Showing papers by "Liang Kung Chen published in 2010"
TL;DR: The data suggested that SirT1 could be a crucial factor involved in the endothelium cells of atherosclerotic CAGB patients and aging rats and RV is a potential candidate for preventing oxidative stress-induced aging in endothelial cells.
Abstract: Aim: Silencing information regulator (SirT1), a NAD-dependent histone deacetylase, is an essential mediator of longevity in normal cells by calorie restriction. SirT1 has many biological functions, including transcription regulation, cell differentiation inhibition, cell cycle regulation, and anti-apoptosis. Resveratrol (RV)-induced SirT1 activation also improves endothelial dysfunction and suppresses vascular inflammation. In this study, we investigated the roles of RV-induced SirT1 activation in endothelial cells under oxidative stress.Methods: SirT1 mRNA expression levels were examined in the endothelium layer (endothelial cells) of cardiac coronary vessels from patients receiving coronary artery bypass graft surgery (CABG) surgery and aged rats using reverse transcriptase polymerase chain reaction (RT-PCR). To further explore the effect of SirT1 activation on oxidative stress-induced aging, senescence-associated β-galactosidase (SA-β-gal) expression in RV-treated human umbilical vein endothelial cells (HUVECs) with or without H2O2 treatment was evaluated.Results: SirT1 expression was decreased in aged and atherosclerotic vessels in vivo, and significantly reduced in endothelial cells purified from vessel tissues. Furthermore, SirT1 levels were dose-dependently increased in RV-treated HUVECs. The SA-β gal assay showed that RV inhibited the senescent phenotype of H2O2-treated HUVECs. Reactive oxygen species (ROS) production and the percentage of cells positive for SA-β gal were significantly increased in siRNA-SirT1 (knockdown of SirT1 expression)-treated HUVEC cells. Importantly, the treatment effect of RV was significantly abolished in the oxidative effects of H2O2-treated HUVECs by siRNA-SirT1.Conclusion: Our data suggested that SirT1 could be a crucial factor involved in the endothelial cells of atherosclerotic CAGB patients and aging rats. RV is a potential candidate for preventing oxidative stress-induced aging in endothelial cells. RV may also prevent ROS-induced damage via increased endothelial SirT1 expression.
223 citations
TL;DR: Future research on ischemic stroke should consider age as a factor that influences stroke prevention and treatment, and should focus on the management of acute stroke in the elderly to reduce the incidence and improve outcomes in this vulnerable group.
Abstract: Stroke mostly occurs in elderly people and patient outcomes after stroke are highly influenced by age. A better understanding of the causes of stroke in the elderly might have important practical implications not only for clinical management, but also for preventive strategies and future health-care policies. In this Review, we explore the evidence from both human and animal studies relating to the effect of old age-in terms of susceptibility, patient outcomes and response to treatment-on ischemic stroke. Several aging-related changes in the brain have been identified that are associated with an increase in vulnerability to ischemic stroke in the elderly. Furthermore, risk factor profiles for stroke and mechanisms of ischemic injury differ between young and elderly patients. Elderly patients with ischemic stroke often receive less-effective treatment and have poorer outcomes than younger individuals who develop this condition. Neuroprotective agents for ischemic stroke have been sought for decades but none has proved effective in humans. One contributing factor for this translational failure is that most preclinical studies have used young animals. Future research on ischemic stroke should consider age as a factor that influences stroke prevention and treatment, and should focus on the management of acute stroke in the elderly to reduce the incidence and improve outcomes in this vulnerable group.
189 citations
TL;DR: A raised WBC is associated with higher risk of type 2 diabetes, and the presence of publication bias and failure to control for all potential confounders in all studies means the observed association is likely an overestimate.
Abstract: Objective: Biological evidence suggests that inflammation might induce type 2 diabetes (T2D), and epidemiological studies have shown an association between higher white blood cell count (WBC) and T2D. However, the association has not been systematically investigated. Research Design and Methods: Studies were identified through computer-based and manual searches. Previously unreported studies were sought through correspondence. 20 studies were identified (8,647 T2D cases and 85,040 noncases). Estimates of the association of WBC with T2D were combined using random effects meta-analysis; sources of heterogeneity as well as presence of publication bias were explored. Results: The combined relative risk (RR) comparing the top to bottom tertile of the WBC count was 1.61 (95% CI: 1.45; 1.79, p=1.5*10 218 ). Substantial heterogeneity was present (I 2 =83%). For granulocytes the RR was 1.38 (95% CI: 1.17; 1.64, p=1.5*10 24 ), for lymphocytes 1.26 (95% CI: 1.02; 1.56, p=0.029), and for monocytes 0.93 (95% CI: 0.68; 1.28, p=0.67) comparing top to bottom tertile. In cross-sectional studies, RR was 1.74 (95% CI: 1.49; 2.02, p=7.7*10 213 ), while in cohort studies it was 1.48 (95% CI: 1.22; 1.79, p=7.7*10 25 ). We assessed the impact of confounding in EPIC-Norfolk study and found that the age and sex adjusted HR of 2.19 (95% CI: 1.74; 2.75) was attenuated to 1.82 (95% CI: 1.45; 2.29) after further accounting for smoking, T2D family history, physical activity, education, BMI and waist circumference. Conclusions: A raised WBC is associated with higher risk of T2D. The presence of publication bias and failure to control for all potential confounders in all studies means the observed association is likely an overestimate.
124 citations
TL;DR: It is concluded that for all ages of chronically dizzy patients, 2 months of VR can reduce handicap, improve balance function and a consequent improvement of life quality.
63 citations
TL;DR: Little is known about diabetes care of elderly people with frailty, disabilities, or multiple comorbidities, and the interrelationship between frailty and DM deserves further investigation.
61 citations
TL;DR: Challenges still include creating a more extensive integration between medical specialties, promotion of an interdisciplinary care model across specialties and health-care settings, and integration of health and social care services.
59 citations
TL;DR: Gaining a better understanding of the contribution of genetics to human longevity may assist in the design of improved treatment methods for age-related diseases, delay the aging process, and, ultimately, prolong the human lifespan.
45 citations
TL;DR: A 4-week CH-based interdisciplinary PAC programme significantly promoted functional recovery and reduced 12-month mortality by 62% for older post-acute patients.
Abstract: Background. Evidence supporting community hospital (CH)-based post-acute care (PAC) on long-term mortality is lacking.Methods. A 4-week comprehensive geriatric assessment-based interdisciplinary ca...
45 citations
TL;DR: Helping senior veterans to effectively improve their subjective mental health and social support, and controlling chronic disease appears to be critical to their quality of life (QOL).
Abstract: Senior veterans living in government sponsored, long-term care (LTC) facilities, known as veterans' homes (VHs), are a special minority group in Taiwan. These seniors came from different provinces of mainland China during their teenage years at the end of civil wars in 1945. The situation of institutionalized senior veterans shares many characteristics with the concept of "total institution". Very little quality of life (QOL) research has involved senior veterans. This study aimed to explore the QOL and related factors of VH-dwelling senior veterans in Taiwan. Chronic conditions and socio-demographic characteristics of 260 male VH residents were recorded. The Brief Form of the World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF, Taiwanese version); Short-Form 36; Inventory of Socially Supportive Behavior questionnaire; Geriatric Depression Scale-short form; Barthel Index; and instrumental activities of daily living were used. Data analyses including descriptive and inferred statistics were performed using SPSS, version 17. WHOQOL-BREF showed acceptable reliability in this study. Compared to Taiwanese male norms, WHOQOL-BREF physical, psychological, and social relationship domain scores were around the 25th percentile, and the environment domain was about the 75th percentile. Our participants scored low in all concepts of SF-36. Although these residents rated the social support of their children, relatives, friends, social and medical staff as low, they gave high satisfaction ratings to their social supports. On multiple stepwise linear regression analysis, depressive symptoms, number of chronic conditions, retired military rank, and relatives' support correlated with QOL in both the physical and psychological domains. Friends' support and depressive symptoms correlated with the social relationships domain. Friends' support and instrumental activities of daily living correlated with the environment domain. In general, institutionalized senior veterans' QOL was lower than Taiwanese male norms. Helping senior veterans to effectively improve their subjective mental health and social support, and controlling chronic disease appears to be critical to their QOL.
43 citations
TL;DR: Independent of comorbidity, the sum of geriatric care problems is a significant predictor of 12-month mortality in a veterans care home, and further intervention studies are needed to evaluate whether elimination of these care problems can improve survival in the long-term care setting.
31 citations
TL;DR: The optimal model of dementia care in Taiwan by evaluating the care cost, patients' QoL and healthcare settings found that community-living subjects were significantly better in cognition, physical function andQoL than institute- living subjects.
TL;DR: Older prehypertensive subjects with higher pulse pressure, higher serum total cholesterol and higher low-density lipoprotein-cholesterol were more likely to become hypertensive within 5 years, and those who became hypertensive were significantly older.
Abstract: Aim: To evaluate the prevalence of prehypertension among middle-aged and elderly people in Taiwan and to explore the evolutionary changes of blood pressure in 5-year follow-up period.Methods: In 2000, people aged over 40 participating in annual health examinations at local health stations in I-Lan County were invited to join the study. Past medical histories were reviewed, physical examinations and serial laboratory tests were performed for participants. All participants were followed in 2005 by a medical record review, telephone survey or personal visit. Subjects with prehypertension were sorted for further analysis.Results: Overall, 1053 people (mean age=64.4±11.4 years, 44.4% males) were enrolled in the primary cohort. The prevalence of hypertension and prehypertension was 40.4% and 35.8%, respectively. In 2005, 677 subjects (mean age: 68.8±10.4 years, 42.5% males) were successfully followed, which revealed a significant increase of systolic blood pressure (3.7±16.8 mmHg, p<0.001), but not diastolic blood pressure (0.3±11.5 mmHg, p=0.758) in prehypertensive subjects; however, both systolic blood pressure (14.3±17.4 mmHg, p<0.001) and diastolic blood pressure (7.7±13.3 mmHg, p<0.001) were significantly increased among normotensive subjects. The cumulative incidence of prehypertensive subjects becoming hypertensive was 31.3%, and those who became hypertensive were significantly older (65.3±8.6 vs. 62.2±12.3 years, p=0.024), having higher pulse pressure in 2000 (49.6±10.6 vs. 45.1±11.6 mmHg, p=0.001), serum total cholesterol (214.3±31.7 vs. 204.0±37.2 mg/dL, p=0.020) and low-density lipoprotein-cholesterol (141.7±29.2 vs. 132.7±34.7 mg/dL, p=0.042).Conclusions: The prevalence of prehypertension among older Taiwanese was 35.8% and the 5-year cumulative incidence of hypertension from prehypertension was 31.3%. Older prehypertensive subjects with higher pulse pressure, higher serum total cholesterol and higher low-density lipoproteincholesterol were more likely to become hypertensive within 5 years.
TL;DR: The annual incidence of cancer among elderly UUWL patients was 6%, and the previously developed cancer scoring system did not effectively predict cancer occurrence.
TL;DR: The clinical effectiveness of integrated care model among severly disabled LTCF residents is minimal and a further cost-effectiveness study is needed to promote optimal quality of care in this setting.
TL;DR: Oral care reduces pneumonia in older patients in nursing homes.[see comment], and genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation.
Abstract: Gram-negative bacillary carriage: a survey of 120 healthy individuals. Chest 1999; 115: 1570–5. 12. Yoneyama T, Yoshida M, Ohrui T et al. Oral care reduces pneumonia in older patients in nursing homes.[see comment]. J Am Geriatr Soc 2002; 50: 430–3. 13. DeRiso AJ, Ladowski JS 2nd, Dillon TA et al. Chlorhexidine gluconate 0.12% oral rinse reduces the incidence of total nosocomial respiratory infection and nonprophylactic systemic antibiotic use in patients undergoing heart surgery. Chest 1996; 109: 1556–61. 14. Altman DG. Practical Statistics for Medical Research. 1st editionLondon, New York: Chapman and Hall, 1991.. 15. Sumi Y, Kagami H, Ohtsuka Y et al. High correlation between the bacterial species in denture plaque and pharyngeal microflora. Gerodontology 2003; 20: 84–7. 16. Sumi Y, Miura H, Nagaya M et al. Colonisation on the tongue surface by respiratory pathogens in residents of a nursing home—a pilot study. Gerodontology 2006; 23: 55–9. 17. Sumi Y, Miura H, Sunakawa M et al. Colonization of denture plaque by respiratory pathogens in dependent elderly. Gerodontology 2002; 19: 25–9. 18. Preston AJ, Gosney MA, Noon S et al. Oral flora of elderly patients following acute medical admission. Gerontology 1999; 45: 49–52. 19. Russell SL, Boylan RJ, Kaslick RS et al. Respiratory pathogen colonization of the dental plaque of institutionalized elders. Spec Care Dentist 1999; 19: 128–34. 20. Samaranayake LP, MacFarlane TW, Lamey PJ et al. A comparison of oral rinse and imprint sampling techniques for the detection of yeast, coliform and Staphylococcus aureus carriage in the oral cavity. J Oral Pathol 1986; 15: 386–8. 21. Heo SM, Haase EM, Lesse AJ et al. Genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation. Clin Infect Dis 2008; 47: 1562–70. 22. Scannapieco FA, Wang B, Shiau HJ. Oral bacteria and respiratory infection: effects on respiratory pathogen adhesion and epithelial cell proinflammatory cytokine production. Ann Periodontol 2001; 6: 78–86.
TL;DR: In conclusion, adjusted for age, sex, and protein-energy malnutrition, serum levels of copper and zinc both were independent predictive factors for hospitalizations among care home residents.
TL;DR: In conclusion, Taiwanese BVs seemed to lead a healthier life, but their metabolic characteristics were not significantly different from the NVs.
TL;DR: The main purpose of this study was to evaluate the distribution of serum thyrotropin (thyroxin-stimulating hormone, TSH) among asymptomatic older people in Taiwan, and the relationship between age and serum TSH.
01 Jan 2010
TL;DR: Future research on ischemic stroke should consider age as a factor that influences stroke prevention and treatment, and should focus on the management of acute stroke in the elderly to reduce the incidence and improve outcomes in this vulnerable group.
Abstract: Stroke mostly occurs in elderly people and patient outcomes after stroke are highly influenced by age. A better understanding of the causes of stroke in the elderly might have important practical implications not only for clinical management, but also for preventive strategies and future health-care policies. In this Review, we explore the evidence from both human and animal studies relating to the effect of old age—in terms of susceptibility, patient outcomes and response to treatment—on ischemic stroke. Several aging- related changes in the brain have been identified that are associated with an increase in vulnerability to ischemic stroke in the elderly. Furthermore, risk factor profiles for stroke and mechanisms of ischemic injury differ between young and elderly patients. Elderly patients with ischemic stroke often receive less-effective treatment and have poorer outcomes than younger individuals who develop this condition. Neuroprotective agents for ischemic stroke have been sought for decades but none has proved effective in humans. One contributing factor for this translational failure is that most preclinical studies have used young animals. Future research on ischemic stroke should consider age as a factor that influences stroke prevention and treatment, and should focus on the management of acute stroke in the elderly to reduce the incidence and improve outcomes in this vulnerable group.