Objective: The prolongation of bleeding time (BT) in systemic lupus erythematosus (SLE) may be du... more Objective: The prolongation of bleeding time (BT) in systemic lupus erythematosus (SLE) may be due to a variety of factors, including thrombocytopenia, the existence of autoantibodies, renal or hepatic dysfunction, or usage of special medications. In this study, we investigated and analyzed the possible causes of prolonged BT in SLE patients. Methods: We retrospectively reviewed medical records of 253 SLE patients who had received BT tests from January 2004 to September 2007. We collected data on the clinical characteristics, current medications, and laboratory data. Results: Thirty-seven SLE patients had prolonged BT and 216 patients were normal. There were significant differences in both groups in terms of serum level of hemoglobin (10.9±2.2 vs. 12.2±1.7 g/dL, p＜0.005); platelet count (178, 200±14, 200 vs. 238,900±5,200/cumm, p＜0.005); the frequency of INR prolongation (10.8% vs. 1%, p＜0.001); APTT prolongation (16.2% vs. 4.6%, p＜0.012); frequencies of serum antiphospholipid antib...
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 1994
Although immunoprecipitable DNA has been found in a subgroup of patients with systemic lupus eryt... more Although immunoprecipitable DNA has been found in a subgroup of patients with systemic lupus erythematosus (SLE) exhibiting systemic vasculitis and/or central nervous system involvement, the mechanism for elevated plasma DNA in these patients is poorly understood. The plasma DNA concentrations and reactivity of serum and lymphocytes to six species of double-stranded DNA from calf thymus, human placenta, Escherichia coli, Micrococcus lysodeikticus, Clostridium perfringens and poly (dG.dC). poly (dG.dC) were measured in twenty-seven patients with active SLE. To understand the mechanism of increased plasma DNA in SLE, the DNA binding and release of the mononuclear cells were examined. Compared with the controls, the incidence of the presence of plasma DNA was markedly increased in SLE (59.3% in SLE vs. 7.4% in controls) as detected by counterimmunoelectrophoresis. Except for DNA from Clostridium perfringens, the reactivity of lupus sera to various DNA samples was significantly higher t...
Five commercial kits including Staclot PNP, Staclot LA, PTT-LA, and 2 dilute Russell's viper ... more Five commercial kits including Staclot PNP, Staclot LA, PTT-LA, and 2 dilute Russell's viper venom time tests for detecting lupus anticoagulant were determined in 102 patients with systemic lupus erythematosus (SLE). The 5 coagulation tests had different positive rates ranging from about 4 to 9%, and the patients might have different result by using different test. If we regarded a patient with two or more positive LA tests as being positive, 8% of the SLE patients in our study were LA positive. Among the 5 LA tests, the highest correlation was between DVVtest and LA-Screen & LA-Confirm (k=0.648), and the test having the highest correlation with the remaining other 4 tests was Staclot LA (k=0.864). The consistency of LA tests and anti-cardiolipin antibody test was good. Due to the heterogeneity of the results of LA tests, the diagnosis of the presence of LA in a patient should be carefully made if only one LA-positive test was obtained.
Sir—Systemic lupus erythematosus (SLE) and Crohn’s disease are multisystemic diseases, and can af... more Sir—Systemic lupus erythematosus (SLE) and Crohn’s disease are multisystemic diseases, and can affect many tissues or organs. The gastrointestinal (GI) manifestations of these two diseases may be quite similar. Without a definite diagnosis, the physician may confuse the two diseases. Massive lower GI bleeding in these two diseases is rare, but lifethreatening. We herein present the case of a patient with SLE combined with Crohn’s disease who developed massive lower GI bleeding, which was initially treated as SLE-related intestinal vasculitis, but in vain. A 49-year-old ethnic Chinese woman with a history of SLE for 5 years was admitted to VGH-Taipei in January 2006 with recurrent diarrhoea, abdominal pain and GI bleeding. She previously had SLErelated manifestations of malar rash, positive antinuclear antibody (ANA), high titre anti-dsDNA antibodies (Ab), nephritis and central nervous system (CNS) involvement. She had undergone intensive immunosuppressive drug therapy (pulse methylprednisolone and cyclophosphamide) for nephritis (WHO class IV) on many occasions 2 years ago, and received low-dose prednisolone therapy (5 mg/day) more than 1 year before this admission. At this presentation, her SLE disease activity index (SLEDAI) score was 4, including elevated anti-dsDNA Ab [234 IU/ml (normal <5 IU/ml)] and fever (38 °C). Her proteinuria was mild, and serum C3 and C4 levels were normal. Serial examinations, including coagulation tests [prothrombin time (PT), activated partial thromboplastin time (aPTT) and bleeding time (BT)], panendoscope, upper GI (UGI) series, small intestinal series, barium enema andTc99mRBC scan, were performed, but with unremarkable findings. The abdominal computed tomographic (CT) scan showed segmental thickening in the proximal jejunum and terminal ileum; SLErelated vasculitis was suspected and she was treated with methylprednisolone (16 mg intravenous t.i.d) for 15 days, but in vain. On 3 March 2006, massive bloody stool developed and plasma haemoglobin dropped from 11.9 to 7.9 g/dl, resulting in hypovolaemic shock. At this time, the coagulation profile (PT, aPTT and platelet count) was all within normal limits. Therefore, emergent angiography was performed, yielding contrast medium pooling at the distal ileum (Figure 1). After this study, an emergent operation with a right hemicolectomy was performed. The pathology studies of the resected intestinal tissue showed transmural fibrosis and inflammation with lymphocyte aggregation, but no evidence of vasculitis (Figure 2). Other colitis, such as viral-induced colitis or infection-related colitis, was excluded because stool culture was negative and the resected colon tissue did not demonstrate virus-related inclusion bodies. The patient was then treated with Asacol (mesalazine) and prednisolone 10 mg b.i.d., with continuous improvement. The possible causes of lower GI bleeding in SLE patients are multifactorial, and include coagulopathy, medication, enteritis, infection, vasculopathy, ischaemia, etc. In this case, the massive lower GI bleeding was most likely caused by Crohn’s disease. Crohn’s disease should be considered in the differential diagnosis in SLE patients with protracted, refractory GI bleeding. Although SLE combined with Crohn’s disease may be coincidental, it is rarely reported.1–8 As a multisystemic disease, GI disorders are frequently presented in SLE; its clinical manifestations are sometimes very Lupus (2008) 17, 1049–1050
Ticlopidine is a com monly pre scribed drug in cerebro vascular or car - dio vas cu lar dis eases... more Ticlopidine is a com monly pre scribed drug in cerebro vascular or car - dio vas cu lar dis eases. Since the first in tro duc tion in 1970's, ticlopidine was shown to be a rel a tively safe drug. The ad verse ef fects of ticli - pidine were mainly bone mar row tox ic ity and el e va tion of liver func - tion tests. Ticlopidine-induced hep a ti tis is rare and only 33 cases were re ported in pre vi ous Eng lish lit er a ture. The 33 cases were mostly cat e go rized in cholestatic liver in jury; only 2 cases were hepato cel lu - lar. In Tai wan, a case of ticlopidine-induced cholestatic hepatitis was ever re ported. Herein, we pres ent an other rare case of ticlopidine- induced hep a ti tis in Tai wan with the na ture of hepato cellular in jury. (Chin Med J (Tai pei) 2001;64:59-63)
Objectives. To determine whether anti-double stranded DNA (anti-dsDNA) autoantibody could bind an... more Objectives. To determine whether anti-double stranded DNA (anti-dsDNA) autoantibody could bind and affect the functions of normal human polymorphonuclear neutrophils (PMN). Methods. Normal human PMN were incubated with different concentrations of a monoclonal mouse anti-dsDNA antibody (12B3) or mouse isotype-matched IgG2a. The binding of anti-dsDNA and PMN was measured by flow cytometry and interleukin-8 (IL-8) gene expression in PMN was detected by enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR). PMN apoptosis was justified by morphological changes. The cognate antigen(s) of anti-dsDNA on the PMN surface was identified by membrane biotinylation, immunoprecipitation and Western blot. Results. The binding of PMN with anti-dsDNA was much higher than with non-specific mouse IgG2a (70.8 vs 2.0%). Anti-dsDNA at concentrations higher than 12.5 nguml significantly enhanced the production and mRNA expression of IL-8 by PMN. However, ant...
Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. The Oral... more Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. The Oral Rheumatoid Arthritis triaL (ORAL) Strategy aimed to assess the comparative efficacy of tofacitinib monotherapy, tofacitinib plus methotrexate, and adalimumab plus methotrexate for the treatment of rheumatoid arthritis in patients with a previous inadequate response to methotrexate. ORAL Strategy was a 1 year, double-blind, phase 3b/4, head-to-head, non-inferiority, randomised controlled trial in patients aged 18 years or older with active rheumatoid arthritis despite methotrexate therapy. Patients were randomly assigned (1:1:1) to receive oral tofacitinib (5 mg twice daily) monotherapy, oral tofacitinib (5 mg twice daily) plus methotrexate, or subcutaneous adalimumab (40 mg every other week) plus methotrexate at 194 centres in 25 countries. Eligible patients received live zoster vaccine at investigators' discretion. The primary endpoint was the proportion of patients who attained an...
Although there are 3 hospice care programs for terminal cancer patients in Taiwan, the medical ut... more Although there are 3 hospice care programs for terminal cancer patients in Taiwan, the medical utilization and expenses for these patients by programs have not been well-explored. The aim of this study was to examine the medical utilization and expenses of terminal cancer patients under different programs of hospice care in the last 90, 30, and 14 days of life.This was a retrospective observational study by secondary data analysis. By using the National Health Insurance claim database and Hospice Shared Care Databases. We identified cancer descents from these databases and classified them into nonhospice care and hospice care groups based on different combination of hospice care received. We then analyzed medical utilization including inpatient care, outpatient care, emergency room visits, and medical expenses by patient groups in the last 90, 30, and 14 days of life.Among 118,376 cancer descents, 46.9% ever received hospice care. Patients had ever received hospice care had signific...
Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to condu... more Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to conduct a study to investigate the factors affecting the autonomy of advanced cancer patients in Taiwan. We conducted a prospective, multicenter study and recruited 574 advanced cancer patients from four inpatient hospice wards in Taiwan; their quality of dying was measured using the validated good death scale and the audit scale. Physician-assessed autonomy and the other scales were measured in a team conference by the primary care physician and the team 1 week after the patient had passed away. The good death scale was measured twice, once at admission and then after the patient had passed away for comparison. We measured factors affecting the improvement in quality of dying of these patients initially by applying multiple linear regression analysis. Then, taking physician-assessed autonomy as a dependent variable, we identified the factors that affected this variable. The good death score ...
To assess the relationship between smoking status and health-related quality of life 1 year after... more To assess the relationship between smoking status and health-related quality of life 1 year after participation in a smoking cessation programme in Taiwan. A cohort study of smokers who voluntarily participated in a smoking cessation programme with two follow-up assessments of smoking status via telephone interview, conducted 6 months and 1 year after finishing the smoking cessation programme. Hospitals and clinics providing smoking cessation services. A total of 3514 participants completed both telephone interviews, which represents a response rate of 64%. After the interviews, participants were divided into four groups according to their smoking status: (1) long-term quitters: participants who had quit tobacco use for 1 year; (2) short-term quitters: participants who had been smoking for at least 6 months and then quit tobacco for 6 months after participating in the programme; (3) relapsed smokers: participants who relapsed into tobacco use after ceasing tobacco use for 6 months; ...
1. J Palliat Care. 2006 Spring;22(1):57-60. Win or lose? Percutaneous nephrostomy for a terminal-... more 1. J Palliat Care. 2006 Spring;22(1):57-60. Win or lose? Percutaneous nephrostomy for a terminal-stage cervical-cancer patient featuring obstructive uropathy. Chang HL, Lim HW, Su FH, Tsai ST, Wang YW. Department of Family ...
... plished at home and thus referrals of these patients to HPC units should be made without hesi... more ... plished at home and thus referrals of these patients to HPC units should be made without hesitation.8 In conclusion, the utilization of the HPC ward in the ... 5 Bergdahl M, Avall-Lundqvist E. Women who died of gynaecologic cancer in the Stockholm county - where do they die? ...
Journal of the Chinese Medical Association : JCMA, 2003
Hepatitis C virus (HCV) infection will result in liver cirrhosis and hepatocellular carcinoma, wh... more Hepatitis C virus (HCV) infection will result in liver cirrhosis and hepatocellular carcinoma, which are the leading causes of death in Taiwan. The prevalence of antibody to HCV (anti-HCV) was 2%-3% in Taipei city. However, it can be as high as 20% to 60% in Central and Southern part of Taiwan. In I-Lan, a county located in northern-east Taiwan, there is no large-scale investigation yet. The objective of this research is to evaluate the prevelance and risk factors of anti-HCV positivity in three towns of I-Lan county. Blood sampled from people in San-Shing, Tou-Cheng and Tong-Shan was collected from October 1999 to June 2000. Totally, 1,316 persons (607 male, 790 female, mean age: 62 +/- 12 years old) were enrolled. Anti-HCV was measured by a second-generation enzyme immunoassay. Risk factors analysis was performed in anti-HCV positive subjects and age-sex matched anti-HCV negative controls. Sixty-seven persons (5.1%) had positive serum anti-HCV. The prevalence rate of anti-HCV incr...
Colorectal cancer (CRC), which has become especially prevalent in developed countries, is current... more Colorectal cancer (CRC), which has become especially prevalent in developed countries, is currently the third highest cause of cancer mortality in Taiwan. Mutation of the adenomatous polyposis coli (APC) gene, a tumour suppressor, is thought to be an early event in colorectal tumourigenesis. To date, however, no large-scale screening for APC gene variants in Chinese subjects has been performed. The present study was undertaken to identify APC gene variants that are significantly associated with the occurrence of CRC in Taiwanese subjects. In order to compare the genotype distribution of variant sites, the full-length APC genes of 74 healthy individuals and 80 CRC patients were sequenced. Among the 154 Taiwanese subjects examined in this study, three new mutations, but no previously reported mutations, were found. One deletion at codon 460 leading to a frameshift and two missense mutations resulting in p.V1125A and p.S1126R substitutions were identified. Additionally, three high risk...
Objective: The prolongation of bleeding time (BT) in systemic lupus erythematosus (SLE) may be du... more Objective: The prolongation of bleeding time (BT) in systemic lupus erythematosus (SLE) may be due to a variety of factors, including thrombocytopenia, the existence of autoantibodies, renal or hepatic dysfunction, or usage of special medications. In this study, we investigated and analyzed the possible causes of prolonged BT in SLE patients. Methods: We retrospectively reviewed medical records of 253 SLE patients who had received BT tests from January 2004 to September 2007. We collected data on the clinical characteristics, current medications, and laboratory data. Results: Thirty-seven SLE patients had prolonged BT and 216 patients were normal. There were significant differences in both groups in terms of serum level of hemoglobin (10.9±2.2 vs. 12.2±1.7 g/dL, p＜0.005); platelet count (178, 200±14, 200 vs. 238,900±5,200/cumm, p＜0.005); the frequency of INR prolongation (10.8% vs. 1%, p＜0.001); APTT prolongation (16.2% vs. 4.6%, p＜0.012); frequencies of serum antiphospholipid antib...
Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 1994
Although immunoprecipitable DNA has been found in a subgroup of patients with systemic lupus eryt... more Although immunoprecipitable DNA has been found in a subgroup of patients with systemic lupus erythematosus (SLE) exhibiting systemic vasculitis and/or central nervous system involvement, the mechanism for elevated plasma DNA in these patients is poorly understood. The plasma DNA concentrations and reactivity of serum and lymphocytes to six species of double-stranded DNA from calf thymus, human placenta, Escherichia coli, Micrococcus lysodeikticus, Clostridium perfringens and poly (dG.dC). poly (dG.dC) were measured in twenty-seven patients with active SLE. To understand the mechanism of increased plasma DNA in SLE, the DNA binding and release of the mononuclear cells were examined. Compared with the controls, the incidence of the presence of plasma DNA was markedly increased in SLE (59.3% in SLE vs. 7.4% in controls) as detected by counterimmunoelectrophoresis. Except for DNA from Clostridium perfringens, the reactivity of lupus sera to various DNA samples was significantly higher t...
Five commercial kits including Staclot PNP, Staclot LA, PTT-LA, and 2 dilute Russell's viper ... more Five commercial kits including Staclot PNP, Staclot LA, PTT-LA, and 2 dilute Russell's viper venom time tests for detecting lupus anticoagulant were determined in 102 patients with systemic lupus erythematosus (SLE). The 5 coagulation tests had different positive rates ranging from about 4 to 9%, and the patients might have different result by using different test. If we regarded a patient with two or more positive LA tests as being positive, 8% of the SLE patients in our study were LA positive. Among the 5 LA tests, the highest correlation was between DVVtest and LA-Screen & LA-Confirm (k=0.648), and the test having the highest correlation with the remaining other 4 tests was Staclot LA (k=0.864). The consistency of LA tests and anti-cardiolipin antibody test was good. Due to the heterogeneity of the results of LA tests, the diagnosis of the presence of LA in a patient should be carefully made if only one LA-positive test was obtained.
Sir—Systemic lupus erythematosus (SLE) and Crohn’s disease are multisystemic diseases, and can af... more Sir—Systemic lupus erythematosus (SLE) and Crohn’s disease are multisystemic diseases, and can affect many tissues or organs. The gastrointestinal (GI) manifestations of these two diseases may be quite similar. Without a definite diagnosis, the physician may confuse the two diseases. Massive lower GI bleeding in these two diseases is rare, but lifethreatening. We herein present the case of a patient with SLE combined with Crohn’s disease who developed massive lower GI bleeding, which was initially treated as SLE-related intestinal vasculitis, but in vain. A 49-year-old ethnic Chinese woman with a history of SLE for 5 years was admitted to VGH-Taipei in January 2006 with recurrent diarrhoea, abdominal pain and GI bleeding. She previously had SLErelated manifestations of malar rash, positive antinuclear antibody (ANA), high titre anti-dsDNA antibodies (Ab), nephritis and central nervous system (CNS) involvement. She had undergone intensive immunosuppressive drug therapy (pulse methylprednisolone and cyclophosphamide) for nephritis (WHO class IV) on many occasions 2 years ago, and received low-dose prednisolone therapy (5 mg/day) more than 1 year before this admission. At this presentation, her SLE disease activity index (SLEDAI) score was 4, including elevated anti-dsDNA Ab [234 IU/ml (normal <5 IU/ml)] and fever (38 °C). Her proteinuria was mild, and serum C3 and C4 levels were normal. Serial examinations, including coagulation tests [prothrombin time (PT), activated partial thromboplastin time (aPTT) and bleeding time (BT)], panendoscope, upper GI (UGI) series, small intestinal series, barium enema andTc99mRBC scan, were performed, but with unremarkable findings. The abdominal computed tomographic (CT) scan showed segmental thickening in the proximal jejunum and terminal ileum; SLErelated vasculitis was suspected and she was treated with methylprednisolone (16 mg intravenous t.i.d) for 15 days, but in vain. On 3 March 2006, massive bloody stool developed and plasma haemoglobin dropped from 11.9 to 7.9 g/dl, resulting in hypovolaemic shock. At this time, the coagulation profile (PT, aPTT and platelet count) was all within normal limits. Therefore, emergent angiography was performed, yielding contrast medium pooling at the distal ileum (Figure 1). After this study, an emergent operation with a right hemicolectomy was performed. The pathology studies of the resected intestinal tissue showed transmural fibrosis and inflammation with lymphocyte aggregation, but no evidence of vasculitis (Figure 2). Other colitis, such as viral-induced colitis or infection-related colitis, was excluded because stool culture was negative and the resected colon tissue did not demonstrate virus-related inclusion bodies. The patient was then treated with Asacol (mesalazine) and prednisolone 10 mg b.i.d., with continuous improvement. The possible causes of lower GI bleeding in SLE patients are multifactorial, and include coagulopathy, medication, enteritis, infection, vasculopathy, ischaemia, etc. In this case, the massive lower GI bleeding was most likely caused by Crohn’s disease. Crohn’s disease should be considered in the differential diagnosis in SLE patients with protracted, refractory GI bleeding. Although SLE combined with Crohn’s disease may be coincidental, it is rarely reported.1–8 As a multisystemic disease, GI disorders are frequently presented in SLE; its clinical manifestations are sometimes very Lupus (2008) 17, 1049–1050
Ticlopidine is a com monly pre scribed drug in cerebro vascular or car - dio vas cu lar dis eases... more Ticlopidine is a com monly pre scribed drug in cerebro vascular or car - dio vas cu lar dis eases. Since the first in tro duc tion in 1970's, ticlopidine was shown to be a rel a tively safe drug. The ad verse ef fects of ticli - pidine were mainly bone mar row tox ic ity and el e va tion of liver func - tion tests. Ticlopidine-induced hep a ti tis is rare and only 33 cases were re ported in pre vi ous Eng lish lit er a ture. The 33 cases were mostly cat e go rized in cholestatic liver in jury; only 2 cases were hepato cel lu - lar. In Tai wan, a case of ticlopidine-induced cholestatic hepatitis was ever re ported. Herein, we pres ent an other rare case of ticlopidine- induced hep a ti tis in Tai wan with the na ture of hepato cellular in jury. (Chin Med J (Tai pei) 2001;64:59-63)
Objectives. To determine whether anti-double stranded DNA (anti-dsDNA) autoantibody could bind an... more Objectives. To determine whether anti-double stranded DNA (anti-dsDNA) autoantibody could bind and affect the functions of normal human polymorphonuclear neutrophils (PMN). Methods. Normal human PMN were incubated with different concentrations of a monoclonal mouse anti-dsDNA antibody (12B3) or mouse isotype-matched IgG2a. The binding of anti-dsDNA and PMN was measured by flow cytometry and interleukin-8 (IL-8) gene expression in PMN was detected by enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR). PMN apoptosis was justified by morphological changes. The cognate antigen(s) of anti-dsDNA on the PMN surface was identified by membrane biotinylation, immunoprecipitation and Western blot. Results. The binding of PMN with anti-dsDNA was much higher than with non-specific mouse IgG2a (70.8 vs 2.0%). Anti-dsDNA at concentrations higher than 12.5 nguml significantly enhanced the production and mRNA expression of IL-8 by PMN. However, ant...
Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. The Oral... more Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis. The Oral Rheumatoid Arthritis triaL (ORAL) Strategy aimed to assess the comparative efficacy of tofacitinib monotherapy, tofacitinib plus methotrexate, and adalimumab plus methotrexate for the treatment of rheumatoid arthritis in patients with a previous inadequate response to methotrexate. ORAL Strategy was a 1 year, double-blind, phase 3b/4, head-to-head, non-inferiority, randomised controlled trial in patients aged 18 years or older with active rheumatoid arthritis despite methotrexate therapy. Patients were randomly assigned (1:1:1) to receive oral tofacitinib (5 mg twice daily) monotherapy, oral tofacitinib (5 mg twice daily) plus methotrexate, or subcutaneous adalimumab (40 mg every other week) plus methotrexate at 194 centres in 25 countries. Eligible patients received live zoster vaccine at investigators' discretion. The primary endpoint was the proportion of patients who attained an...
Although there are 3 hospice care programs for terminal cancer patients in Taiwan, the medical ut... more Although there are 3 hospice care programs for terminal cancer patients in Taiwan, the medical utilization and expenses for these patients by programs have not been well-explored. The aim of this study was to examine the medical utilization and expenses of terminal cancer patients under different programs of hospice care in the last 90, 30, and 14 days of life.This was a retrospective observational study by secondary data analysis. By using the National Health Insurance claim database and Hospice Shared Care Databases. We identified cancer descents from these databases and classified them into nonhospice care and hospice care groups based on different combination of hospice care received. We then analyzed medical utilization including inpatient care, outpatient care, emergency room visits, and medical expenses by patient groups in the last 90, 30, and 14 days of life.Among 118,376 cancer descents, 46.9% ever received hospice care. Patients had ever received hospice care had signific...
Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to condu... more Patient autonomy is an essential factor in the measurement of quality of dying. We aimed to conduct a study to investigate the factors affecting the autonomy of advanced cancer patients in Taiwan. We conducted a prospective, multicenter study and recruited 574 advanced cancer patients from four inpatient hospice wards in Taiwan; their quality of dying was measured using the validated good death scale and the audit scale. Physician-assessed autonomy and the other scales were measured in a team conference by the primary care physician and the team 1 week after the patient had passed away. The good death scale was measured twice, once at admission and then after the patient had passed away for comparison. We measured factors affecting the improvement in quality of dying of these patients initially by applying multiple linear regression analysis. Then, taking physician-assessed autonomy as a dependent variable, we identified the factors that affected this variable. The good death score ...
To assess the relationship between smoking status and health-related quality of life 1 year after... more To assess the relationship between smoking status and health-related quality of life 1 year after participation in a smoking cessation programme in Taiwan. A cohort study of smokers who voluntarily participated in a smoking cessation programme with two follow-up assessments of smoking status via telephone interview, conducted 6 months and 1 year after finishing the smoking cessation programme. Hospitals and clinics providing smoking cessation services. A total of 3514 participants completed both telephone interviews, which represents a response rate of 64%. After the interviews, participants were divided into four groups according to their smoking status: (1) long-term quitters: participants who had quit tobacco use for 1 year; (2) short-term quitters: participants who had been smoking for at least 6 months and then quit tobacco for 6 months after participating in the programme; (3) relapsed smokers: participants who relapsed into tobacco use after ceasing tobacco use for 6 months; ...
1. J Palliat Care. 2006 Spring;22(1):57-60. Win or lose? Percutaneous nephrostomy for a terminal-... more 1. J Palliat Care. 2006 Spring;22(1):57-60. Win or lose? Percutaneous nephrostomy for a terminal-stage cervical-cancer patient featuring obstructive uropathy. Chang HL, Lim HW, Su FH, Tsai ST, Wang YW. Department of Family ...
... plished at home and thus referrals of these patients to HPC units should be made without hesi... more ... plished at home and thus referrals of these patients to HPC units should be made without hesitation.8 In conclusion, the utilization of the HPC ward in the ... 5 Bergdahl M, Avall-Lundqvist E. Women who died of gynaecologic cancer in the Stockholm county - where do they die? ...
Journal of the Chinese Medical Association : JCMA, 2003
Hepatitis C virus (HCV) infection will result in liver cirrhosis and hepatocellular carcinoma, wh... more Hepatitis C virus (HCV) infection will result in liver cirrhosis and hepatocellular carcinoma, which are the leading causes of death in Taiwan. The prevalence of antibody to HCV (anti-HCV) was 2%-3% in Taipei city. However, it can be as high as 20% to 60% in Central and Southern part of Taiwan. In I-Lan, a county located in northern-east Taiwan, there is no large-scale investigation yet. The objective of this research is to evaluate the prevelance and risk factors of anti-HCV positivity in three towns of I-Lan county. Blood sampled from people in San-Shing, Tou-Cheng and Tong-Shan was collected from October 1999 to June 2000. Totally, 1,316 persons (607 male, 790 female, mean age: 62 +/- 12 years old) were enrolled. Anti-HCV was measured by a second-generation enzyme immunoassay. Risk factors analysis was performed in anti-HCV positive subjects and age-sex matched anti-HCV negative controls. Sixty-seven persons (5.1%) had positive serum anti-HCV. The prevalence rate of anti-HCV incr...
Colorectal cancer (CRC), which has become especially prevalent in developed countries, is current... more Colorectal cancer (CRC), which has become especially prevalent in developed countries, is currently the third highest cause of cancer mortality in Taiwan. Mutation of the adenomatous polyposis coli (APC) gene, a tumour suppressor, is thought to be an early event in colorectal tumourigenesis. To date, however, no large-scale screening for APC gene variants in Chinese subjects has been performed. The present study was undertaken to identify APC gene variants that are significantly associated with the occurrence of CRC in Taiwanese subjects. In order to compare the genotype distribution of variant sites, the full-length APC genes of 74 healthy individuals and 80 CRC patients were sequenced. Among the 154 Taiwanese subjects examined in this study, three new mutations, but no previously reported mutations, were found. One deletion at codon 460 leading to a frameshift and two missense mutations resulting in p.V1125A and p.S1126R substitutions were identified. Additionally, three high risk...
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