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Biomedical subjects

C C Tseng

Publications and source records attributed to C C Tseng.

At least 73 records · Page 4Linked to original sources

Verruciform xanthoma. Case report and literature review.

Verruciform xanthoma is a relatively uncommon lesion. Half of the reported cases occurred in the gingiva or alveolar ridge. In most cases, the clinical impressions are papilloma or verrucous carcinoma, which demonstrates the importance of the clinical and pathological recognition of this lesion. The cause of pathogenesis is still unknown since the first report in 1971. There are some cases reported in conjunction with leukoplakia, carcinoma in situ, pemphigus, and discoid lupus erythematosus (DLE), which merits close evaluation of this disease. This article reports two cases of verruciform xanthoma and reviews the evidence of its pathogenesis from the available literature.

Adult↗

Changes of propofol levels in isolated cardiopulmonary bypass circuit.

BACKGROUND: High dose fentanyl anesthesia in cardiac surgery has been supplemented with propofol to prevent patient's awareness and recall. It has been known that during cardiopulmonary bypass (CPB), fentanyl or midazolam concentration decreases, except for propofol where it remains unknown. This study evaluated the interaction between propofol and the CPB circuit in vitro. METHODS: Three identical experiments were conducted. In each experiment we used a set of CPB circuit composed of a standard 3/8 inch PVC tubing trap, a reservoir and a pump. The reservoir was primed with 2,000 ml solution of 2.5% dextrose and 0.45% NaCl in which 20 mg propofol was added. The solution was circulated in the circuit at a flow rate of 2 L/min. The experimental period was 30 min. A 5 ml sample of the solution was taken from the venous sampling site of the circuit immediately prior to the experiment, and thereafter each from the arterial and venous sampling sites at 1, 3, 5, 10, 20 and 30 min after the start of the experiment. The samples were kept at 4 degrees C and assayed by HPLC. RESULTS: The propofol concentrations decreased exponentially with the increase of experimental time. There were no significant differences in the concentrations and the rates of decrease between the arterial sampling site and the venous sampling site. The decrease was 20% at 1 min, 68% at 10 min, 83% at 20 min, and 92% at 30 min after the beginning of the experiment. CONCLUSIONS: The results demonstrate the presence of propofol sequestration by the CPB circuit. Evaporation in the bubble oxygenator, absorption by and/or adherence to the circuit are suspected as the possible causative factors.

Anesthetics, Intravenous↗

[Post-obstructive pulmonary edema following extubation--report of two cases].

Pulmonary edema may develop in healthy patients after anesthesia. It usually results from upper airway obstruction which may be caused by laryngospasm or aspiration. Increased inspiratory effort following airway obstruction significantly produces negative intrathoracic pressure that may lead to pulmonary edema. We reported two cases of post-obstructive pulmonary edema following extubation. They were essentially healthy young males, one of whom received urethroplasty and the other received pulmonary blebectomy. Their hemodynamic and ventilatory conditions had been kept stable during surgery. Upper airway obstruction followed by pulmonary edema developed immediately after extubation, which was successfully treated without any sequelae.

Adult↗

Shortening and superlon-wrapping the downstream tube can increase the useful range of the blood warmer.

BACKGROUND: Hypothermia occurs frequently in clinical anesthesia. Many apparatus were introduced to keep intravenous fluid warm. But at low to medium flow rates little effects have been achieved because of heat lost along the tube. Superlon, an industrial heat-preserving material widely used in air conditioning to prevent temperature change, has never been used in the blood warmer. METHODS: The study was performed in three groups group I using standard (120 cm) unwrapped tube (Animac AM-4 set), group II using a shortened downstream tube (60 cm), and group III using the downstream tube which was further wrapped with superlon (Super LTD). The blood warmer used was identical in all 3 groups. We recorded the fluid temperatures at different points downstream at various flow rates. The values were then compared among groups. RESULTS: The fluid temperatures before entering the warmer were around 20 degrees C and 37 degrees C at the 2 cm post-warmer points at various flow rates. The end point temperatures rose with flow rates and were the highest in group III and lowest in group I at each flow rate (p < 0.01). In group III the temperature could be kept above 32 degrees C at a very low flow rate (150 ml/h) and above 35 degrees C at 300 ml/h. In group I, 1,000 to 2,000 ml/h were needed to keep the same temperature. CONCLUSIONS: These refinements increase the useful range of the Animac AM-4 warmer and make it useful in pediatric rapid fluid resuscitation and current fluid management. Moreover, they are easy to set up, inexpensive, and can be applied to any kind of blood warmers.

Anesthesia↗

Decrease of anesthetics activity by electroacupuncture on Jen-Chung point in rabbits.

The effect of acupuncture at life-saving point on the central nervous depressive action of anesthetics was investigated in rabbits. Stimulation with electroacupuncture (EA) inserted in Jen-Chung point, which is located at the mid-point on the upper lip, decreased the sleeping time induced by pentobarbital or propofol. However, this action of acupuncture was not modified by naloxone at the doses sufficient to block opiate receptors. Plasma beta-endorphin detected by radioimmunoassay was also not markedly changed in rabbits which received similar electrostimulation. Moreover, pretreatment with para-chlorophenylalanine at a dose sufficient to deplete endogenous 5-hydroxytryptamine (5-HT) failed to influence the action of EA. Mediation of endogenous opioids and/or 5-HT in this action of EA was then ruled out. Prazosin reversed the sleeping time decreasing action of acupuncture in a dose-dependent manner. Also, the action of acupuncture was eliminated in rabbits which received intracerebroventricular injection of guanethidine at a dose which could block noradrenergic nerve terminals. It is suggested that stimulation of Jen-Chung point through EA can activate noradrenergic neurotransmission in the brain, which in turn reduces the central nervous depressive activity of anesthetics.

Acupuncture Analgesia↗

Glucose-dependent insulinotropic peptide (GIP) gene expression in the rat salivary gland.

Previous studies have indicated that following nutrient ingestion, GIP is released principally from the upper small intestine. In addition to its presence in the rat small intestine, GIP transcripts have also been localized to the submandibular salivary gland (SSG). The present studies were directed to further characterize expression of the GIP gene in the SSG. Pregnant rats were sacrificed at gestational days 18 and 20, followed by the removal of rat fetuses. The duodenum pancreas, and SSG were then excised from the fetuses, as well as from neonatal pups at ages 1, 3, 7, 10, 14, and 21 days. RNA was extracted and measured by Northern blot analysis using specific rat GIP probes. GIP transcripts were first detected in the duodenum in the 18-day fetus and reached maximum levels at birth. In contrast, GIP mRNA was not observed in the SSG until 10 days postnatally and was not detected at all in either the fetal or neonatal pancreas. In situ hybridization of the SSG using an 35S-labelled antisense GIP RNA probe demonstrated expression of the GIP gene to be limited to ductal cells, with no transcripts present in acini. In separate experiments, rats fasted overnight were given water or 10% glucose. While no changes were detected in water-fed rats following oral glucose ingestion, small, but significant increases in SSG GIP gene expression were detected at 60 and 240 min. The results of these initial studies suggest the possibility of a functional role for GIP in the rat salivary gland by the demonstration of GIP mRNA in the SSG by Northern analysis and in situ hybridization, as well as by an increase in SSG GIP gene expression following a glucose meal.

Animals↗

Binding proteins on synaptic membranes for crotoxin and taipoxin, two phospholipases A2 with neurotoxicity.

Crotoxin and taipoxin are both neurotoxic phospholipases A2 capable of affecting the presynaptic activity to bring about ultimate blockade of synaptic transmission. The enzymatic activity has generally been considered to be necessary but not sufficient for the blockade. Since many phospholipases A2 with comparable or even higher enzymatic activity are not toxic, it has been postulated that the difference lies in the affinity of binding to the presynaptic membrane. In confirmation of this proposition, we and others have previously shown that iodinated crotoxin and taipoxin bind specifically with high affinity to the isolated synaptic membrane fraction from guinea-pig brain, whereas specific binding is not detected with the nontoxic pancreatic phospholipase A2. Experiments based on photoaffinity labeling and simple chemical cross-linking techniques have led to the identification of three polypeptides preferentially present in neuronal membranes as (subunits of) the binding protein(s) for crotoxin and/or taipoxin. Some, but not all, other toxic phospholipases A2 also appear to be ligands for the three polypeptides. We now report studies on partial purification of these polypeptides using affinity chromatography and other techniques. In order to learn the normal physiological roles played by the toxin-binding proteins, the phospholipase-independent effects of the toxins on the synaptosomes have been sought. We have found that under Ca(2+)-free condition, taipoxin or crotoxin inhibits with IC50 of 20-1000 nM the Na(+)-dependent uptake of norepinephrine, dopamine and serotonin by the synaptosomes. In contrast, choline uptake is not affected.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Different growth control of the two human thyroid cell lines of adenomatous goiter and papillary carcinoma.

To study the growth control of human thyroid cells in different stages of differentiation, we established two human thyroid cell lines of adenomatous goiter and papillary carcinoma. A 59-year-old female patient with adenomatous goiter was operated in September 1991, and a 27-year-old female patient with papillary carcinoma in May 1990. The thyroid cell lines were established by successive passage without cellular or genetic manipulations such as fusing other cell lines or oncogenic viral infection. These cell lines, human adenomatous goiter cells (hAG) and human papillary thyroid carcinoma cells (hPTC), exhibited a flattened polygonal shape and proliferated as a monolayer in cell culture. The doubling time of the hAG cells was 60 h in Ham's F12 medium supplemented with 10% fetal bovine serum, and that of the hPTC cells, 18 h in the same medium. Both cell lines expressed mRNA for TSH receptor and secreted cAMP into the medium during incubation with thyrotropin (TSH) at concentrations as low as 0.01 mU/mL. The effects of activators of protein kinase A (PKA), protein kinase C (PKC), tyrosine kinase (TK), and estradiol (E2) on proliferation of the hAG cells and the hPTC cells were assessed by measuring cellular DNA content in 24-well plates with diaminobenzoic acid. TSH stimulated proliferation of the hAG cells, but it inhibited proliferation of the hPTC cells. Since TSH activates two signaling pathways, the adenyl cyclase-PKA system and phospholipase C-PKC system, we tested effects of dibutylyl cAMP (dBC) and phorbol myristate 13-acetate (PMA), separately. dBC stimulated proliferation of the hAG cells, but it inhibited that of the hPTC cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗

Elimination of AC interference in electrocardiogram using IIR notch filter with transient suppression.

In this paper, a technique for suppressing the transient states of IIR notch filter is investigated. This technique uses the vector projection to find better initial values for notch filters. When a notch or comb filter is used to eliminate power line (AC) interference in the recording of electrocardiograms (ECG), the performance of the notch filter with transient suppression is better than that of the conventional notch filter with arbitrary initial condition. The improvements with this technique are at the cost of additional computation load at the beginning of filtering.

Artifacts↗

[Changes of arterial oxygen tension in supine position during one-lung anesthesia].

BACKGROUND: One-lung ventilation during anesthesia (one-lung anesthesia) in patients under lateral decubitus position to help performing intra-thoracic surgical procedures was well known to have larger alveolar-to-arterial oxygen tension difference and lower arterial oxygen tension (PaO2) as compared to two-lung ventilation. In the present study, we investigate the changes of arterial oxygen tension in the supine position during one-lung anesthesia. METHODS: Forty-two patients of palmar hyperhidrosis, ASA class I-II, scheduled to receive bilateral transthoracic endoscopic sympathectomy were studied. After anesthetic induction (fentanyl, thiopental, and succinylcholine), a 35 (for female) or 37 (for male) French left-sided Robertshaw double-lumen endobronchial tube was intubated. Anesthesia was maintained with isoflurane 1.0-1.5% and 50% O2-N2O. They were changed to isoflurane 1.5-2.0% and 100% O2 during one-lung ventilation. Once the surgical operation is completed, they were changed to 100% O2 and two-lung ventilation. Arterial blood gases were measured at 4 phases: 5 min after endobronchial intubation (two-lung ventilation), 5 min after left one-lung ventilation, 5 min after right one-lung ventilation, and 5 min after accomplishing operation (two-lung ventilation). RESULTS: The results showed PaO2 were significantly lower in left and right one-lung ventilation with 100% O2 as compared with that obtained from two-lung ventilation with 50% O2 5 min after endobronchial intubation (p < 0.05). Furthermore, right one-lung ventilation had a lower PaO2 than left one-lung ventilation (p < 0.05). CONCLUSIONS: We conclude that arterial oxygen tension can be safely maintained during one-lung anesthesia with pure oxygen in healthy patients lying in a supine position.

Adolescent↗

Correction of a large periradicular lesion and mucosal defect using combined endodontic and periodontal therapy: a case report.

The successful treatment of a large endodontically induced periradicular defect and soft tissue fenestration by combined endodontic and periodontal therapy is described. Endodontics was performed on the mandibular left central incisor, the apex was resected, and a retrograde amalgam was placed. The defect was thoroughly debrided and the exposed root surface was planed with curettes. Demineralized freeze-dried bone allograft and a nonresorbable membrane were placed over the defect and the exposed root surface. The membrane was removed in 6 months and there appeared to be bone regeneration with complete closure of the soft tissue fenestration. Endodontic therapy in combination with guided tissue regeneration and bone grafting may provide another modality of treatment for endodontically related hard and soft tissue defects.

Alveolar Bone Loss↗

Anticancer chemosensitivity profile of freshly separated human pancreatic cancer cells assessed by DNA synthesis inhibition assay.

The chemosensitivity of 49 freshly separated human pancreatic cancers to seven kinds of anticancer agents were assessed by a DNA synthesis (3H-thymidine incorporation) inhibition assay. DNA synthesis is higher in involved lymph nodes (n = 7), malignant effusion (n = 15), liver metastasis (n = 7), primary cancer (n = 15), and skin metastasis (n = 5). Chemosensitivity assay demonstrates that etoposide, 4-epirubicin, carboquone, and 5-fluorouracil are more effective than cisplatin, mitomycin-C, and Adriamycin. In general, metastatic lesions of pancreatic cancer tend to show higher chemosensitivity than primary lesions. Pathological analysis demonstrates that small primary pancreatic cancers tend to be more responsive than large primary cancers, and primary pancreatic cancers with no regional lymph node involvement also tend to be more responsive than those with nodal involvement. No significant differences are seen in terms of tumor spread, vascular involvement, sex of patient, and histological type. When chemosensitivity assay is not available, the results of the present study may be beneficial to choose the regimens.

Adult↗

Sclerotherapy for esophageal variceal bleeding in advanced hepatocellular carcinoma: an 8-year experience in Taiwan.

Between August 1983 and December 1991 at the Taichung Veterans General Hospital, Taiwan, 65 advanced hepatocellular carcinoma (HCC) patients with esophageal variceal bleeding received endoscopic injection sclerotherapy (EIS) and 60 such patients received conservative medical treatment without EIS. The rate of successful control of acute bleeding was 72.5% (27/40 patients) in the EIS group and 56.7% (34/60 patients) in the non-EIS group. The rebleeding rate was lower in the EIS group than in the non-EIS group (26.9% vs 73.5%). Thirty-one of the EIS and 44 of the non-EIS treatment patients, mainly Child's B and C patients, died within 2 months after the first bleeding. In the short term, EIS decreased the mortality due to esophageal variceal bleeding, but the survivors still had to face hepatic failure and tumor growth. Thus, benefits of EIS were noted on short- but not on long-term survival. The mean survival times were 2.38 months for the EIS group and 1.79 months for the non-EIS group. Since EIS had no beneficial effects on long-term survival it is doubtful whether sclerotherapy applied to esophageal variceal bleeding in patients with advanced HCC would be worthwhile, as the endoscopic procedure would only add to their suffering.

Acute Disease↗

Rat cluster of differentiation 1 molecule: expression on the surface of intestinal epithelial cells and hepatocytes.

BACKGROUND/AIMS: Cluster of differentiation 1 (CD1) is a family of nonpolymorphic, major histocompatibility complex class I-like molecules with prominent expression in the liver and intestinal epithelium of humans and mice. Models of intestinal and hepatobiliary inflammation and experimental liver transplantation are conducted in the rat, yet nothing is known of CD1 expression in this species. METHODS: Monoclonal antibodies against murine CD1 were used to identify a rat CD1 homologue. Tissue messenger RNA expression was confirmed by Northern blot analysis with a murine CD1 complementary DNA probe. RESULTS: Immunoperoxidase staining detected CD1 in intestinal epithelial and liver cells but not in the thymus. Immunofluorescence of isolated hepatocytes and a rat fetal intestinal cell line, SLC-44, showed cell surface expression of CD1. Metabolic labeling and immunoprecipitation of the SLC-44 cell line and a mouse intestinal epithelial cell line, MODE-K, showed a protein of 55 kilodaltons. Immunoblotting of CD1 in isolated intestinal epithelial cells and hepatocytes showed a molecule of 55 kilodaltons. Northern blot analysis showed a single message of approximately 2.2 kilobases in hepatocytes. CONCLUSIONS: A CD1 homologue exists in the rat. Expression in the rat intestine and liver are similar to those in the human and mouse. The rat may be useful as a model for the study of CD1 function.

Animals↗

Gene expression of tumor necrosis factor alpha and interferon gamma in the lungs of Mycoplasma pulmonis-infected mice.

ICR mice were infected intranasally with Mycoplasma pulmonis isolated freshly from the lungs of a rat with pneumonia. We demonstrated with high reproducibility the expressions of messenger RNAs of cytokines, tumor necrosis factor alpha (TNF alpha) and interferon gamma (IFN gamma) in the lung tissue of M. pulmonis-infected mice by the reverse transcriptase-polymerase chain reaction and confirmed specific mRNA of the cytokines by restriction endonuclease digestion. Both the viable population of M. pulmonis in the lung tissue and the titers of the neutralizing antibody in the serum increased between 7 and 21 days, and reached their maximum 35 days after infection. The pneumonia in mice progresses with the development of lung lesions after 7 days of infection. The early lesions are characterized primarily by neutrophils and edema in the alveolar spaces. mRNAs prepared from the lung tissue of M. pulmonis-infected and -uninfected mice were also tested for the presence of messages specific to TNF alpha and IFN gamma by the reverse transcriptase-polymerase chain reaction. The expression of the genes encoding TNF alpha and IFN gamma was constitutively demonstrated from 24 hr through 35 days after the intranasal inoculation of M. pulmonis. Furthermore, cells of two types, adherent and nonadherent cells, in bronchoalveolar lavage fluids obtained from the mice 3 weeks after inoculation of M. pulmonis were also found to express the genes of TNF alpha and IFN gamma respectively. These data suggest that these cytokines would play a role in both stimulation in the development of pathological changes in mycoplasmal infection, affecting the inflammatory responses.

Administration, Intranasal↗

Functional complementation of the adenovirus E1B 19-kilodalton protein with Bcl-2 in the inhibition of apoptosis in infected cells.

Expression of the adenovirus E1A oncogene induces apoptosis which impedes both the transformation of primary rodent cells and productive adenovirus infection of human cells. Coexpression of E1A with the E1B 19,000-molecular-weight protein (19K protein) or the Bcl-2 protein, both of which have antiapoptotic activity, is necessary for efficient transformation. Induction of apoptosis by E1A in rodent cells is mediated by the p53 tumor suppressor gene, and both the E1B 19K protein and the Bcl-2 protein can overcome this p53-dependent apoptosis. The functional similarity between Bcl-2 and the E1B 19K protein suggested that they may act by similar mechanisms and that Bcl-2 may complement the requirement for E1B 19K expression during productive infection. Infection of human HeLa cells with E1B 19K loss-of-function mutant adenovirus produces apoptosis characterized by enhanced cytopathic effects (cyt phenotype) and degradation of host cell chromosomal DNA and viral DNA (deg phenotype). Failure to inhibit apoptosis results in premature host cell death, which impairs virus yield. HeLa cells express extremely low levels of p53 because of expression of human papillomavirus E6 protein. Levels of p53 were substantially increased by E1A expression during adenovirus infection. Therefore, E1A may induce apoptosis by overriding the E6-induced degradation of p53 and promoting p53 accumulation. Stable Bcl-2 overexpression in HeLa cells infected with the E1B 19K- mutant adenovirus blocked the induction of the cyt and deg phenotypes. Expression of Bcl-2 in HeLa cells also conferred resistance to apoptosis mediated by tumor necrosis factor alpha and Fas antigen, which is also an established function of the E1B 19K protein. A comparison of the amino acid sequences of Bcl-2 family members and that of the E1B 19K protein indicated that there was limited amino acid sequence homology between the central conserved domains of E1B 19K and Bcl-2. This domain of the E1B 19K protein is important in transformation and regulation of apoptosis, as determined by mutational analysis. The limited sequence homology and functional equivalency provided further evidence that the Bcl-2 and E1B 19K proteins may possess related mechanisms of action and that the E1B 19K protein may be the adenovirus equivalent of the cellular Bcl-2 protein.

Adenovirus E1A Proteins↗

Regulation of glucose-dependent insulinotropic peptide gene expression by a glucose meal.

Glucose-dependent insulinotropic peptide (GIP) enhances insulin secretion by pancreatic beta-islet cells. Its release has been demonstrated predominantly after the ingestion of carbohydrate and fat. We have recently cloned a rat intestinal GIP cDNA and in the present studies have used this cDNA as a probe for measuring rat duodenal GIP mRNA after nutrient administration. Rats were fasted overnight, after which they were permitted to drink water or 10% glucose. The duodenum was then removed, GIP mRNA was measured by Northern hybridization analysis, and duodenal mucosa and serum GIP levels were determined by radioimmunoassay. In response to oral 10% glucose, duodenal mucosal GIP mRNA concentrations increased from 2 to 4 h, and at the end of 4 h a threefold increase was detected. Serum and mucosal GIP concentrations increased earlier, starting at 60 min, and levels remained elevated at 4 h. In separate studies, nuclear run-on assays were performed to compare the effects of glucose and water ingestion on transcription of the GIP gene. Whereas no increase in GIP gene transcription was detected in rats ingesting water, the rate of transcription doubled in glucose-fed rats. Actin gene transcription was nearly identical in both groups, indicating genomic specificity. The results of these studies indicate that duodenal GIP gene expression is stimulated at both the pre- and posttranslational levels by glucose-containing meals. These studies further suggest that the release of GIP from cellular storage granules might account for the initial increase in serum GIP levels after oral glucose ingestion.

Animals↗

Sclerotherapy on liver cirrhosis with esophageal variceal bleeding: eight years of experience.

BACKGROUND: Patients with liver cirrhosis usually die of hepatic failure and variceal bleeding. Successful treatment of the latter can reduce mortality. Sclerotherapy is one method often used. This study compared (a) the successful rate of acute bleeding control; (b) short- and long-term survival rate between those with and without treatment with sclerotherapy to evaluate the clinical benefit of sclerotherapy for liver cirrhosis patients with esophageal variceal bleeding. METHODS: Between August 1983 and December 1991, 183 cirrhotic patients with esophageal variceal bleeding receiving endoscopic injection sclerotherapy (EIS) was compared with 123 patients without sclerotherapy treatment retrospectively. The severity of underlying liver disease was classified using a modified Child's classification. Sclerotherapy was done within 48 hours after active bleeding in the sclerotherapy-treated group, while the medical treatment group received Sengstaken-Blakemore (SB) tube or pitressin infusion only. RESULTS: Successful rate of acute bleeding control was 81.63% (120/147) in the EIS group and 59.35% (73/123) in the medical treatment group. The worse the hepatic function of the patients, the lower the success of acute bleeding control in both groups. Fifty subjects (74.63%) had varices eradicated in 67 sclerotherapy treatment patients with regular follow-up. Patients receiving EIS had a better long-term survival than those without treatment. Benefit of EIS on long-term survival was more significant in Child B patients and less in Child C and Child A patients. Death from variceal bleeding was lower in the EIS group than in the medical treatment group (32% vs 62.6%). Complications of EIS were rare. Eight patients died of aspiration pneumonia, spontaneous bacterial peritonitis or acute renal failure after sclerotherapy, and most were Child B and C patients. Sixteen patients had esophageal stricture. Four needed dilatation treatment. CONCLUSIONS: The sclerotherapy-treated group had a higher control rate of acute bleeding and lower mortality rate from esophageal variceal bleeding compared with the medical-treated group. The procedure prolonged long-term survival in Child B patients but did so less frequently in Child A and Child C patients. The incidence of complications was low. As a whole, EIS is a safe and efficient method for control of esophageal variceal bleeding.

Adult↗