Biomedical subjects

C C Huang

Publications and source records attributed to C C Huang.

At least 289 records · Page 16Linked to original sources

PubMed1997

Glomerular transforming growth factor-beta1 mRNA as a marker of glomerulosclerosis-application in renal biopsies.

As transforming growth factor-beta1 (TGF-beta1) is implicated in the pathogenesis of glomerulosclerosis, the aim of the study was to demonstrate if levels of glomerular TGF-beta1 mRNA in renal biopsies correlated with glomerulosclerosis. Glomeruli were collected by microdissection from renal biopsies in patients with membranous nephropathy, lupus nephritis, diabetic nephropathy, minimal change disease and IgA nephropathy presented by proteinuria when serum creatinine was <3 mg%. Glomerular mRNAs were reverse transcribed and TGF-beta1, alpha2(IV) collagen, beta-actin cDNA quantitated by competitive polymerase chain reaction (PCR). By semiquantitative electron microscopy, a 3.5-fold increase of glomerular TGF-beta1/beta-actin mRNA ratio in the moderate sclerotic group (n = 23, p < 0.01) and a 1.5-fold increase in the mild sclerotic group (n = 22, p < 0.05) were observed when compared to the minimal sclerotic group (n = 12). A concordant increase of glomerular alpha2(IV) collagen mRNA was found with 2.2- and 1.3-fold in moderate and mild sclerotic groups, respectively. The TGF-beta1/beta-actin mRNA ratios were highest in membranous nephropathy (466.4 +/- 133.4, n = 11), followed by lupus nephritis (394.9 +/- 94.8, n = 12) and diabetic nephropathy (333.2 +/- 97.6, n = 10). Patients with minimal change disease(233.1 +/- 54.1, n = 15)and IgA nephropathy(185.3 +/- 39.6, n = 9) had low levels. The degree of glomerulosclerosis in each group followed the TGF-beta1/beta-actin mRNA ratios indicating that the level is the major determinant ofglomerulosclerosis but not the disease entities. Glomerular TGF-beta1/beta-actin mRNA ratio did not correlate with clinical parameters such as the urinary protein excretion and creatinine clearance. These results suggest that glomerular TGF-beta1/beta-actin mRNA ratio may be used as a marker of glomerulosclerosis in renal biopsy to reflect the local sclerotic process.

Actins↗

PubMed1997

Respiratory drive and pulmonary mechanics during haemodialysis with ultrafiltration in ventilated patients.

The improvements of respiratory drive and pulmonary mechanics which follow haemodialysis with ultrafiltration in mechanically ventilated renal failure patients seem predictable but have not been studied before. In this study, 14 renal failure patients with stable haemodynamics mechanically ventilated with pressure support ventilation (PSV) were enrolled. Respiratory drive (represented as P0.1), pulmonary mechanics, breathing pattern, arterial blood gas and haemodynamics were measured according to the time schedule: pre-dialysis (Time 0), and at 60, 120, 180, 240 minutes thereafter. Following the removal of excess lung water during haemodialysis, auto-PEEP and patient's work of breathing (WOBp) decreased gradually. P0.1 lessened progressively along with the improvement in pulmonary mechanics. The changes in auto-PEEP and WOBp correlated closely to the pre- and post-dialysis decline of P0.1 (delta P0.1). There was a negative, moderately significant correlation between the amount of fluid ultrafiltrated during dialysis (delta UF) and the delta P0.1 (R = -0.54). The breathing pattern remained stable during dialysis. No hypoventilation or hypoxaemia occurred despite the development of metabolic alkalosis induced by bicarbonate dialysate. We have shown that respiratory drive decreases gradually during bicarbonate haemodialysis. The improvements of pulmonary mechanics, rather than the rapid alkalization of body fluids, responds to the decrease of P0.1 in renal failure patients ventilated with PSV.

Aged↗

PubMed1997

Bilateral diaphragmatic paralysis--a rare cause of acute respiratory failure managed with nasal mask bilevel positive airway pressure (BiPAP) ventilation.

A 68 yr old woman presented with acute respiratory failure. She was suspected of having a phrenic-diaphragmatic impairment, without evidence of an intrinsic lung disease or generalized neuromuscular disorder, after 3 weeks of prolonged mechanical ventilation. A series of studies, including fluoroscopy, phrenic nerve stimulation test and diaphragmatic electromyography, was performed before the diagnosis of bilateral diaphragmatic paralysis (BDP) was confirmed. The patient was successfully weaned from the conventional mechanical ventilator, and was placed on nasal mask bi-level positive airway pressure (BiPAP) ventilation. A high degree of clinical suspicion of bilateral diaphragmatic paralysis should always be raised in patients suffering respiratory failure without definite predisposing factors. Weaning with noninvasive nasal mask ventilation should be tried first instead of direct tracheostomy.

Acute Disease↗

PubMed1997

Presynaptic and postsynaptic striatal dopaminergic function in patients with manganese intoxication: a positron emission tomography study.

We performed PET on four patients with chronic industrial Mn intoxication; presynaptic and postsynaptic dopaminergic function were measured with [18F]6-fluoro-L-dopa (6FD) and [11C]raclopride (RAC). All patients had a rigid-akinetic syndrome; they had no sustained benefit from L-dopa. Influx constants (Ki) of 6FD were normal in the caudate and putamen. RAC binding was mildly reduced in the caudate and normal in the putamen. We conclude that nigrostriatal dopaminergic dysfunction is not responsible for the parkinsonism caused by chronic Mn intoxication. The pathology is likely to be downstream of the dopaminergic projection.

Adult↗

PubMed1997

Differential screening of a subtracted cDNA library: a method to search for genes preferentially expressed in multiple tissues.

We have developed a new strategy for differential screening of genes that are expressed in two or more tissues, and have used it to identify genes that are preferentially expressed in both testis and ovary. In this approach, testis-specific cDNAs were first generated using the suppression subtractive hybridization technique, cloned and arrayed in microplates. The inserts from the subtracted testis-specific library were amplified by PCR and spotted on filters. The dot blots were screened by hybridization using either testis- or ovary-specific subtracted cDNA mixtures as probes. By screening about 2000 putative clones from the subtracted testis-specific library, we identified 14 candidate genes that hybridized to both cDNA probes. Northern blot analysis showed that 12 clones were preferentially or exclusively expressed in testis and ovary. Nucleotide sequence analysis indicated that three of the identified clones represented cDNAs from novel genes.

Animals↗

PubMed1997

Age differences in remote pointing performance.

The purpose of this study was to investigate age differences in remote pointing movements. The subjects were recruited from three age groups (ages 18-22 yr., 40-50 yr., and 60-70 yr., with 9 men and 9 women in each group). They were required to perform cursor-positioning tasks using a remote pointing device, in which the dependent measures were the time taken to reposition the cursor and the accuracy of subjects' movement trajectories. The movement time was further separated into two components, First Submovement duration and Adjustment Submovement duration. Analysis indicated that age groups showed reduced performance on remote pointing. Moreover, remote positioning movement for the young-adult group was mostly completed in their First Submovement phase, while the elderly subjects spent most of their movement time on the Adjustment Submovement phase. These results support the proposition that different age groups exhibit different kinds of movement patterns.

Adult↗

PubMed1997

Blue toe syndrome associated with rapidly progressive glomerulonephritis: ultimately revealed essential mixed cryoglobulinemia.

The blue toe syndrome is a rare presentation in a number of medical disorders. We report a 35-year-old woman who initially presented with blue toe syndrome and rapidly progressive glomerulonephritis. Essential mixed cryoglobulinemia with vasculitis and renal failure was documented by laboratory tests and renal biopsy. She was on maintenance hemodialysis as renal failure persisted after steroid and immunosuppressive agents therapy. Her gangrenous changes of bilateral toes were autoamputated symmetrically and uneventfully.

Adult↗

PubMed1997

Assessment of dialysis adequacy using the dialysate urea monitor: preliminary experience of the dialysate urea monitor.

Numerous studies have identified a strong linkage between the delivered dialysis dose (Kt/V) and the survival of hemodialysis (HD) patients. However, the current method used to calculate Kt/V requires multiple blood samples and the process is complex and time consuming. We evaluate the performance of a recently developed on-line monitor (Biostat 1000 dialysate urea monitor, Baxter) that measures the urea concentration in the effluent dialysate and displays Kt/V and nPCR immediately after hemodialysis. To verify the performance of the urea monitor, we selected 21 hemodialysis patients, calculated their Kt/V and nPCR values from blood samples obtained during each hemodialysis, and compared the results with data obtained using the urea monitor. The Kt/V and nPCR values calculated by the urea monitor were both significantly correlated with those obtained using blood samples (R = 0.804, p < 0.001 in Kt/V and R = 0.749, p < 0.001 in nPCR). Our results suggest that the urea monitor may be used for on-line assessment of dialysis adequacy and obviates the need for blood sampling.

Blood Urea Nitrogen↗

PubMed1997

Unusual presentations of extrapulmonary tuberculosis in three hemodialysis patients.

We report three patients who received maintenance hemodialysis and suffered from extrapulmonary tuberculosis with unusual presentations. The first patient presented with fever of unknown origin. All studies showed negative findings except high erythrocyte sedimentation rate and high value of C-reactive protein. He failed to response to broad-spectrum antibiotics but showed a complete response to antituberculosis therapy. The second patient presented with right supraclavicular lymphadenopathy and weakness. Lymph node biopsy revealed caseating granuloma with positive acid-fast bacilli. The third patient presented with tumor mass of left sternoclavicular joint for which malignancy was suspected initially. Ultimately, tuberculosis was documented by histopathologic studies showing caseating granuloma. All three patients had normal findings of chest x-ray and did not have previous history of tuberculosis and diabetes mellitus.

Adult↗

PubMed1997

Simultaneous team approach of a crown-lengthening procedure and an operative restoration: technique and long-term effect.

Traditionally, crown-lengthening procedures to expose subgingival caries for operative restorative work are carried out in a two-stage approach. A disadvantage of this procedure is that the gingival margin associated with the treated tooth moves apically; this may create an esthetic problem. Resin-modified glass-ionomer cement has been demonstrated to have good biocompatibility with dental hard and soft tissues. Surgical and restorative procedures were combined at the same appointment in an effort to achieve a restoration with minimal change in the gingival margin. Four patients have been treated with this one-stage team approach and followed for 8 to 13 months. The clinical results demonstrated this team approach procedure is excellent for the dentition when esthetics is a consideration.

Adult↗

PubMed1997

[Identification of Candida albicans by specific primers of polymerase chain reaction and DNA probes].

Candida albicans is a pathogenic yeast. Two sets of universal primers were used for specific identification of Candida albicans with PCR-amplified ribosomal DNA internal transcribed spacers (ITS). Among the species of Candida, the amplified ITSI and ITSII of DNA fragments were similar in size. The PCR product was purified and labeled with digoxigenin and used as DNA probe in the detection with target DNA of Candida albicans by hybridization. Two sets of specific primers (CA1 and CA2 to amplify ITSI, CA3 and CA4 to amplify ITSII) were designed by alignment of ribosomal ITS sequence of pathogenic Candida albicans with other species to detect C. albicans by PCR. The sensitivity of PCR using the specific primers to detect pure culture of C. albicans was 0.1 ng (about 10(3)-10(4) cells). If the yeast cells were mixed with two other strains, there was a 10-fold decrease in sensitivity (1 ng or 10(4)-10(5) cells) under the same PCR conditions.

Base Sequence↗

PubMed1997

Small isolated paraspinal arteriovenous fistula.

We report a case of a small, isolated paraspinal arteriovenous fistula (AVF) that arose in an adult without obvious trauma. The fistula, despite its extraspinal location and small size, caused hypertension of the intrathecal venous system and produced symptoms that were similar to those of spinal dural AVF. Detecting such a small lesion is difficult, but contrast-enhanced MR imaging can prove helpful in this regard.

Adult↗

PubMed1997

Clinical and electrophysiological correlation in chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulin therapy: a case report.

The clinical effect of high-dose intravenous immunoglobulin (IVIg) is reported as correlated with electrophysiological study in a 15-year-old boy with chronic inflammatory demyelinating polyneuropathy (CIDP). Within three months the patient developed from progressive paraparesis to complete quadriplegia with relative preservative of sensory and bulbar functions. High dose IVIg with 0.4 gm/kg per day was given for five consecutive days, and recovery occurred during the first week, particularly in both the lower limbs. Maximal benefit was achieved by another course of IVIg treatment. The effect maintained for six weeks, but muscle power deteriorated rapidly one week later. Muscle power improved again after another two courses of IVIg infusion. Serial nerve conduction velocity studies showed an improvement in the distal latencies and the amplitudes of compound muscle action potentials (CMAPs) which were not, however, well correlated with the clinical improvement. No improvement in nerve conduction velocities was ever noted.

Action Potentials↗

PubMed1997

Light-induced fluorescence spectroscopy to differentiate benign and malignant uterine cervical lesions.

In Taiwan, cervical cancer is the leading malignancy among women. For the early detection of cervical neoplasia, light-induced fluorescence spectroscopy was conducted ex vivo to assess the ability of this technique to differentiate cervical neoplastic tissue (20 samples) from normal or inflammatory cervical tissue (37 samples) at an excitation wavelength of 280 nm. The principal fluorescent peaks occurred within +/- 5 nm of 330 nm and 470 nm emission. At 330 nm emission, the spectrum of the normal or inflammatory tissue was significantly stronger than that of the neoplastic tissue after are normalization. However, at 470 nm emission, the spectrum of the normal or inflammatory tissue was significantly weaker than that of the neoplastic tissue. A diagnostic algorithm based on the ratio of relative intensities of 330 nm to 470 nm emission within the 5 +/- nm peak area of each sample was calculated and paired. The ratios showed that histologically neoplastic lesions could be distinguished from inflammatory samples using a 280-nm-excitation wavelength with a sensitivity, specificity and positive predictive value of 94%, 82% and 73%, respectively. The average ratio of malignant or dysplastic cervical samples was significantly greater than that of the inflammatory samples (p < 0.001). Our ex vivo study indicated that light-induced fluorescence spectroscopy may be useful in differentiating malignant or premalignant from normal or inflammatory cervical tissue.

Algorithms↗

PubMed1997

Occupational neurotoxic diseases in Taiwan: a review of the outbreaks and clinical features.

In the past 20 years, several outbreaks of neurotoxic disease due to occupational exposure have occurred in Taiwan. The most notorious outbreaks were 'Yu-cheng' due to contamination of polychlorinated biphenyls in cooking oil, lead poisoning in battery manufacturers and workers in a ship-scrapping yard, tile factory and battery recycling plants, and n-Hexane intoxication in press-proffers and ball-manufacturers. In addition, there were manganese intoxication in ferromanganese smelters, mercury intoxication in lamp-socket workers, carbon disulfide intoxication in viscose rayon workers and hydrogen sulfide intoxication in chemical synthetic plants. Although the incidence of occupational neurotoxic diseases has increased, the real incidence is probably still underestimated. The reasons for the underestimation include: 1) the education for workers in industrial hygiene is inadequate; 2) high risk workers are not screened well; 3) physicians are not well trained in early diagnosis of occupational diseases; 4) material safety data information is not readily available in the factories; and 5) the threshold limit values for toxic substances are relatively high in Taiwan, compared with other developed countries.

Carbon Disulfide↗

PubMed1997

Serum beta-carotene level, arsenic methylation capability, and incidence of skin cancer.

To elucidate the associations of arsenic-induced skin cancer with serum beta-carotene level and arsenic methylation capability, a total of 654 residents of age 30 or older were recruited from three arseniasis-hyperendemic villages in Taiwan and regularly examined for skin lesions during the follow-up period. There were 33 cases affected with newly diagnosed skin cancer during the follow-up, giving an incidence of 14.74 per 1000 person-years. Although most study subjects had stopped consuming high-arsenic artesian well water more than 20 years ago, the risk of skin cancer was found to increase significantly with cumulative arsenic exposure before the cessation of drinking artesian well water in a dose-response relationship. Frozen serum samples collected at the recruitment from newly developed skin cancer cases and matched controls were tested for beta-carotene levels by high-performance liquid chromatography. Frozen urine samples of these subjects were examined by high-performance liquid chromatography to speciate arsenite (AsIII), arsenate (AsV), monomethylarsonic acid (MMA), and dimethylarsinic acid and then quantitated by hydride generator combined with atomic absorption spectrometry. Skin cancer cases had a significantly lower serum level of beta-carotene than matched healthy controls. Although the primary methylation capability indexed by the ratio of MMA/(AsIII + AsV) was greater in cases than in controls, the secondary methylation capability indexed by the ratio of dimethylarsinic acid/MMA was lower in cases than in controls. An elevated proportion of MMA in total urinary arsenic level was associated with an increased risk of skin cancer. Subjects with a cumulative arsenic exposure of > or = 20.0 mg/liter-year and a proportion of MMA in total urinary arsenic level >26.7% had a multivariate-adjusted odds ratio of developing skin cancer as high as 20.91 (95% confidence interval, 2.63-166.5) compared wih those who had a cumulative arsenic exposure of <20.0 mg/liter-year and a MMA percentage of < or = 26.7%. Whether the association with capability of inorganic methylation is also applied to cancers of internal organs, including lung, liver, and urinary bladder, remains to be elucidated.

Adult↗

PubMed1997

Streptococcal toxic shock syndrome complicating varicella in children.

The most common complication in children with varicella is cutaneous superimposed infection with pyogenic bacteria. Group A beta-hemolytic streptococci, which are known to cause life-threatening infections in both previously healthy children and those with underlying diseases, are the most frequently associated pathogens. A newly recognized disease, called streptococcal toxic shock syndrome, is associated with severe morbidity and mortality. We report a 3-year-old boy with a diagnosis of this syndrome who presented with increasing fever, vomiting, and lethargy 7 days after the development of a classic varicella skin lesion. In spite of aggressive fluid supply, administration of inotropic agents, and cardiopulmonary resuscitation, a rapidly deteriorating clinical course led to death 4 hours after hospitalization. This is the first report of this association in Taiwan. Pediatricians evaluating children with varicella must be mindful of the potential for Group A beta-hemolytic streptococcal infection.

Chickenpox↗

PubMed1997

Demographic characteristics and medical aspects of menopausal women in Taiwan.

This report describes the medical and demographic characteristics of menopausal women in Taiwan in order to provide information for consideration during future healthcare planning. The medical and demographic data analyzed were taken from officially published materials of the Government of the Republic of China on Taiwan, our own studies, and those of other researchers. In 1994, the average lifespan of men in Taiwan was 71.8 years and that of women was 77.7 years. The age of menarche was 13.6 years and the age of menopause was 49.5 years. Women aged 50 and over accounted for 18.3% of the total female population and 8.9% of the total population in Taiwan. In 1994, 68.9% of women in Taiwan aged 50 and over were married. The most frequently occurring menopausal symptoms in Taiwanese women were lumbago or low backpain (68%), fatigue (59%), impairment of memory (55%), vaginal dryness (50%), and hot flushes and sweating (49%). The spinal bone mineral density of women decreased markedly after the age of 50 years. The prevalence of vertebral fracture in women 65 years and over was 19.8%, which was higher than the 12.5% in men of the same age group. The prevalence of hypertension and coronary heart disease in women 50 years or older was also higher than in men. The most frequent sites of cancer in women in 1992 were the cervix uteri, breast, sigmoid colon and rectum, lungs, liver, stomach, thyroid, ovaries, hemopoietic and reticuloendothelial systems, and skin. There were 14,298 newly reported cases of malignant neoplasms in women in 1992. About 60% of these occurred in women aged 50 years or more. The median age of occurrence of cervix uteri, breast, and ovarian cancers was 48 to 49 years, which is very close to the menopause age. About 30% of menopausal women in Taiwan are currently living without a husband. Although 18.3% of women in Taiwan were at least 50 years old, approximately 60% of all malignant neoplasms in the female population occurred in this group. There is an urgent need for menopausal women in Taiwan to receive psychologic support and comprehensive medical care.

Adult↗