. Prevalence of shoulder and upper-limb disorders among workers in the fish-processing industry. Scand J Work Environ Health 1993;19:12~31. A cross-sectional study was conducted among fish-processing workers to evaluate the prevalence of shoulder and upper-limb discomforts and to assess the associated ergonomic risk factors. A prestructured interview, a medical check-up, and job analyses were performed to determine musculoskeletal disorders among 207 workers in eight factories. The results showed shoulder girdle pain (30.9%), epicondylitis (14.5%), and carpal tunnel syndrome (15.0%) as the three most common soft-tissue disorders. The odds ratio of shoulder girdle pain was 1.6 (95% CI 1.1-2.5) among the workers who performed tasks with repetitive movement of their upper limbs, while it was 1.8 (95% CI 1.2-2.5) for the workers who sustainedforceful movement of their upper limbs during work. Women taking oral contraceptives had a 2.0 times higher odds ratio for carpal tunnel syndrome than did other women. It would appear that untrained or unskilled workers were prone to suffer from musculoskeletal disorders.

Areca nut is the most widely used psychoactive substance and an important environmental risk factor for development of oral premalignant lesions and cancer. Arecoline, the major alkaloid of areca nut, has been known to cause cytotoxicity and genotoxicity in mammalian cells in vivo and in vitro and even contributes to carcinogenicity. However, the susceptible genes accounting for arecoline-induced damage in normal human oral cells are still lacking, which possibly involves in initial molecular damage via alternation of gene expression level on biological pathways. The present study was undertaken to characterize the toxic effects of arecoline in gene expression profiling on normal human gingival fibroblasts (HGF) using cDNA microarray and quantitative real-time reverse transcription PCR. The cytotoxicity of arecoline on HGF-1 cell line was elevated in a dose-dependent manner (p < 0.05) accompanied with distinct morphological change and formation of intracellular vacuoles were observed. At optimum concentration of arecoline determined from dose-response curve of the cytotoxicity, a large number of genes were significantly repressed than induced by arecoline in global gene expression profiling. Five induced- and seven repressed genes including glutathione synthetase were further validated, and their gene expression changes were increased in a dose-dependent manner in a concentration range of 50-150 microg/ml. In conclusion, we proposed a tentative model to explain arecoline-induced effects on contribution of oral pathogenesis. The findings identified that 12 susceptible genes can potentially serve as biomarkers of arecoline-induced damage in betel chewers.

BackgroundImpaired liver function in men can result in erectile dysfunction or hypogonadism or both. We investigated whether living donor liver transplantation (LDLT) results in improvement in male sexual function.MethodsA total of 58 patients with end-stage liver disease (ESLD) were included in this prospective, cross-sectional study. Erectile function was measured before and after LDLT using a five-item modified version of the International Index of Erectile Function scale (IIEF-5) and hypogonadism was evaluated before and after LDLT using the Androgen Deficiency in the Aging Male (ADAM) questionnaire. Differences in mean values from the questionnaires before and after the operation were than evaluated to determine whether there is an association between LDLT and improvement in sexual function.ResultsWe found that mean IIEF-5 scores significantly increased after LDLT (from 11.7 ± 7.7 before LDLT to 14.7 ± 7.5 after LDLT, p <0.01), indicating that the operation played a role in improving erectile function. In addition, the prevalence of hypogonadism among the patients with ESLD decreased markedly after liver transplantation (hypogonadism before LDLT, n = 41 versus hypogonadism after LDLT, n = 31, p = 0.03). Patients with hypogonadism reported a higher prevalence of erectile dysfunction after LDLT than patients without hypogonadism (p <0.01).ConclusionsLDLT results in improvement in erectile function. In addition, improvement in erectile function is associated with self-reported absence of hypogonadism.

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Problem‐based learning (PBL) is a learner‐centered educational method based on the principles of heuristics and collaboration. It has been considered an effective learning method in general and in professional education, especially in medical education. This article analyzes the thinking structure and philosophical background of PBL through the educational ideas of Socrates and the truth conception of Karl Popper. In the different phases of the PBL process, various truth conceptions will help to formulate the thinking framework of PBL—from Socrates' truth of openness toward the truth of scientific accuracy of our modern age. Meanwhile, Popper's scientific theory of falsifiability further leads us to discuss the relationship between PBL and critical thinking.

Self-cleaning surfaces allow the reversible attachment and detachment of microorganisms which show great promise in regards to their reusability as smart biomaterials. However, a widely used biomaterial such as polydimethylsiloxane (PDMS) suffers from high biofouling activity and hydrophobic recovery that results in decreased efficiency and stability. A current challenge is to modify and fabricate self-cleaning PDMS surfaces by incorporating antifouling and pH-sensitive properties. To address this, we synthesized a zwitterionic and pH-sensitive random poly(glycidyl methacrylate- co-sulfobetaine methacrylate- co-2-(dimethylamino)ethyl methacrylate) polymer, poly(GMA- co-SBMA- co-DMAEMA). In this work, chemical modification of PDMS was done by grafting onto poly(GMA- co-SBMA- co-DMAEMA) after surface activation via UV and ozone for 90 min to ensure the formation of covalent bonds necessary for stable grafting. The PDMS grafted with G20-S40-D40 exhibit antifouling and pH-sensitive properties by mitigating fibrinogen adsorption, blood cell adhesion, and releasing 98% adhered E. coli bacteria after immersion at basic pH. The grafting of poly(GMA- co-SBMA- co-DMAEMA) presented in this work shows attractive potential for biomedical and industrial applications as a simple, smart, and effective method for the modification of PDMS interfaces.

Two groups of randomly chosen individuals who lived in two communities located different distances from the airport were studied. We monitored audiometry and brainstem auditory-evoked potentials to evaluate cochlear and retrocochlear functions in the individuals studied. The results of audiometry measurements indicated that hearing ability was reduced significantly in individuals who lived near the airport and who were exposed frequently to aircraft noise. Values of pure-tone average, high pure-tone average, and threshold at 4 kHz were all higher in individuals who lived near the airport, compared with those who lived farther away. With respect to brainstem auditory-evoked potentials, latencies between the two groups were not consistently different; however, the abnormality rate of such potentials was significantly higher in volunteers who lived near the airport, compared with less-exposed counterparts. In addition, a positive correlation was found between brainstem auditory-evoked potential latency and behavioral hearing threshold of high-frequency tone in exposed volunteers. We not only confirmed that damage to the peripheral cochlear organs occurred in individuals exposed frequently to aircraft noise, but we demonstrated involvement of the central auditory pathway.

The purpose of this study was to investigate the environmental lead exposure of the general population in Taiwan. A total of 2919 residents of Taiwan were selected by multistage sampling methods. The participants were characterized by questionnaires and 10 ml venous blood was collected for blood lead measurement. A quality assurance/quality control program was designed during the analysis of blood lead levels. The mean blood lead level of 2719 residents without occupational lead exposure was 8.29 +/- 5.92 micrograms/dl. After adjustment for age and sex distribution to the Taiwan general population, the mean blood lead level was 8.10 micrograms/dl. Adjusted for an 11% underestimation of blood lead levels among the six laboratories, the mean blood lead level was estimated to be 8.99 micrograms/dl. This study also found that blood lead levels were associated with personal characteristics, i.e., gender, ethnic group, education level; lifestyle factors, i.e., smoking, alcohol consumption, sources of drinking water; and residential location, i.e., levels of urbanization, distance of house from the road. However, age, floor of residence, milk consumption, betel nut consumption, and Chinese herbal drug consumption were not found to be associated with blood lead levels. These results show that blood lead levels in Taiwan residents were not higher than in most developed and developing countries. Environmental lead pollution does not seem to be a serious problem in Taiwan.