compared with those aged < or = 29 years). The most common type of eye injury in the occupational exposure group was foreign body injury (31.2%), followed by blunt injuries (20.6%), chemical burn (19.6%), UV light radiation (12.7%), and corneal abrasions (11.6%). On the other hand, in the non-occupational exposure group, the most common types of eye injury were blunt injuries (43.4%), corneal abrasions (28.3%), and foreign body injury (20.2%). Our study found that foreign body injury and blunt injuries were the two highest priority injuries for which prevention strategies should be developed in Kaohsiung city. Furthermore, after advanced examination of types of media that caused eye injuries, we found that being hit by wooden objects around the eye, by flying objects in the eye, and by welding flashes are important risk factors for workers to avoid. In conclusion, most of the occupational eye injuries occurred among male workers aged 30-49 years. Due to the lack of an occupational eye injury surveillance system to monitor the incidence of eye injuries and to undertake risk assessment, preventable occupational eye injuries have not been properly controlled. We hope to provide information for further development of preventive strategies.

Study Objective: We assess the prognostic role of initial glucose levels in patients with a first acute myocardial infarction in the emergency department (ED)., Methods: We conducted a 3-year retrospective cohort study. Patients with a first acute myocardial infarction were recruited from the ED of a tertiary hospital from January 1, 2001, to December 31, 2003. Initial glucose levels in the ED were stratified into 3 levels (normal < 140 mg/dL; intermediate 140 to 200 mg/dL; and high > or = 200 mg/dL). Logistic and Cox regression models were applied to estimate the 1-month short-term and 1-year long-term adverse prognoses, respectively., Results: A total of 198 eligible subjects (159 men and 39 women; mean age 63.1+/-14.2 years) were recruited. The estimated survival curves among the 3 initial glucose levels were significantly different (P=.0002). After adjustment for sex, age, diabetic status, reperfusion therapy, and infarct subtype, the adjusted odds ratio for short-term prognosis progressed with higher levels when compared with the normal level (intermediate level: odds ratio 3.87; 95% confidence interval [CI] 1.71 to 8.78; high level: odds ratio 5.16; 95% CI 1.97 to 13.51). High initial glucose level was an important risk factor for long-term adverse prognosis (hazard ratio 3.08; 95% CI 1.59 to 5.98)., Conclusion: A high initial glucose level in the ED is an important and independent predictor of short- and long-term adverse prognoses in patients with first acute myocardial infarction.

investigated in milkfish Chanos chanos, which had a cumulative mortality of up to 66.7% over the course of 1 yr. Gross reddish- or greyish-white nodules appeared on the peritoneal surface, spleen, kidney, liver and gastrointestinal (GI) tract. Epithelioid granulomas with the formation of Langhan's type giant cells were the prominent histopathological changes. Despite large numbers of acid-fast bacilli in the granulomas, neither caseous necrosis nor dystrophic calcification were observed. Using degenerate primers that targeted the heat shock protein 65 kDa gene of Mycobacterium spp., a 441 bp product was amplified. When compared with published sequences, our products were identical to those of Mycobacterium abscessus Type II (GenBank accession number AY603554). This is the first report of M. abscessus infection in milkfish.

Lifestyle factors are considered important for the pathogenesis of both nasopharyngeal and oropharyngeal carcinomas. In Taiwan, the incidence of nasopharyngeal carcinoma gradually decreased over the past 20 years, whereas that of oropharyngeal carcinoma increased rapidly. To compare the incidence trends of nasopharyngeal and oropharyngeal carcinomas in Taiwan, the age-period-cohort model was used to analyze epidemiologic data from 1981 to 2000 obtained from the Taiwan Cancer Registry. The calendar time period of 1986 to 1990 and the 1931 to 1940 birth cohort were used as reference groups for estimates of relative risk. For nasopharyngeal carcinoma, the incidence seemed to decrease in most age groups and was more prominent in women (30%) than in men (23%). For oropharyngeal carcinoma, the incidence increased in all age groups and was more prominent in men (391.4%) than in women (59.2%). Cohort effect was found for both nasopharyngeal and oropharyngeal carcinomas. The relative risk of nasopharyngeal carcinoma for the 1971 to 1980 birth cohort was 0.38 for women and 0.68 for men. The relative risk of oropharyngeal carcinoma for the 1971 to 1980 cohort was 45.67 for men and 2.69 for women. Change in lifestyle seemed to be an important factor for the difference in the incidence trend between nasopharyngeal and oropharyngeal carcinomas and between men and women.

Female invasive breast cancer (FIBC) in Taiwan is characterized by a striking recent increase of incidence and a relatively young median age (45-49 years) at diagnosis. The Westernization of lifestyle that is increasingly affecting younger generations of Taiwanese may have an important impact on this change. We compared epidemiologic data on FIBC in Taiwanese obtained from the Taiwan Cancer Registry with data for Caucasian Americans obtained from the database of the Surveillance, Epidemiology, and End Results Program for the period from 1980 to 1999. Age-specific incidence rates of FIBC were plotted by calendar year at diagnosis and by birth cohort for both populations. The individual effects of time period and birth cohort on the incidence trends of FIBC in both populations were evaluated using the age-period-cohort analysis. The incidence rate of FIBC was continuously increased in Taiwanese throughout the past 2 decades, whereas the increase of incidence was slowing down in Caucasian Americans. The incidence rates in Taiwanese women born after the 1960s were approaching that of Caucasian Americans. The age-period-cohort analysis showed a much stronger birth cohort effect on the incidence trend of FIBC in Taiwanese than in Caucasian Americans. This strong birth cohort effect corresponded to the Westernization of lifestyle in Taiwan since 1960. These findings indicate that a continued shift in the incidence and age distribution pattern of FIBC in Taiwanese toward that of Caucasian Americans should be anticipated.