Investigation of interleukin-13 gene polymorphisms in individuals with chronic and generalized aggressive periodontitis in a Taiwanese (Chinese) population.

BACKGROUND AND OBJECTIVE: The interleukin-13 (IL-13) -1112 C/T polymorphisms have been analyzed previously in a North European population of patients with aggressive periodontitis. The present study was carried out to investigate the association of polymorphisms in the IL-13 gene with susceptibility to periodontitis in a Taiwanese population. MATERIAL AND METHODS: The genotyping of IL-13 -1112 C/T polymorphisms in 60 patients with aggressive periodontitis, 204 patients with chronic periodontitis and 95 healthy controls was carried out using the polymerase chain reaction-restriction fragment length polymorphism technique. Genotypes and allele frequencies among study groups were compared using Fisher's exact test (p < 0.05). Pearson's chi-square test was used for analysis of the Hardy-Weinberg equilibrium. RESULTS: The distributions of CC genotypes and C alleles between patients with aggressive periodontitis and healthy controls were significantly different (p = 0.034 and 0.046). After adjustment for age, gender, betel nut chewing and smoking status using logistic regression analysis, the odds ratio (OR) was 6.45 [95% confidence interval (CI) = 1.99-23.72, p = 0.003] for aggressive periodontitis. However, the CC genotype was only significantly associated with the risk of aggressive periodontitis in the nonsmoking group (OR = 4.48, 95% CI = 1.31-16.93, p = 0.020). CONCLUSION: The CC genotype or C allele appears to increase the risk of developing aggressive periodontitis in Taiwanese subjects.

Association of secular trends in unemployment with suicide in Taiwan, 1959-2007: a time-series analysis.

OBJECTIVE: Despite the wealth of research investigating the association of unemployment with suicide in the West, few studies have investigated the association in non-Western countries. This study aimed to investigate the relationship between secular trends in unemployment and suicide in Taiwan. STUDY DESIGN: Time-series analysis. METHODS: Overall and age-specific suicide rates (1959-2007) for Taiwanese men and women aged 15 years or above were calculated from national population and mortality statistics. The association of secular trends in unemployment with suicide was investigated graphically and using time-series modelling (Prais-Winsten regression). RESULTS: Rises in unemployment were associated with an increase in male suicide rates, but evidence for an association in females was limited. In the model controlling for changes in gross domestic product (GDP) per capita, GDP growth, divorce and female labour force participation, for every 1% rise in unemployment, male suicide rates increased by 3.1 (95% confidence interval 1.4-4.8) per 100,000. There is no evidence for a difference in the strength of association between men of different ages. CONCLUSION: Trends in suicide, particularly for adult males, appear to be influenced by unemployment. The results have implications for suicide prevention, in particular for societies facing acute rises in unemployment during recessions.

Clinical factors associated with fatigue over time in paediatric oncology patients receiving chemotherapy.

The purpose of this study was to investigate the relationships between clinical factors (including haemoglobin value, chemotherapeutic agents, and corticosteroid use) and changing patterns of fatigue before and for the next 10 days following the start of a new round of chemotherapy in children with cancer. A prospective longitudinal design was used to collect data from 48 paediatric oncology patients who were about to begin a new round of chemotherapy and their parents. Fatigue levels were assessed using multidomain questionnaires with three categories of patient self-report (including 'General Fatigue', 'Sleep/Rest Fatigue', and 'Cognitive Fatigue') and four categories of parent proxy-report (including 'Lack of Energy', 'Unable to Function', 'Altered Sleep', and 'Altered Mood'). The findings suggest that fatigue from both patient self-report and parent proxy-report changed significantly over time. The major findings from this study are that patients have more problems with fatigue in the first few days after the start of a cycle of chemotherapy. Corticosteroid use and haemoglobin value were associated with significant increases in fatigue that were sustained for several days and reached the highest level of fatigue at day 5 for those receiving concurrent steroids. The association of chemotherapeutic agents with fatigue varied between patient self-report and parent report, but the type of chemotherapeutic agents used was not associated with most changes in fatigue.

Impact of enhanced infection control procedures on clinical outcome following resuscitation attempts.

The impact of infection control measures (ICMs) on emergency resuscitation during an outbreak is unclear. The purpose of this retrospective observational study was to investigate the outcomes of emergency resuscitation after implementation of ICMs. Data were collected for the period 1 January to 4 July in 2003 from a 1732-bed tertiary care hospital in central Taiwan. Non-trauma patients who required emergency resuscitation were classified into two groups: before (period 1), and after (period 2), the date on which strict ICMs were implemented. The analysis variables included demographic data of patients, place of resuscitation, number of participating resuscitators, response time and duration of resuscitation, fever, pneumonia status and results of resuscitation. The response time was unchanged but the number of patient resuscitations without an emergency intubation, rapid sequence intubation or a 'do not resuscitate' order increased from 88 (24.4%), 23 (6.4%) and 16 (4.4%) in period 1 to 103 (33.0%), 32 (10.3%) and 29 (9.3%) in period 2, respectively. The failure rate of resuscitation was significantly higher in period 2 (odds ratio: 1.59, 95% confidence interval: 1.17-2.16). The number of emergency resuscitations in patients with fever or pneumonia was not significantly different between these two periods. In conclusion, strict ICM implementation appeared to play a role in the increased failure rate in emergency resuscitation. Normal provision of healthcare to patients and adequate protection of healthcare workers during emergency resuscitation will be of paramount importance during the next outbreak of a highly contagious disease.

Carpal tunnel syndrome induced by tophaceous deposits on the median nerve: case report.

The symptoms of a 62-year-old man with carpal tunnel syndrome resulting from poorly controlled gout subsided after the transverse carpal ligament was released surgically. At the time of the operation, the tophi were found to deposit on the median nerve rather than the transverse ligament, a situation reported only once before. The absence of gouty tenosynovitis in this patient was supported by the wound healing well without the chalky discharge that patients have had in previous reports.

A reexamination of "sociological and economic theories of suicide: a comparison of the U.S.A. and Taiwan".

This paper is an update and reexamination of Yang et al. [Yang B., Lester D. and Yang C. Soc. Sci. Med. 34, 333, 1992]. Time-series analyses were carried out to explore the importance of sociological and economic determinants of suicide rates in the U.S. and in Taiwan for 1952-1992. Labor market related variables (unemployment and female labor force participation) were found to play similar roles in multiple regressions for both nations, while general economic and social conditions (GNP per capita and divorce) played a role only in the U.S.A comparison of standardized coefficients revealed that pure economic variables exerted greater influence over national suicide rates than sociological variables.

Craniofacial resection for tumors of the nasal cavity and paranasal sinuses.

BACKGROUND AND PURPOSE: Craniofacial resection provides multidirectional approaches to remove nasal and paranasal tumors that involve the skull base. The purpose of this study was to determine the survival and local control rate in patients undergoing craniofacial resection for tumors of the nasal cavity, paranasal sinuses, and adjacent areas. METHODS: The medical records of 30 consecutive patients who had undergone craniofacial resection for tumors of the nasal cavity, paranasal sinuses, and adjacent areas were reviewed. The extent of disease, treatment results, complications, and prognoses were analyzed. RESULTS: Lesions were malignant in 28 patients and benign in two. Sixteen of the patients had dural or intradural involvement. There was no surgical mortality, and the rate of surgical morbidity was 7%. The 2-year survival of the 28 patients with malignancies was 46% and the mean follow-up time was 35 months. Local control was achieved in 53% of patients. Nine of 16 patients with dural or intradural invasion had a mean survival time of 17 months. There was no significant difference in the frequency of local control between previously treated and untreated patients. Patients who had a clear margin showed significantly better local control than those with an involved or questionable margin. CONCLUSIONS: Tumors of the nasal cavity and paranasal sinus that involve the skull base can be effectively treated using craniofacial resection, with a reasonable survival and low complication rate.

Membranous obstruction of the fourth ventricle outlet. A case report.

We report the case of a 15-year-old girl with amenorrhea and a several-week history of headache. After the diagnosis of membranous obstruction of the foramen of Magendie suggested by MRI, suboccipital craniotomy for removal of the membrane was carried out. The patient made an excellent postoperative recovery, and postoperative phase-contrast MRI demonstrated patent cerebrospinal fluid (CSF) pathways at the level of the foramina of Magendie and Luschka. We believe that this case is of interest because of the unequivocal evidence on MRI studies of the occlusion of the foramen of Magendie preoperatively, and because of the dramatic postoperative MRI findings demonstrating the effectiveness of the surgical procedure both in terms of ventricular size and CSF flow characterization.

The Chinese version of the Parenting Stress Index: a psychometric study.

UNLABELLED: This study examined the psychometric properties of a Chinese version of the Parenting Stress Index/Short Form (PSI/SF). A 15-item simplified PSI/SF (S-PSI/SF) was subsequently developed which maintained a level of reliability and validity similar to the full version. The Chinese PSI/SF was tested on 149 parents (100 mothers, 49 fathers) of pediatric cancer patients in Taiwan. Psychometric testing was conducted using item analysis, Cronbach's alpha and confirmatory factor analysis. The S-PSI/SF was constructed based on the item analysis of the PSI/SF. Both the PSI/SF and S-PSI/SF produced good reliability coefficients. Confirmatory factor analyses indicated that both PSI/SF and S-PSI/SF met all criteria for goodness of fit. Compared with the PSI/SF, the S-PSI/SF demonstrated better internal consistency and overall fit at the one-subscale level, and satisfactory overall fit at two- and three-subscale levels. Despite the limited number of items included, the S-PSI/SF had a very good factor structure. No gender difference in parenting distress index was observed between mothers and fathers of pediatric cancer patients. CONCLUSION: The 15-item S-PSI/SF is a brief, easily administered instrument that has evidence of reliability and validity in Taiwanese parents of children with cancer. It could serve as a valuable assessment tool in clinical practice to identify parenting stress with a need for intervention.

Ex vivo gene therapy in autologous bone marrow stromal stem cells for tissue-engineered maxillofacial bone regeneration.

This study examines the clinical relevance of tissue engineering integrating gene therapy and polymer science to bone regeneration. Bilateral maxillary defects (3 x 1.2 cm(2)) in 20 miniature swine were bridged with a bioresorbable internal splint. Constructs were created using ex vivo adenovirus bone morphogenetic protein (BMP)-2-mediated gene transfer to the expanded bone marrow mesenchymal stem cells (MSCs) 7 days before implantation. Controls were performed using adenovirus beta-galactosidase. The BMP-2 cell/construct displayed white solid bone formation after 3 months. Meanwhile, the hematoxylin and eosin and Von Kossa stains demonstrated exhibited mature woven bone with good mineralization. Additionally, three-dimensional computer tomography imaging revealed a nearly complete infraorbital rim repair. Quantitative analysis demonstrated a significant difference (P<0.001) in bone formation. Finally, biomechanical testing revealed no statistically significant difference in the maximal compressive strength of new bone formed by BMP-2 cell constructs and the normal maxilla. The data evidenced de novo bone formation capable of sustaining axial compressive loads. The measurement results showed that ex vivo replication defective adenovirus-mediated human BMP-2 gene transfer to MSCs enhances autologous bone formation in the repair of maxillary defects.