Chen Wy

Approaching healthy body mass index norms for children and adolescents from health-related physical fitness.

Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health‐related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation‐wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600‐m run/walk; a standing long jump; bent‐leg curl‐ups; and a sit‐and‐reach test. The BMI percentiles developed from the subgroup whose test scores were better than the ‘poor’ quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18‐year‐old‐students (23.7 and 25.5 kg m−2 for boys; 22.6 and 24.6 kg m−2 for girls) linked well with the adult cut‐off points of 23 and 25 kg m−2, which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.

Volumetric modulated arc therapy for nasopharyngeal carcinoma: A dosimetric comparison with TomoTherapy and step-and-shoot IMRT

PURPOSE Volumetric modulated arc therapy (VMAT), a novel technique, employs a linear accelerator to conduct dynamic modulation rotation radiotherapy. The goal of this study was to compare VMAT with helical tomotherapy (HT) and step-and-shoot intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) patients with regard to the sparing effect on organs at risk (OARs), dosimetric quality, and efficiency of delivery. MATERIALS AND METHODS Twenty patients with NPC treated by HT were re-planned by VMAT (two arcs) and IMRT (7-9 fields) for dosimetric comparison. The target area received three dose levels (70, 60, and 54 Gy) in 33 fractions using simultaneous integrated boosts technique. The Philips Pinnacle Planning System 9.0 was adopted to design VMAT, using SmartArc as the planning algorithm. For a fair comparison, the planning target volume (PTV) coverage of the 3 plans was normalized to the same level. Dosimetric comparisons between VMAT, HT, and IMRT plans were analyzed to evaluate (1) coverage, homogeneity, and conformity of PTV, (2) sparing of OARs, (3) delivery time, and (4) monitor units (MUs). RESULTS The VMAT, HT, and IMRT plans had similar PTV coverage with an average of 96%. There was no significant difference between VMAT and HT in homogeneity, while the homogeneity indices of VMAT (1.06) and HT (1.06) were better than IMRT plans (1.07, p<0.05). HT plans provided a better conformity index (1.17) than VMAT (1.28, p=0.01) and IMRT (1.36, p=0.02). When compared with IMRT, VMAT and HT had a better sparing effect on brain stem and spinal cord (p<0.05). The effect of parotid sparing was similar between VMAT (mean=26.3 Gy) and HT (mean=27.5 Gy), but better than IMRT (mean=31.3 Gy, p<0.01). The delivery time per fraction for VMAT (5.7 min) were much lower than for HT (9.5 min, p<0.01) and IMRT (9.2 min, p<0.01). CONCLUSIONS Our results indicate that VMAT provides better sparing of normal tissue, homogeneity, and conformity than IMRT, and shorter delivery time than HT.

Extreme BMI predicts higher asthma prevalence and is associated with lung function impairment in school-aged children†

The prevalence of obesity and asthma has increased in recent decades. We investigated the relationship between body mass index (BMI) and lung function, and also tried to determine if asthma prevalence differs between obese and non‐obese children.

Lack of association between obesity and dental caries in three-year-old children.

To investigate whether the obese children are prone to develop dental caries, the cross-sectional data from a Three-year-old Childrens Health Survey were evaluated. The body weight, height, body mass index (BMI), and decayed and filled teeth (dft) score were analyzed in 5,133 children. The prevalence of dental caries was not different significantly among different BMI groups. There were no significant differences in the dft score of carious children among different BMI groups. Little or no relationship was found between BMI and dft score. We conclude that there is no relationship between carious deciduous teeth and weight status in three-year-old children.

Expansion of adipose tissue mesenchymal stromal progenitors in serum-free medium supplemented with virally inactivated allogeneic human platelet lysate

BACKGROUND: Single‐donor or pooled platelet lysates (PL) can substitute for fetal bovine serum (FBS) for mesenchymal stromal cell (MSC) expansion. However, for clinical applications of MSCs, the use of virally inactivated PL would be desirable. Recently, we have developed a solvent/detergent (S/D)‐treated human PL preparation (S/D‐PL) rich in growth factors. The capacity to use this virally inactivated preparation for MSC expansion needs to be evaluated.

Obesity in children and adolescents: Working group report of the second world congress of pediatric gastroenterology, hepatology, and nutrition

Latin American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (M.F., R.U.); Commonwealth Association of Paediatric Gastroenterology and Nutrition (L.B., T.N.); Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (W.C., D.L.); North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (A.H., R.S.); and European Society for Paediatric Gastroenterology, Hepatology and Nutrition (B.K., L.M.).

Effect of Nucleotides on Diarrhea and Immune Responses in Healthy Term Infants in Taiwan

ObjectivesThe aim of this study was to compare the effects of an infant formula fortified with nucleotides (NF) with those of a control formula (CF) on the incidence of diarrhea, respiratory tract infections (RTIs), and immune responses in healthy term infants. MethodsThis 12-month, double-blind study was conducted on 1- to 7-day-old infants randomized to receive NF or CF exclusively until 12 weeks of age, and fed the assigned formula with solid food until 12 months. NF was supplemented with 72 mg/L of nucleotides, based on the total potentially available nucleotide content of human milk. Subjects were evaluated within 1 week of birth, at 4 weeks, and every 4 weeks thereafter until 48 weeks of age. The primary outcome variable was the incidence of diarrhea. Secondary variables included RTIs, serum immunoglobulin concentrations, and response to hepatitis B vaccine. ResultsCompared with subjects fed CF (n = 170), those fed NF (n = 166) had a trend toward reduced risk of diarrhea from 8 to 48 weeks of age and a significantly lower risk of 25.4% (P = 0.05) between 8 and 28 weeks. NF subjects had significantly higher serum immunoglobulin A concentrations (P < 0.05) throughout the 48-week study. The NF group had an increased risk of upper RTIs, the same incidence of lower RTIs, and the same antibody response to hepatitis B vaccination as the CF group, based on one-sided tests. Growth was normal in both groups, and no adverse events were considered to be formula-related. ConclusionsHealthy term infants from 8 to 28 weeks of life are less likely to experience diarrhea and have higher serum immunoglobulin A concentrations with NF compared with formula without added nucleotides.

Clinical and immunopathologic study of mesangial IgM nephropathy: report of 41 cases

Forty‐one out of 408 cases (or 10%) of primary glosnerular disease had diffuse fine granular to are‐like short linear mesangial deposits of IgM by direct immunofluorescence. The IgM deposition was accompanied by C1q and/or C4 in the same locality in 29 cases, by C3 in 10, and by trace amounts of IgA in 6. Properdinfactor B was not detected. Fine granular electron dense deposits of low density were detected in the mesangium in all 41 cases by electron microscopy, usually as a discrete granular or are‐like pattern beneath the mesangial glomerular basement membrane and correlated well with the immunofluorescence findings. An immune complex disease with complement activation via the classical pathway is suggested. The ages of the patients varied from 2 to 58 years (average 23.8 years). A male predominance of 2.2:1 was identified. Serum IgM level was elevated in 46.7% of the cases. The majority (87.8%) of the cases manifested a nephrotic syndrome or relapse at time of biopsy, and the remaining cases experienced persistent or intermittent proteinuria. Among the 36 nephrotic patients, 22 cases (61.1%) demonstrated complete remission with steroid therapy, 9 cases (25%) were resistant, and 5 cases (13.9%) had partial remission. Complete and partial remissions were later achieved with cytotoxic drugs or methylprednisolone pulse therapy in 3 and 4 cases respectively in the steroid resistant patients. Frequent relapses occurred during the course in 22 out of 32 cases (68.8%) who had experienced complete or partial remission. Follow‐up study after blopsy demonstrated that sustained complete remission was achieved with prednisolone with or without cytotoxic drugs and pulse therapy in only 14 (42.4%) of the 33 nephrotic cases who had been followed up for longer than 6 months, and six of them had had

p38 MAPK and NF-κB pathways are involved in naphtho[1,2-b] furan-4,5-dione induced anti-proliferation and apoptosis of human hepatoma cells

Naphtho[1,2-b] furan-4,5-dione (NFD) was investigated for its anti-proliferation effect on human hepatocellular carcinoma (HCC), Hep3B, HepG(2), and Huh-7 cells. The effect of NFD on inhibiting proliferation and apoptosis was correlated with up-regulation of pro-apoptotic protein and down-regulation of pro-survival proteins. Remarkably, we found that NFD inhibited the nuclear translocation of NF-kappaB, likely accounting for the down-regulation of pro-survival Bcl-2 family. Furthermore, suppression of p38 MAPK activity by a specific inhibitor significantly rescued the cell proliferation inhibited by NFD. These findings suggest that signaling imbalance between p38 MAPK and NF-kappaB by NFD results in the proliferative inhibition and apoptosis of HCC tumor cells.

Economic, Social, and Psychological Factors Associated With Health-Related Quality of Life of Chronic Hemodialysis Patients in Northern Taiwan: A Multicenter Study

This study evaluated the associations between economic, social, psychological factors, and health-related quality of life of hemodialysis patients. Cross-sectional study design was used. End-stage renal disease patients who had received maintenance hemodialysis for more than 2 months at 14 centers in northern Taiwan were invited to participate. Demographic, economic, and psychosocial data of patients were collected. Depression was assessed by the Beck Depression Inventory. Health-related quality of life was measured by the Medical Outcomes Study Short-Form 36. Multivariable linear regression analyses were performed. Eight hundred sixty-one patients (373 males, mean age 59.4 +/- 13.2 years) completed the study. Higher monthly income was positively associated with role emotional and mental health (P < 0.05), and so was increased frequency of social activities with social functioning (P < 0.05). The more worries, the stronger the inverse associations with social functioning (P < 0.05) and mental health (P < 0.01). Higher depression scores were associated with lower scores of all Short-Form 36 dimensions (P < 0.01). Higher monthly income and increased social activities are associated with better health-related quality of life, whereas more worries and higher depression scores are associated with worse health-related quality of life of hemodialysis patients.