The current paper describes the age, period and cohort effects on breast cancer mortality in Taiwan. Female breast cancer mortality data were collected from the Taiwan death registries for 1971-2010. The annual percentage changes, age- standardised mortality rates (ASMR) and age-period-cohort model were calculated. The mortality rates increased with advancing age groups when fixing the period. The percentage change in the breast cancer mortality rate increased from 54.79% at aged 20-44 years, to 149.78% in those aged 45-64 years (between 1971-75 and 2006-10). The mortality rates in the 45-64 age group increased steadily from 1971 to 1975 and 2006-10. The 1951 birth cohorts (actual birth cohort; 1947-55) showed peak mortalities in both the 50-54 and 45-49 age groups. We found that the 1951 birth cohorts had the greatest mortality risk from breast cancer. This might be attributed to the DDT that was used in large amounts to prevent deaths from malaria in Taiwan. However, future researches require DDT data to evaluate the association between breast cancer and DDT use.

Recent study on optical-field-ionization collisional-excitation extreme-ultraviolet lasing of Ni-like krypton at 32.8 nm pumped by a 100-TW laser system with an optically preformed plasma waveguide is reported. By using a 9-mm-long pure krypton plasma waveguide fabricated with the axicon-ignitor-heater scheme, the 32.8-nm extreme-ultraviolet laser provided an average output of 10(12) photons/pulse at pump energy of 1 J, more than one order of magnitude enhancement relative to the previous results with the same scheme at pump energy of 235 mJ. It is also found the far-field pattern of laser beams varies from a single peak profile at low pump energy to an annular profile at high pump energy due to over-ionization of krypton ions at the center of the plasma channel.

OBJECTIVE:To determine whether plasminogen activators (PAs) are involved in the pathologic process of toxoplasmosis.MATERIALS AND METHODS:Out of 220 pregnant women the study included 26 with a diagnosis of toxoplasmosis: six based on seropositivity for Toxoplasma gondii IgM and 20 based on seropositivity for T. gondii IgG. We measured serum activities and protein levels of PAs by casein zymography and Western blotting, respectively.RESULTS:Serum PAs were higher in healthy pregnant women than in their healthy nonpregnant counterparts. Furthermore, serum PAs were significantly higher in pregnant women infected with T. gondii than in their healthy counterparts.CONCLUSION:PAs participate in the pathogenesis of toxoplasmosis in pregnant women and may be useful markers of T. gondii infection.

A systematic experimental study on injection of electrons in a gas-jet-based laser wakefield accelerator via ionization of dopant was conducted. The pump-pulse threshold energy for producing a quasi-monoenergetic electron beam was significantly reduced by doping the hydrogen gas jet with argon atoms, resulting in a much better spatial contrast of the electron beam. Furthermore, laser wakefield electron acceleration in an optically preformed plasma waveguide based on the axicon-ignitor-heater scheme was achieved. It was found that doping with argon atoms can also lower the pump-pulse threshold energy in this experimental configuration.

Posttransplantation diabetes mellitus (PTDM) is a major complication in renal transplant recipients. Some studies have demonstrated that tumor necrosis factor alpha (TNF-α) expression and its genetic polymorphism are associated with diabetes mellitus. We investigated this association in Asian renal transplant recipients. Polymerase chain reaction-restriction-fragment length polymorphism was used to measure TNF-α G-238A and G-308A gene polymorphisms among 241 nonposttransplantation diabetic subjects and 73 PTDM patients. PTDM patients showed higher values of body weight and body mass index (BMI) than the non-PTDM group. However, no significant association was observed between TNF-α G-238A and TNF-α G-308A polymorphisms with PTDM incidence, gender, age at transplantation, follow-up duration, BMI, or type of immunosuppression.

Compared with single-step exposure of X-ray light source of high-power synchrotron radiation, lithographic process using multi-step exposures with a conformal mask has some advantages such as a thinner absorption layer, better heat dissipation, and shorter developing time. In this study, a conformal mask with an aurum (Au) absorber is fabricated using traditional ultraviolet (UV) lithography and Au electroplating process. For X-ray exposure, an analytical model of the absorption dosage (exposure dosage) along the exposed depth of x is developed. It can estimate accurately the time and dosage required for exposure. Based on the calculated dosage, 2-mm-thick PMMA (Polymethylmethacrylate) template with high-aspect ratio of 20 is fabricated by this multi-step exposures and developing process. With this template, nickel-cobalt (Ni–Co) alloy electroplating process is applied to fabricate a metallic mold with high hardness. For high-aspect-ratio microstructures, hardness and internal stress of the metallic mold by electroplating is a key factor to the quality. Experimentally, it is found that changing the ratio of Ni sulfamate to Co sulfamate can affect hardness and internal stress of the deposit. Though the hardness of the electroplated alloy is improved due to Co sulfamate, internal stress is induced at the same time. Thus, it is necessary to add a stress reducer to reduce internal stress. The currently result shows that the hardness of the mold of about 550 Hv with about 25wt.% of Co and zero internal stress can be made successfully after adding a stress reducer. With this electroplating technique, the 2-mm-thick and 100-μm-wide microstructure with high hardness is fabricated.

We experimentally demonstrate that the plasma waveguide can be efficiently produced in a pure Xe, Kr, and Ar cluster jet operated at a high backing pressure with axicon ignitor-heater scheme. The lasing photon number of Ni-like Kr laser at 32.8 nm generated in waveguide is dramatically enhanced by about three orders of magnitude in comparison to that without plasma waveguide, resulting in a photon number of 8×1010 and an energy conversion efficiency of 2×10−6 with a pump pulse of just 235 mJ. Due to the high atom density and long gain length provided by the plasma waveguide, Ne-like Ar laser at 46.9 nm is achieved in OFI plasma channel at the first time and simultaneous lasing in two ion species is also generated in a 10-mm gas jet with Kr and Ar mixtures. With sufficient x-ray photons, we show that x-ray digital holographic microscopy can be achieved in single-shot measurement providing a spatial resolution of >500 nm and a temporal resolution of >10 ps.

A general method for fabricating transient plasma structures with high-intensity laser pulses is developed to gain fine control over laser-plasma interactions. These structures have been used as programmable photonic devices in the development of laser-wakefield accelerators, soft X-ray lasers and plasma nonlinear optics driven by multi-terawatt laser pulses. Plasma ramps are used to control electron injection in laser-wakefield accelerators, plasma waveguides are used to enhance the efficiency of soft X-ray lasers by orders of magnitude and periodic plasma structures are used to achieve quasi-phase matching in relativistic harmonic generation. By scanning the interaction length with the same plasma, fabrication method, tomographic measurements are carried out to resolve the injection/acceleration process in laser-wakefield accelerators and amplification processes in X-ray lasers and relativistic harmonic generation. A theoretical analysis and a computer simulation are also carried out to provide insightful pictures of these processes. These research works show that by controlling plasma structures with optical fabrication methods, laser-plasma interaction can be engineered to expand and enrich the frontier of high-field physics.

A simple stacking process to fabricate microstructures with a high aspect ratio of 30 is presented in this study. For the x-ray absorption of a substance, an analytical model of the absorption dosage (exposure dosage) along a depth of x is developed. It can accurately estimate the time and dosage required for exposure. Based on the calculated result, 1 mm thick PMMA (polymethylmethacrylate) photoresist with a separate gold (Au)/graphite mask is exposed using x-rays followed by a developing process. Then a stacking process is applied for these 1 mm thick PMMA microstructures to form a microstructure with a high aspect ratio. With this stacking method, a PMMA microstructure with a height of 3 mm has been fabricated. In addition, a nickel–cobalt (Ni–Co) alloy electroplating process is applied to fabricate a metallic mold with high hardness. The hardness of the mold by electroforming is the key factor to the quality of the micro-punch process. As an integrated micro-punch head for IC leadframes, the hardness should be higher than 500 Vickers hardness (Hv). In addition, it was found experimentally that changing the ratio of Ni sulfamate to Co sulfamate can affect the deposit hardness and internal stress. The deposit internal stress varies with Co content. Thus, it is necessary to add a stress reducer to improve the hardness and reduce internal stress. A hardness of the mold of 550–560 Hv with 26–28 wt.% of Co and zero internal stress have been made successfully after adding a stress reducer. With this electroplating technique, a micro-punching head with high hardness and high aspect ratio can be fabricated by LIGA technology.

The aim of this study is to investigate how the exposure dosage and developing temperature affect the developing rate for microstructures, with and without ultrasonic stirring, when the photoresist is exposed to X-ray radiation. Two experiments, “thick photoresist with low aspect ratio microstructure” (TPLARM) and “thick photoresist with high aspect ratio microstructure” (TPHARM) were conducted in this study. The TPLARM experiment was performed in order to investigate the relationship between exposure dosage and developing rate under ultrasonic agitation during the developing process. X-rays with an incident dose of 3500 mAmin/cm passed through the beryllium (Be) window and fell directly onto three graphite membranes of different thicknesses to expose a 3-mm thick PMMA substrate. PMMAs exposed to the X-rays were then placed into beakers filled with GG developer in two separate 28 and 36 °C isothermal baths for developing for 400 min. The TPHARM experiment was performed in order to study the effects of a high aspect ratio on developing rate using a Au microstructure as the absorber (15 μm in thickness; gap of 10 μm). This absorber was transferred onto a 3-mm thick PMMA substrate to form a conformal mask. The incident X-ray, at a dose of 800 mAmin/cm, passed through the Be window and directly exposed the PMMA substrate; the PMMA exposed to the X-ray was then immersed in a beaker filled with GG developer in a 28 °C isothermal bath for developing. The relationship between developing depth and time was then measured without the use of ultrasonic agitation stirring.

Dramatic enhancement of optical-field-ionization collisional-excitation x-ray lasing is achieved by using an optically preformed plasma waveguide. With a 9-mm-long pure krypton plasma waveguide prepared by using the axicon-ignitor-heater scheme, lasing at 32.8 nm is enhanced by 400 folds relative to the case without the plasma waveguide. An output level of 8x10(10) photon/shot is reached at an energy conversion efficiency of 2x10(-6). The same method is used to achieve x-ray lasing in a gas jet for the high-threshold low-gain transition at 46.9 nm in neonlike argon.

We experimentally demonstrate the amplification of optical-field-ionization soft x-ray lasers in krypton cluster jets at pump energy of only 200 mJ. With the employment of small f-number optics, nature diffraction and ionization-induced refraction in plasmas can be suppressed to enable the pump pulse producing a longer column of gains provided the focal position is optimized. A simple wave propagation code is developed to study and optimize the laser propagation in optical-field driven plasmas. Good agreements between experimental observations and simulations are found. The further enhancement of Kr x-ray laser output at 32.8 nm is achieved by guiding the pump beam in the optically preformed plasma waveguide. More than 4 times of x-ray photons are generated from pure Kr plasma waveguide at the same pump energy. Significant reductions of the pump energy make these pumping configurations favorable for practical high-repetition-rate operations.

Optical-field-ionization x-ray lasers in an optically preformed plasma waveguide for pure xenon, krypton, and argon gases, respectively, are achieved. In addition to the 46.9 nm main lasing line for Ne-like argon, the 45.1 and 46.5 nm lasing lines are also observed, indicative of the strong enhancement effect and the large gas density in the plasma waveguide. With this technique multispecies parallel x-ray lasing is also demonstrated in a Kr-Ar mixed-gas waveguide. Extensive experimental results including the pump-energy dependence, the density dependence, and the effects of parameters that control the waveguide fabrication are reported and discussed.

Postoperative complications of endoscopic thoracic sympathectomy may be troublesome in some patients. Between January 1998 and September 2002, a total of 16 patients with recurrent palmar hyperhidrosis underwent video-assisted thoracoscopic T2 and T3 sympathetic block. There were seven men and nine women, with a mean age of 21.1 years (range, 12-35 years). All patients were placed in a semi-sitting position under single-lumen intubated anesthesia. We performed the T2 sympathetic block for patients with still intact T2 ganglion using an 8-mm, 0 degrees thoracoscope. An additional T3 block should be given if patients received either previous T2 sympathectomy or elevated palmar temperature <1 degrees C after T2 sympathetic block. The mean operation time was 30 minutes. The level of sympathetic blocks were the T2 and T3 in five patients, only T2 block in four, patients, and only T3 block in seven patients. Improvement of palmar hyperhidrosis can be obtained in all patients. One patient received a reverse operation 12 days after the T2 and T3 clipping and obtained improvement of troublesome compensatory sweating and dry hands 1 day after removal of all clips. All patients obtained improvement of palmar hyperhidrosis without recurrence after a mean of 37.1 months of follow-up (range, 12-56 months). Endoscopic thoracic T2 with or without T3 sympathetic block by clipping is a safe and effective method in treating patients with recurrent palmar hyperhidrosis.

Hypermethylation has been shown in the promoter region of the endothelin receptor B (EDNRB) gene in several human tumors, but its role in lung cancer formation is unclear. In this study, genomic DNA from lung cancer patients was subjected to methylation-specific PCR to determine the methylation status of the EDNRB gene in lung cancer. Aberrant methylation of the EDNRB gene was detected in 32.9% (26 of 79) lung cancer patients. Promoter hypermethylation of EDNRB was found to significantly differ with histological type but was not correlated to other clinicopathological characteristics. Decreased mRNA transcripts were correlated to aberrant methylation. Treatment with 5-aza-deoxycytidine reversed the methylation status and re-expression of the EDNRB gene in the H1355 human lung cancer cell line. Our results suggest that inactivation of the EDNRB gene through epigenetic alteration is highly prevalent in lung cancer in Taiwan.

Leukotriene receptor antagonists (LTRAs) were recently added to the method of treating allergic rhinitis (AR). However, in children under 6 yr old, there has been no study about its efficacy in treating AR. We aim to compare the clinical efficacy of montelukast, cetirizine and placebo in the treatment of children from 2 to 6 yr old with perennial allergic rhinitis (PAR), to see if there are any significant differences. Sixty children were selected and treated with montelukast, or cetirizine, or placebo once daily. The efficacy of the three agents was compared with the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and Total Symptom Score (TSS) by diary. In addition, we also examined serum IgE, serum eosinophil cationic protein (ECP), blood eosinophil counts, nasal airway resistance (NAR) and eosinophil percentage in nasal smears. The results revealed that both montelukast and cetirizine were significantly efficacious compared with placebo in NAR, eosinophil percentage in nasal smears, PRQLQ, TSS and all symptom items except nasal itching, throat itching and tearing. For nasal itching, only cetirizine was significantly efficacious. On the other hand, for night sleep quality, montelukast was significantly superior to cetirizine.

Background: Prescription patterns of anti-asthrna medications in children vary among doctors in different disciplines and settings, and may reflect differences in treatment outcome. The purpose of this study was to analyze the prescribing patterns of anti-asthma drugs by pediatricians, family physicians and other practitioners.Methods: Data for a total of 225,537 anti-asthma prescriptions were collected from the National Health Insurance Research Database for the period from January 1, 2002 to March 31, 2002. These medications included inhaled and oral adrenergics, inhaled and oral corticosteroids, xanthine derivatives, and leukotriene receptor antagonists prescribed by general pediatricians, family physicians and physicians in other disciplines.Results: Oral beta 2-agonist was the most commonly prescribed drug used as monotherapy, with prescription rates of 70.4%, 46.9% and 58.0% by pediatricians, family physicians and other physicians, respectively. A xanthine derivative was the next most commonly prescribed monotherapy. Oral corticosteroid combined with oral beta 2-agonist, followed by oral beta 2-agonist combined with a xanthine derivative were the two most common), prescribed dual-agent combined therapies by all three physician categories. The prescription rate for inhaled corticosteroid monotherapy was 7.8% by pediatricians, 5.6% by family physicians, and 8.0% by other physicians. The Prescription rate for inhaled adrenergic was the highest in family physicians (14.9%), followed by the other physicians (7.2%), and was lowest in pediatricians (3.1%).Conclusion: Pediatricians and family physicians appeared to share similar opinions on the medical management of children with asthma in that both most commonly prescribed oral beta 2-agonists and xanthine derivatives, either alone or in combination. Family physicians were least likely to prescribe an inhaled corticosteroid and most likely to prescribe an inhaled adrenergic agent. 11 Formos Med Assoc 2006; 105(4): 277-2831].

Optical-field-ionization collisional-excitation soft x-ray lasers in clustered gas jets were experimentally investigated in detail. A tomographic measurement based on laser machining technique was used to resolve the growth of x-ray lasing intensity as a function of position in a cluster jet, exploring the origins of the dependences of x-ray lasing intensity on atom density and laser polarization. The presence of optimal atom density was found to be a result of ionizationinduced refraction. An unexpected observation is that circular polarization appears to be not the optimal polarization ellipticity, which may be a manifestation of effects of pre-ionization at the laser-cluster ionization front.

Summary: The aim of this prospective study was to evaluate the usefulness of the thallium-201 (201Tl) thyroid scan in the detection of malignancy in cold thyroid nodules whose status was equivocal following palpation fine-needle aspiration cytology (FNAC). Patients, methods: Fifty-one patients with clinically palpable solitary cold thyroid nodules classified as non-diagnostic or suspicious following biopsy underwent 201Tl thyroid scans. Each scan was performed 15 min (early scan) and 3 h (delayed scan) after an intravenous administration of 74 MBq 201Tl. Thallium uptake in the nodules was visually assessed and scored on a three point scale, with a grade of three defining malignancy. All patients underwent surgery and the histopathology of nodule tissues were compared with results of the scans. Results: Fifty-one nodules were examined. Forty were benign and 11 were malignant. For early scans, the diagnostically relevant parameters were: sensitivity (100%), specificity (75%), and accuracy (80%). Corresponding findings for the delayed scan were: 91%, 98%, and 96%. Conclusion: The 201Tl scan is useful for detecting malignancy in cold thyroid nodules classified as nondiagnostic or suspicious lesions by FNAC.