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Lin G.-M.,Tzu Chi University | Chen Y.-J.,Hualien Armed Forces General Hospital | Chen Y.-J.,Tzu Chi University | Jaiteh L.E.S.,Royal Victoria Teaching Hospital | And 3 more authors.
Schizophrenia Bulletin | Year: 2013

Background: Both genetic and environmental factors have been reasoned for cancer development in schizophrenia patients. However, the influence of age of onset and duration of schizophrenia on cancer incidence has rarely been emphasized. Besides, bipolar disorder tends to resemble schizophrenia from the perspective of multiple rare mutations. Comparing pattern and risk of cancers between schizophrenia and bipolar patients is illuminating. Methods: This study used the Taiwan National Health Insurance Database. A total of 71 317 schizophrenia and 20 567 bipolar disorder patients from 1997 to 2009 were enrolled. Both cohorts were followed up for cancer during the same period by record linkage with the cancer certification in Taiwan. Age and gender standardized incidence ratios (SIRs) of overall and site-specific cancers were calculated. Results: The SIR for all cancers was 1.17 for the schizophrenia cohort. Increased cancer risk (SIR: 1.31, 95% CI: 1.17-1.48) was observed in females but not males. For the bipolar disorder cohort, the SIR for all cancers was 1.29, but the excess risk was found in males (SIR: 1.42, 95% CI: 1.14-1.77) and not females. Cancer risk decreases as the duration and age of onset of schizophrenia increases. If schizophrenia is diagnosed before 50, the SIRs for colorectal, breast, cervical, and uterine cancers increase but if diagnosed after 50, the SIRs for all cancers decrease except for breast cancer. In bipolar disorder, the SIRs for all site-specific cancers were insignificant. Conclusions: Among schizophrenia patients, overall cancer risk varies inversely with age at diagnosis and disease duration. Besides, gender-specific cancer risks differ between schizophrenia and bipolar disorder. © 2013 The Author.


Yeh K.-D.,Hualien Armed Forces General Hospital | Popowics T.E.,University of Washington
Archives of Oral Biology | Year: 2011

Objectives: This study investigated the effects of growth and tooth loading on the structural adaptation of the developing alveolar bone adjacent to the tooth root as the tooth erupted into function. Growth and occlusal function were expected to lead to increased alveolar bone density. Meanwhile, the supporting alveolar bone was expected to develop a dominant trabecular orientation (anisotropy) only after occlusal loading. Design: Minipigs with erupting and occluding mandibular first molars (M1's) were used to study the effects of growth and occlusal function on developing alveolar bone structure through comparison of alveolar bone surrounding M1's. A second minipig model with one side upper opponent teeth extracted prior to occlusal contact with the M1 was raised until the non-extraction side M 1's developed full occlusal contact. The comparisons between extraction and non-extraction side M1 alveolar bone were used to emphasize the impact of occlusal loading on alveolar bone structure. Specimens were scanned on a Scanco Medical μCT 20 at a 22 μm voxel resolution for structural analysis. Results: With growth and occlusal function a distinct alveolar bone proper tended to develop immediately adjacent to the tooth root. The cancellous bone had thicker but fewer and more separated trabeculae after growth or occlusal loading. On the other hand, occlusal function did not lead to increased alveolar structural anisotropy. Conclusion: During tooth eruption, growth and masticatory loads effect structural change in alveolar bone. The impact of occlusal function on cancellous bone anisotropy may need a more extensive period of time to demonstrate.


Lin G.-M.,Hualien Armed Forces General Hospital
Cardiovascular and Hematological Disorders - Drug Targets | Year: 2011

Pexelizumab, an anti-C5 complement antibody, as adjunctive therapy to reduce reperfusion injury after coronary revascularization in acute myocardial infarction and severe coronary artery disease had been approved in animal studies and further demonstrated clinical benefits in phase II study: the COMMA trial and phase III study: the PRIMOCABG trial. However, the negative results of pexelizumab were observed in the COMPLY trial and the APEX-AMI trial. In the APEX-AMI trial, the effectiveness of pexelizumab has reasoned to be prominent in high-risk patients. Similarly, an exploratory analysis of the combined PRIMO-CABG I and II data set using an established predictive risk model demonstrated a mortality benefit for high-risk surgical patients. Accordingly, the result of these trials supported a moderational model to explain the usefulness of pexelizumab affected by the baseline risk profiles of patients. In this regard, we have commented that pexelizumab may be hazardous to patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention without using adequate anti-thrombotic agents (glycoprotein IIb-IIIa antiplatelet inhibitors, clopidogrel and haparin non-responders) according to the results of the experiment by professor Røger and coworkers and the mathematic estimations of the relative risks. Herein, we proposed a mediational model to account for the effectiveness of pexelizumab. © 2011 Bentham Science Publishers.


Lin H.-F.,Tzu Chi University | Li Y.-H.,Tzu Chi University | Wang C.-H.,Hualien Buddhist Tzu Chi General Hospital | Chou C.-L.,Hualien Armed Forces General Hospital | Fang T.-C.,Tzu Chi University
Nephrology Dialysis Transplantation | Year: 2012

Background. An increased incidence of cancer in chronic dialysis patients has not been confirmed in the Chinese population. The aim of this population-based study was to examine the risk of various types of cancers in chronic dialysis patients in Taiwan. Methods. Data of 92348 chronic dialysis patients extracted from the National Health Institutes Research Database during 1997-2008 were analyzed. Patients newly diagnosed with end-stage renal disease, free of cancer and receiving dialysis for >3 months were eligible for inclusion in the study. Results. After a mean follow-up of 4.4 years, a new cancer was diagnosed in 4328 chronic dialysis patients. The standardized incidence ratio (SIR) of chronic dialysis patients was 1.4 [95% confidence interval (CI): 1.3-1.4] and annual incidence of cancer was 1.1%. A trend of an increased SIR of cancer was observed in young patients and within the first year of dialysis. Bladder cancer carried the highest SIR (SIR: 8.2, 95% CI: 6.7-9.9) and had the highest frequency (21.2%). Importantly, the frequency (15.3%) of liver cancer was the second highest and the SIR (SIR: 1.4, 95% CI: 1.2-1.5) of liver cancer in chronic dialysis patients was higher than that of their healthy counterparts. Unexpectedly, chronic dialysis patients had a significantly reduced risk of developing lung cancer.Conclusion. Increased risk of cancer in chronic dialysis patients is confirmed in the Taiwanese population and it is necessary to develop different strategies for cancer screening in chronic dialysis patients among different ethnicities. © 2011 The Author.


Li J.-M.,Taoyuan Armed Forces General Hospital | Lu C.-L.,Hualien Armed Forces General Hospital | Cheng M.-C.,Yuli Mental Health Research Center | Luu S.-U.,Taoyuan Armed Forces General Hospital | And 4 more authors.
Psychiatry Research | Year: 2013

Schizophrenia is a severe chronic mental disorder with high genetic components in its etiology. Several studies indicated that synaptic dysfunction is involved in the pathophysiology of schizophrenia. Postsynaptic synapse-associated protein 90/postsynaptic density 95-associated proteins (SAPAPs) constitute a part of the N-methyl-d-aspartate receptor-associated postsynaptic density proteins, and are involved in synapse formation. We hypothesized that genetic variants of the SAPAPs might be associated with schizophrenia. Thus, we systemically sequenced all the exons of the discs, large (Drosophila) homolog-associated protein 1 (DLGAP1) gene that encodes SAPAP1 in a sample of 121 schizophrenic patients and 120 controls from Taiwan. We totally identified six genetic variants, including five known SNPs (rs145691437, rs3786431, rs201567254, rs3745051 and rs11662259) and one rare missense mutation (c.1922A>G) in this sample. SNP- and haplotype-based analyses showed no association of these SNPs with schizophrenia. The c.1922A>G mutation that changes the amino acid lysine to arginine at codon 641 was found in one out of 121 patients, but not in 275 control subjects, suggesting it might be a patient-specific mutation. Nevertheless, bioinformatic analysis showed this mutation does not affect the function of the DLGAP1 gene and appears to be a benign variant. Hence, its relationship with the pathogenesis remains to be investigated. © 2012 Elsevier Ireland Ltd.

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