Search PubMed⌕ Search

Biomedical subjects

C C Liu

Publications and source records attributed to C C Liu.

At least 109 records · Page 6Linked to original sources
PubMed1997

Prediction of bleeding diathesis in patients undergoing cardiopulmonary bypass during cardiac surgery: viscoelastic measures versus routine coagulation test.

BACKGROUND: Severe hemorrhagic tendency often complicates cardiopulmonary bypass (CPB) in cardiac surgery. In this study, we compared the effectiveness of thromboelastography (TEG), Sonoclot (SCT), and routine coagulation test (RCT) in the prediction of coagulation defects. METHODS: Forty-three patients undergoing cardiac surgery with CPB were included. Blood for RCT, TEG, and SCT profiles was sampled before systemic heparinization and after protamine administration. Clinically significant bleeding was defined as chest tube drainage in excess of 100 ml/h for 3 consecutive hours or 300 ml/h in 1 h. All coagulation parameters obtained before and after CPB were compared. The sensitivity, specificity, accuracy, false positive, and false negative rate were also calculated and compared. RESULTS: All coagulation tests were within normal range except higher partial thromboplastin time. Variables which were significantly different from those before CPB included platelet count, fibrinogen level, prothrombin time, and thrombin time in RCT, alpha angle and maximum amplitude in TEG, and R2 and peak time in SCT. In the TEG tracing, all variables had high sensitivity, specificity, and accuracy (average 85.4%, 83%, and 83.5% respectively) and low false positive and negative rate (12.5% and 5% respectively). Although SCT had high sensitivity (76.3%) and low false negative rate (6.5%), its specificity and accuracy were all under 50%. CONCLUSIONS: Our data demonstrated that the TEG monitoring is a useful tool for detecting post-CPB bleeding diathesis and can provide much predictive information. RCT and SCT are of limited value because of higher rate of unreliable results.

Blood Coagulation Tests↗
PubMed1996

The involvement of interleukin (IL)-15 in regulating the differentiation of granulated metrial gland cells in mouse pregnant uterus.

Previous studies have suggested that granulated metrial gland (GMG) cells are bone marrow-derived lymphoid cells, which differentiate in situ in the mouse pregnant uterus into natural killer (NK)-like cells. Similar to NK cells, GMG cells express an abundant level of cytolytic mediators such as perforin. The factor(s) regulating the differentiation of GMG cells remain(s) to be identified, although cytokines previously implicated in the stimulation/activation of NK cells (e.g., IL-2, IL-6, IL-7, and IL-12) can be considered as potential candidates. Recently, IL-15, a novel cytokine, which displays biological activities similar to IL-2, has also been shown to be capable of activating NK cells. Using reverse transcription-polymerase chain reaction (RT-PCR) analysis, we have demonstrated in the present study that IL-15 and its cognate receptor, but not the other cytokines, are expressed in the mouse pregnant uterus, with a time course concomitant with those of cytolytic mediators in differentiated GMG cells. Moreover, IL-15, though not IL-2, is capable of inducing the expression of perforin and granzymes in pregnant uterine tissues explanted in vitro. Data obtained from in situ hybridization study have suggested that the macrophages present in the pregnant uterus may be responsible for the production of IL-15. These results suggest that IL-15 is involved in regulating the differentiation of GMG cells during mouse pregnancy.

Animals↗
PubMed1996

Interleukin-15 induces the expression of mRNAs of cytolytic mediators and augments cytotoxic activities in primary murine lymphocytes.

Interleukin-15 (IL-15) is a novel cytokine displaying biological activities that overlap those of interleukin-2 (IL-2). Like IL-2, IL-15 has been shown to be capable of stimulating the proliferation of human natural killer cells and PHA-treated T lymphocytes and of generating cytotoxic activity in stimulated lymphocyte populations. Using primary murine lymphocytes as a model in the present study, we have investigated the effects of IL-15 on the induction of the expression of mRNAs encoding different lymphocyte cytolytic mediators and the enhancement of cytolytic activities. Using reverse transcription-polymerase chain reaction analysis, both IL-15 and IL-2 have been shown to induce the expression of mRNAs for perforin, granzymes A and B, interferon-gamma, and Fas ligand in primary murine splenic lymphocytes. The induction effect of IL-15 has been shown to be at least partially independent of cell proliferation. Although IL-15 and IL-2 appear to be comparably effective in inducing the expression of cytolytic mediator mRNAs, the former is less potent in eliciting functional cytolytic activity in stimulated lymphocyte populations. The inadequate cytolytic activity of IL-15-stimulated lymphocytes may in part be due to the less efficient production of cytolytic mediator proteins, e.g., perforin and granzyme A, in these cells.

Animals↗
PubMed1996

Cell-free conversion of a ubiquitous nuclear protein into a killer-cell-specific form that binds to the NF-P enhancer element of the mouse perforin gene.

Two nuclear factors, designated NF-PI and NF-P2, have been shown to bind to an enhancer 9-base motif (5'-ACAGGAAGT-3', NF-P motif) present within the 5'-flanking region of the mouse perforin gene. Our previous studies have shown that, although NF-P1 and NF-P2 differ in cell-type distribution and molecular mass, with NF-P2 being killer-cell-specific and smaller, the two factors appear to share common DNA-binding subunit(s). We have postulated that the biochemical event involved in the induction of NF-P2 could be the dissociation of a non-DNA-binding subunit from NF-P1, rendering the newly formed NF-P2 transcriptionally active. By using a cell-free system in the present study, we have demonstrated that a variety of chemical agents capable of denaturing or dissociating protein complexes, including guanidinium/HCl, detergents (SDS plus Nonidet P-40) and high-salt solutions, could convert NF-P1 into NF-P2. Unlike in intact cells, where induction of NF-P2 is restricted to killer lymphocytes, this conversion occurred in nuclear extracts derived from both cytotoxic lymphocytes and non-cytotoxic cells. Although the mechanism that restricts the induction of NF-P2 to killer- lymphocytes in vivo remains unresolved, these results support the hypothetical 'dissociation' model for the generation of NF-P2. The results also imply that the absence of perforin expression in non-cytotoxic cells may be due to the suppression of the induction of the killer-cell-specific trans-acting factor NF-P2.

Animals↗
PubMed1996

Expression and characterization of functionally active recombinant perforin produced in insect cells.

A key cytolytic mediator used by killer lymphocytes, perforin (also known as pore-forming protein or cytolysin), has been shown to be capable of undergoing polymerization to form pores in cell membranes and cause osmotic lysis of target cells. Although perforin has been purified from killer lymphocytes and the coding gene has been cloned and sequenced, information concerning the domain structure of the perforin molecule has remained scarce. To overcome the difficulty in obtaining sufficient amounts of perforin and to further assess the functional relevance of the N-terminal portion of the perforin molecule in its lytic activity, we have attempted in the present study to produce recombinant perforins. Three forms of recombinant mouse perforin, a full-length form and two N-terminal truncated forms, have been expressed in insect (Spodoptera frugiperda (Sf9)) cells using recombinant baculovirus. Biochemical and functional characterization showed the purified full-length recombinant perforin to be capable of lysing target cells, inducing Ca2+ influx into target cells, and forming structural pores in target membranes. Significant lytic activities were also detected for the two truncated recombinant perforins lacking, respectively, the N-terminal 21 amino acid residues and 121 amino acid residues. Time course study showed that the latter acted less efficiently than the former. These results suggest the N-terminal portion of the perforin molecule to be an important, but not the only, domain responsible for the lytic function of the perforin molecule.

Animals↗
PubMed1996

Anaesthetic managements for conjoined twins with complex cardiac anomalies.

PURPOSE: To describe the perioperative assessment and anaesthetic management for surgical separation of three sets of conjoined twins with complex cardiac anomalies threatened with arterial desaturation and haemodynamic instability. CLINICAL FEATURES: Three sets of conjoined twins, one omphaloischiopagus, one omphalopagus, and one thoraco-omphalopagus, were considered for separation during the perinatal or infantile period. Preoperative functional evaluation including continuous pulse oximetry, capnography, and cardiac electrophysiological studies were considered to be as important as anatomical evaluation of the cardiac anomalies and cross-circulation by angiography in assessing the feasibility of surgical separation. Ipsilateral infusion of prostaglandin E1 and phenylephrine were applied to the cyanotic and healthy twins respectively, to restore arterial oxygenation intraoperatively and to avoid profound hypoxaemia. CONCLUSION: Surgical separation and anaesthesia should be well planned and rehearsed before clinical deterioration of the weaker twin. Aggressive pharmacological intervention and understanding of the cross-circulation pathophysiology is necessary to manage critical situations during surgical separation and in the postoperative period.

Anesthesia↗
PubMed1996

Frequency of linear hyperechogenicity over the basal ganglia in young infants with congenital rubella syndrome.

Five young infants with congenital rubella syndrome (CRS) underwent cranial ultrasonographic examinations and/or computed tomographic examinations. Only two of these infants were small for their gestational age, and none of them were microcephalic at birth. Deafness and ocular lesions were found in four patients, and congenital heart disease was found in three. All had abnormal ultrasonographic findings: linear-shaped hyperechogenicity over the basal ganglia was noted for five patients, periventricular punctate hyperechogenicity was noted for three, and subependymal cysts were observed in two. Follow-up ultrasonograms for two of the patients showed progressively enlarging hyperechogenic lesions. Calcification was found in both patients examined by means of computed tomography. All patients became microcephalic, with profound global developmental delay. Intracranial calcifications are common findings in patients with CRS. Ultrasonography should be performed for high-risk neonates, regardless of their symptoms. The finding of linear hyperechogenicity over the basal ganglia should prompt a search for all congenital infections, including CRS.

Basal Ganglia↗
PubMed1996

Utilization of iron sources and its possible roles in the pathogenesis of Vibrio parahaemolyticus.

Vibrio parahaemolyticus is an important enteropathogen in Japan, Taiwan and other coastal regions. The influence of the regulation of iron on the pathogenesis of this pathogen has not been well characterized. The growth of pathogenic and non-pathogenic strains of V. parahaemolyticus on iron-limited agar plates was stimulated by ferritin, lactoferrin and transferrin at 30 microM, and also by hemin, hemoglobin and ferric ammonium citrate at 100 microM. Spontaneous iron-utilizing mutant strains (mutants) were derived from a clinical strain, ST550. Compared with the parent strain, lowered virulence was demonstrated for these mutants, as assayed by adult mouse and suckling mouse models. The in vivo growth and enterotoxigenicity of these mutants were also lower in the suckling mice. Adherence of the mutants to excised mouse intestine was lower as demonstrated by scanning electron microscopy. The iron-regulated outer membrane protein profile also changed in selected mutants. These results indicate that iron-regulated outer membrane proteins and other unknown factors associated with iron utilization may have profound influences, besides iron acquisition, on the pathogenesis of V. parahaemolyticus.

Animals↗
PubMed1996

Silicone cream occlusive dressing--a novel noninvasive regimen in the treatment of keloid.

BACKGROUND: The use of silicone oil in the treatment of hypertrophic scars has recently been much discussed. Silicone gel and silicone cream containing 20% silicone oil have been demonstrated to effectively treat hypertrophic scars. However, the results in treating keloid are variable. OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy of silicone cream with occlusive dressing in the treatment of keloid. METHODS: An open study was performed in 15 Chinese patients with single or multiple keloids. Nineteen keloids were randomly selected and treated with silicone cream occlusive dressing (SCOD). The effectiveness was assessed using a scoring system involving elevation, redness, hardness, itching and tenderness or pain of the lesions. RESULTS: Fifteen out of 19 keloids (79%) showed significant improvement after using SCOD for 6 months. None of the keloids progressed. CONCLUSIONS: We conclude that SCOD is easy to apply, noninvasive, painless, almost free of side effects. It is especially useful in children and those who cannot tolerate the pain or inconvenience of other treatment procedures. The action mechanism of SCOD is still unclear, though hydration and occlusion rather than silicone itself may play an important role.

Adult↗
PubMed1996

Seroepidemiology of measles in southern Taiwan: two years after implementation of the measles elimination program.

The seroprevalence of the measles antibody in southern Taiwan 2 years after the launch of the two-dose measles elimination program was studied using serological surveillance. Sera from 868 healthy inhabitants were collected from January to December 1993. Measles IgG antibody was detected by enzyme-linked immunosorbent assay. Measles antibody was found in 82% of infants under 3 months of age, 26% of those between 4 and 9 months and 54% of those between 10 and 15 months of age. The most common reason for postponement of vaccination was due to concomitant illness during the scheduled vaccination period. The presence of measles antibody rose sharply in children over 15 months of age, reached 90% among preschool-aged children and was 93% in school-aged children. These data suggest that a high immunization coverage rate was achieved in children over 15 months of age (92%) and that a third measles immunization at age 12 is not necessary. Future strategies for measles control should aim at increasing the immunization coverage for children between 9 and 15 months of age.

Adolescent↗
PubMed1996

Blood and central venous pressure responses after serial tourniquet deflation during bilateral total knee replacement.

Thirty-five patients who underwent one-stage bilateral total knee replacement were included in this study to determine whether there was any difference in hemodynamic effects following the deflation of the first and second tourniquets. The values of hemodynamic variables were not significantly different immediately before either the first or the second tourniquet release as compared to preoperative values. The changes in heart rate after the release of the first and second tourniquets showed similar patterns. The systolic and diastolic blood pressure decreased significantly after deflation of the first and second tourniquets. However, the decrease was more marked after the second tourniquet deflation. The level of central venous pressure decreased significantly after the release of the first and second tourniquets but the patterns of change were not significantly different. The need for administration of ephedrine was also higher after the deflation of the second tourniquet than after the first. We conclude that the blood pressure changes after the second tourniquet deflation are more pronounced than those following the first tourniquet deflation. Anesthesiologists must be aware of this phenomenon and prevent marked hemodynamic changes that could be detrimental to high-risk patients.

Aged↗
PubMed1996

Coamplification of the ZFX and ZFY genes for sex identification in preimplantation embryos.

Knowledge of the sex of an embryo may be particularly useful for couples who have a high risk of producing offspring with inherited genetic disorders. We present a rapid and reliable nested polymerase chain reaction strategy to simultaneously amplify the ZFX and ZFY genes at the single cell level. Forty single blastomeres isolated from six triploid preembryos were subjected to coamplification of ZFX and ZFY genes. The results obtained from the preembryo were consistent with the assigned genotype. The amplification rate was 80% for ZFX and 84% for ZFY. Our strategy can be applied to preimplantation diagnosis of single gene disorders, and is especially useful for preimplantation diagnosis and prevention of X-linked diseases in in vitro fertilization programs.

Blastocyst↗
PubMed1996

Rapid airway access by modified retrograde intubation.

Rapid access to the airway is important to ensure successful resuscitation. However, the establishment of a patent airway by orotracheal intubation is not always easy. This is especially true in patients with upper airway pathology or anatomic variations. A modified retrograde intubation technique was developed using the plastic sheath of the spring guidewire of a central venous pressure (CVP) kit as an introducer. This is considered to be a simple and safe method to provide a secure airway where intubation is difficult or in an emergency. This report presents our clinical experience using this method in 10 patients.

Emergencies↗
PubMed1996

[Clinical experience of automated double filtration plasmapheresis].

Double filtration plasmapheresis, one kind of fractionation plasmapheresis, was developed from membrane type plasmapheresis to remove only the pathogen and return the normal protein back to the patient. We started our automated double filtration plasmapheresis since December 1993. There were 13 patients who received one hundred treatments totally during one year period. And they are myasthenia gravis (8 patients); acute inflammatory demyelinating polyneuropathy (1 patient), multiple myeloma (1 patient); acquired factor VIII inhibitor (1 patient); autoimmune hemolytic anemia (1 patient); systemic lupus erythematous (1 patient). Technically double filtration plasmapheresis is easy to perform and time-saving. It also makes necessity of replacement fluid less frequent. Incidence of complication is rare, and this includes hypotension 2%, palpitation 1%, headache 1%, hemolysis 4%, air emboli 1%, high secondary pressure 2%, and no motality during our treatment. Clinical response is documented in cases of myasthenia gravis; acute inflammatory demyelinating polyneuropathy and acquired factor VIII inhibitor in our study. In conclusion, double filtration plasmapheresis is a time-saving, convenient, and safe therapeutic modality with rare complication. Because its effectiveness on limited kinds of diseases and costs relatively high price, thus plasmapheresis should be used in selected cases and treat aggressively if indicated.

Adolescent↗