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Taipei, Taiwan

The National Taiwan University Hospital started operations under Japanese rule in Daitōtei on June 18, 1895, and moved to its present location in 1898. The Hospital was later annexed to the Medical School of Taihoku Imperial University and renamed Taihoku Imperial University Medical School Affiliated Hospital in 1937. The present name was adopted after the Republic of China took over the hospital upon Taiwan's retrocession in 1945.On October 19, 1991, the completion of a large new building complex on the so-called East Site marked another milestone in the history of the NTUH. Today, the East and West Sites together have more than 4,000 employees, serving 2,000 inpatients and 8,000 outpatients daily. The hospital remains the best-known and most highly renowned medical center in Taiwan.The hospital is a world-renowned medical center for liver diseases. Advanced surgical, angiographical, and endoscopic procedures are routinely performed. Wikipedia.

Tseng C.-H.,National Taiwan University | Tseng C.-H.,National Taiwan University Hospital
Diabetes Care | Year: 2012

OBJECTIVE - The association between pioglitazone and bladder cancer has not been investigated in Asians. We aimed to investigate this association. RESEARCH DESIGN AND METHODS - A total of 1,000,000 individuals were randomly sampled from the National Health Insurance database, and incident cases of bladder cancer during the period from 1 January 2006 to 31 December 2009 were analyzed among 54,928 patients with type 2 diabetes and without previous bladder cancer. RESULTS - Among 165 incident case subjects, 10 (0.39%) were ever users and 155 (0.30%) were never users of pioglitazone (adjusted hazard ratio in full model 1.305 [95% CI 0.661-2.576]). All bladder cancer in ever users occurred within a duration of therapy <24 months, suggesting an early effect of pioglitazone on bladder cancer or late use of pioglitazone in high-risk patients. CONCLUSIONS - The association between pioglitazone and bladder cancer was not significant. However, confirmation of this finding is required because of the possible lack of statistical power owing to the small number of events. © 2012 by the American Diabetes Association.

Young Y.-H.,National Taiwan University Hospital
Laryngoscope | Year: 2013

By stimulating the ear with air-conducted sound or bone-conducted vibration stimuli, vestibular-evoked myogenic potential (VEMP) can be recorded on the contracted neck muscles, termed cervical VEMP (cVEMP), and on the extraocular muscles, termed ocular VEMP (oVEMP). These two electrophysiological tests expand the test battery for clinicians to explore the dynamic otolithic function, adding a potential usefulness to the sacculocollic reflex and vestibulo-ocular reflex, respectively. The inner ear test battery, including audiometry, and cVEMP, oVEMP and caloric tests, is designed for complete evaluation of the inner ear function, namely, the cochlea, saccule, utricle, and semicircular canals, respectively. Using this test battery to study the localization and prevalence of hydrops formation reveals that the declining function in the cochlea, saccule, utricle, and semicircular canals mimics the declining sequence of hydrops formation in temporal bone studies. This study reviewed the physiological results in Meniere's patients via the inner ear test battery, especially the potential application of the oVEMP and cVEMP tests, to correlate with the histopathological findings of Meniere's disease. Laryngoscope, 2012 Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Cheng A.L.,National Taiwan University Hospital
Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2013

Open-label, phase III trial evaluating whether sunitinib was superior or equivalent to sorafenib in hepatocellular cancer. Patients were stratified and randomly assigned to receive sunitinib 37.5 mg once per day or sorafenib 400 mg twice per day. Primary end point was overall survival (OS). Early trial termination occurred for futility and safety reasons. A total of 1,074 patients were randomly assigned to the study (sunitinib arm, n = 530; sorafenib arm, n = 544). For sunitinib and sorafenib, respectively, median OS was 7.9 versus 10.2 months (hazard ratio [HR], 1.30; one-sided P = .9990; two-sided P = .0014); median progression-free survival (PFS; 3.6 v 3.0 months; HR, 1.13; one-sided P = .8785; two-sided P = .2286) and time to progression (TTP; 4.1 v 3.8 months; HR, 1.13; one-sided P = .8312; two-sided P = .3082) were comparable. Median OS was similar among Asian (7.7 v 8.8 months; HR, 1.21; one-sided P = .9829) and hepatitis B-infected patients (7.6 v 8.0 months; HR, 1.10; one-sided P = .8286), but was shorter with sunitinib in hepatitis C-infected patients (9.2 v 17.6 months; HR, 1.52; one-sided P = .9835). Sunitinib was associated with more frequent and severe adverse events (AEs) than sorafenib. Common grade 3/4 AEs were thrombocytopenia (29.7%) and neutropenia (25.7%) for sunitinib; hand-foot syndrome (21.2%) for sorafenib. Discontinuations owing to AEs were similar (sunitinib, 13.3%; sorafenib, 12.7%). OS with sunitinib was not superior or equivalent but was significantly inferior to sorafenib. OS was comparable in Asian and hepatitis B-infected patients. OS was superior in hepatitis C-infected patients who received sorafenib. Sunitinib-treated patients reported more frequent and severe toxicity.

Kao J.-H.,National Taiwan University Hospital
Liver International | Year: 2014

Although chronic hepatitis B (CHB) is a global health threat, it is now a preventable and treatable disease. Seven agents have been approved for the treatment of CHB. Although many patients prefer potent long-term nucleos(t)ide analogues (NAs) as the first-line therapy because they are convenient to use and well-tolerated, a finite duration of pegylated interferon (PEG-IFN) is still an attractive strategy because it provides higher rates of off-therapy host immune control over hepatitis B virus (HBV) compared with NAs. In addition, the rates of HBeAg/HBsAg loss or seroconversion increase over time in patients who respond to PEG-IFN therapy. Nevertheless, these benefits are limited to 30% of all patients, and significant adverse effects are still a concern. Therefore, patients who can benefit most from PEG-IFN therapy should be more carefully selected according to baseline host and viral predictors, such as age, ALT level, viral load, HBV genotype and HBV mutants. In addition, on-treatment predictors including HBV DNA, HBeAg and HBsAg kinetics, can help decide who should continue or discontinue PEG-IFN and shift to NA. Understanding these factors can help determine personalized PEG-IFN therapy for CHB patients. In the near future, the treatment paradigm of CHB should be tailored on the basis of viral (HBV DNA level, HBV genotype and HBV mutants) and host (age, gender, ALT level and host genetic polymorphisms) factors, disease status (stage of fibrosis and comorbidities) and the selection of antiviral agents (immunomodulatory effect, antiviral potency, adverse effects and rate of drug resistance). © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Tseng C.-H.,National Taiwan University Hospital
Pancreas | Year: 2013

OBJECTIVE: This study aimed to investigate whether the reported relationship between diabetes and pancreatic cancer (PC) could result from detection bias and whether dyslipidemia and/or new-onset diabetes (diagnosed within 1 year) could predict PC. METHODS: A random sample of 1 million subjects covered by National Health Insurance was recruited. From 2003 to 2005, 495,493 men and 503,901 women without PC were followed up. Cox regression was used to evaluate the adjusted relative risk considering potential PC detection examinations and covariates. RESULTS: Diabetic patients had a significantly higher probability of receiving examinations that might lead to PC diagnosis. In Cox proportional hazards regression models, diabetes was not a significant predictor, but dyslipidemia was significantly associated with an approximately 40% higher risk of PC. Age, living in more urbanized regions, and potential PC detection examinations were significant covariates. Patients with new-onset diabetes and previous dyslipidemia had a remarkably higher risk compared with those without either condition (relative risk [95% confidence interval], 2.512 [1.169-5.398]). CONCLUSIONS: Dyslipidemia, but not diabetes, is a significant risk factor for PC. The link between diabetes and PC is likely due to confounders and detection bias. Patients with new-onset diabetes and a history of dyslipidemia are at an especially high risk of PC. Copyright © 2012 by Lippincott Williams & Wilkins.

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