Prevalence, Incidence, and Factor Concentrate Usage Trends of Hemophiliacs in Taiwan

Tsu-Chiang Tu,Wen-Shyong Liou,Tsui-Yun Chou,Tsung-Kun Lin,Chuan-Fang Lee,Jye-Daa Chen,Thau-Ming Cham,Mei-Ing Chung 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.1

Purpose: Hemophilia A and B (HA, HB) are the most common X-linked inherited bleeding disorders. The introduction of factor concentrates has allowed for control of the lifelong chronic disease. However, no studies have been published regarding the epidemiology of hemophilia in Taiwan. Our aim was to determine the prevalence, incidence, and mortality rate, as well as trends in the use of factor concentrates,in individuals with hemophilia in Taiwan. Materials and Methods: A retrospective study was conducted using the National Health Insurance Research Database between 1997 and 2007. Results: We identified 988 males with hemophilia (HA : HB ratio=5.4 : 1). The mean prevalence per 100000 males was 6.7±0.1 for HA and 1.2±0.1 for HB. The estimated mean annual incidence per live male birth was 1 in 10752 for HA and 1 in 47619 for HB. Standardized mortality ratios for males with hemophilia (all severities) or severe hemophilia were 1.3- and 2.1-fold higher than that of the general male population, respectively. Mean factor VIII (FVIII) and factor IX (FIX) usage was 1.5003±0.4029 and 0.3126±0.0904 international units (IUs) per capita, respectively. Mean FVIII and FIX usage per patient with hemophilia (all severities) or severe hemophilia was 44027±11532 and 72341±17298, respectively, and 49407±13015 and 74369±18411 IUs per person with HA or HB, respectively. Conclusion: Our data revealed epidemiologic and factor concentrate usage trends in males with hemophilia in Taiwan, highlighting a need for improvements in the mandatory National Health Insurance registry. A better-designed, patient-centered registry system would enable more detailed patient information collection and analysis, improving subsequent care.

Prevalence, Incidence, and Factor Concentrate Usage Trends of Hemophiliacs in Taiwan

Tsu-Chiang Tu,Wen-Shyong Liou,Tsui-Yun Chou,Tsung-Kun Lin,Chuan-Fang Lee,Jye-Daa Chen,Thau-Ming Cham,Mei-Ing Chung 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.2

Purpose Hemophilia A and B (HA, HB) are the most common X-linked inherited bleeding disorders. The introduction of factor concentrates has allowed for control of the lifelong chronic disease. However, no studies have been published regarding the epidemiology of hemophilia in Taiwan. Our aim was to determine the prevalence, incidence, and mortality rate, as well as trends in the use of factor concentrates, in individuals with hemophilia in Taiwan. Materials and Methods A retrospective study was conducted using the National Health Insurance Research Database between 1997 and 2007. Results We identified 988 males with hemophilia (HA : HB ratio=5.4 : 1). The mean prevalence per 100000 males was 6.7±0.1 for HA and 1.2±0.1 for HB. The estimated mean annual incidence per live male birth was 1 in 10752 for HA and 1 in 47619 for HB. Standardized mortality ratios for males with hemophilia (all severities) or severe hemophilia were 1.3- and 2.1-fold higher than that of the general male population, respectively. Mean factor VIII (FVIII) and factor IX (FIX) usage was 1.5003±0.4029 and 0.3126±0.0904 international units (IUs) per capita, respectively. Mean FVIII and FIX usage per patient with hemophilia (all severities) or severe hemophilia was 44027±11532 and 72341±17298, respectively, and 49407±13015 and 74369±18411 IUs per person with HA or HB, respectively. Conclusion Our data revealed epidemiologic and factor concentrate usage trends in males with hemophilia in Taiwan, highlighting a need for improvements in the mandatory National Health Insurance registry. A better-designed, patient-centered registry system would enable more detailed patient information collection and analysis, improving subsequent care.

Economic Burden of High-Responding Inhibitors in Patients with Hemophilia A in Taiwan

Tsu-Chiang Tu,Shin-Nan Cheng,Jye-Daa Chen,Thau-Ming Cham,Mei-Ing Chung 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.2

Purpose: Hemophilia A (HA) is the most common X-linked inherited bleeding disorder. In some patients with HA, particularly those with severe HA, replacement therapy results in the production of high-responding clotting factor VIII inhibitors. The economic burden of this complication is the highest reported for a chronic disease. Our aim was to investigate the direct medical expenditure burden of high-responding inhibitors in patients with HA. Materials and Methods: A retrospective study was conducted using the National Health Insurance Research Database,utilizing data covering the period of 2004-2007. Results: In total, 638 males with HA¸ including 37 patients with high-responding inhibitors were evaluated. Over 99% of the annual median medical expenditure was attributable to the cost of clotting factor concentrates (CFCs) in patients with high-responding inhibitors. The annual median expenditure related to CFCs of the total medical care and outpatient care were US$170611 and US$141982, respectively, and were 4.6- and 4.3-fold higher in these patients during the study period, respectively. In patients with high-responding inhibitors, the median hospitalization expenditure and daily hospitalization cost with or without surgical procedures were 3.0- and 2.4-fold higher, respectively, and 4.3 and 5.6-fold higher, respectively. Conclusion: Our data reveal higher medical expenditures burden for patients with HA and high-responding inhibitors in Taiwan. Future research is encouraged to evaluate the impact of this burden on patient quality of life.

Piecewise exact solution for analysis of base-isolated structures under earthquakes

C. S. Tsai,Tsu-Cheng Chiang,Bo-Jen Chen,Kuei-Chi Chen 국제구조공학회 2005 Structural Engineering and Mechanics, An Int'l Jou Vol.19 No.4

Base isolation technologies have been proven to be very efficient in protecting structures from seismic hazards during experimental and theoretical studies. In recent years, there have been more and more engineering applications using base isolators to upgrade the seismic resistibility of structures. Optimum design of the base isolator can lessen the undesirable seismic hazard with the most efficiency. Hence, tracing the nonlinear behavior of the base isolator with good accuracy is important in the engineering profession. In order to predict the nonlinear behavior of base isolated structures precisely, hundreds even thousands of degrees-of-freedom and iterative algorithm are required for nonlinear time history analysis. In view of this, a simple and feasible exact formulation without any iteration has been proposed in this study to calculate the seismic responses of structures with base isolators. Comparison between the experimental results from shaking table tests conducted at National Center for Research on Earthquake Engineering in Taiwan and the analytical results show that the proposed method can accurately simulate the seismic behavior of base isolated structures with elastomeric bearings. Furthermore, it is also shown that the proposed method can predict the nonlinear behavior of the VCFPS isolated structure with accuracy as compared to that from the nonlinear finite element program. Therefore, the proposed concept can be used as a simple and practical tool for engineering professions for designing the elastomeric bearing as well as sliding bearing.

Piecewise exact solution for analysis of base-isolated structures under earthquakes

Tsai, C.S.,Chiang, Tsu-Cheng,Chen, Bo-Jen,Chen, Kuei-Chi Techno-Press 2005 Structural Engineering and Mechanics, An Int'l Jou Vol.19 No.4

Base isolation technologies have been proven to be very efficient in protecting structures from seismic hazards during experimental and theoretical studies. In recent years, there have been more and more engineering applications using base isolators to upgrade the seismic resistibility of structures. Optimum design of the base isolator can lessen the undesirable seismic hazard with the most efficiency. Hence, tracing the nonlinear behavior of the base isolator with good accuracy is important in the engineering profession. In order to predict the nonlinear behavior of base isolated structures precisely, hundreds even thousands of degrees-of-freedom and iterative algorithm are required for nonlinear time history analysis. In view of this, a simple and feasible exact formulation without any iteration has been proposed in this study to calculate the seismic responses of structures with base isolators. Comparison between the experimental results from shaking table tests conducted at National Center for Research on Earthquake Engineering in Taiwan and the analytical results show that the proposed method can accurately simulate the seismic behavior of base isolated structures with elastomeric bearings. Furthermore, it is also shown that the proposed method can predict the nonlinear behavior of the VCFPS isolated structure with accuracy as compared to that from the nonlinear finite element program. Therefore, the proposed concept can be used as a simple and practical tool for engineering professions for designing the elastomeric bearing as well as sliding bearing.

Lipolysis-Stimulating Peptide from Soybean Protects Against High Fat Diet-Induced Apoptosis in Skeletal Muscles

Shibu Marthandam Asokan,Tsu-Han Hung,Wen-Dee Chiang,Wan-Teng Lin 한국식품영양과학회 2018 Journal of medicinal food Vol.21 No.3

Obesity is generally associated with low-grade chronic inflammation that involves the recruitment of macrophages and other inflammation factors to the adipocytes of obese individuals. Tumor necrosis factor-alpha (TNF-α), a cytokine associated with systemic inflammation, is elevated in conditions of obesity. TNF-α is an important factor that plays an important role in skeletal muscle wasting. Apoptosis of myonuclei contributes to the loss of muscle mass and therefore plays an important role in skeletal muscle atrophy. In mouse models that were fed a high fat diet (HFD), a lipolysis-stimulating peptide-VHVV (purified from hydrolysate resulting from flavourzyme treatment of soy protein) was found to reduce HFD-related apoptotic effects in mice skeletal muscle and potentially control atrophy. HFD fed mice had heavier body weight than those fed with normal chow, and VHVV administration restricted lipid accumulation in muscle tissues of mice fed with HFD but increased nutrient uptake. Moreover, specific concentrations of VHVV regulated TNF-α expression that was elevated by HFD, suppressed apoptosis-related proteins and regulated the proteins of lipid metabolism.

Experimental and numerical studies of trench friction pendulum system

C.S. Tsai,Wen-Shin Chen,Tsu-Cheng Chiang 국제구조공학회 2010 Structural Engineering and Mechanics, An Int'l Jou Vol.34 No.2

Seismic behavior of structures isolated with a hybrid system of rubber bearings

Bo-Jen Chen,L. L. Chung,Tsu-Cheng Chiang,C. S. Tsai 국제구조공학회 2006 Structural Engineering and Mechanics, An Int'l Jou Vol.22 No.6

Experimental and numerical studies of trench friction pendulum system

Tsai, C.S.,Chen, Wen-Shin,Chiang, Tsu-Cheng Techno-Press 2010 Structural Engineering and Mechanics, An Int'l Jou Vol.34 No.2

Seismic behavior of structures isolated with a hybrid system of rubber bearings

Chen, Bo-Jen,Tsai, C.S.,Chung, L.L.,Chiang, Tsu-Cheng Techno-Press 2006 Structural Engineering and Mechanics, An Int'l Jou Vol.22 No.6

The enlargement of interest in base isolators as an earthquake-proof design strategy has dramatically accelerated experimental studies of elastomeric bearings worldwide. In this paper, a new base isolator concept that is a hybrid system of rubber bearings is proposed. Uniaxial, biaxial, and triaxial shaking table tests are also performed to study the seismic behavior of a 0.4-scale three-story isolated steel structure in the National Center for Research on Earthquake Engineering in Taiwan. Experimental results demonstrate that structures with a hybrid system of rubber bearings composed of stirruped rubber bearings and laminated rubber bearings can actually decrease the seismic responses of the superstructure. It has been proved through the shaking table tests that the proposed hybrid system of rubber bearings is a very promising tool to enhance the seismic resistance of structures. Moreover, it is demonstrated that the proposed analytical model in this paper can predict the mechanical behavior of the hybrid system of rubber bearings and seismic responses of the base-isolated structures.