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Biomedical subjects

C C Yang

Publications and source records attributed to C C Yang.

At least 199 records · Page 11Linked to original sources
PubMed1995

Bacteremia in acute pancreatitis of different etiologies.

To evaluate the rationale of using antibiotics in acute pancreatitis and to determine whether the indication for their use depends upon the etiology of the pancreatitis, the records of 202 patients with acute pancreatitis were retrospectively reviewed. The incidence of abnormal body temperature, leukocytosis, bacteremia and the results of biochemistry tests in different etiologies of the disease were investigated. Pancreatitis was found to be alcohol-related (47 patients), gallstone-related (105 patients), idiopathic (26 patients) and miscellaneous (24 patients). On admission, 83 patients had abnormal body temperature and 146 patients showed leukocytosis. Bacteremia occurred in 20 patients. Of these, 15 had gallstone-related pancreatitis, two had pancreatic cancers and one developed bacteremia after endoscopic retrograde cholangio-pancreatography (ERCP). These 18 patients had abnormal biochemistry results (including high serum levels of direct bilirubin, alkaline phosphatase and gamma-glutamyltransferase) and dilated bile ducts on imaging studies, indicating biliary infections. The remaining two patients with bacteremia included one alcoholic patient and one patient with idiopathic pancreatitis. The most commonly involved pathogens were Escherichia coli and Klebsiella pneumoniae. In addition, eight patients (4%) developed secondary pancreatic infections during hospitalization; the blood cultures of seven of these patients were negative on admission. Although fever and leukocytosis are not good predictors of infection in acute pancreatitis our results showed that bacteremia is common in patients whose pancreatitis is related to gallstones, ERCP or pancreatic malignancy with obstructive jaundice. We recommend that antibiotics be used only in this subset of acute pancreatitis patients.

Acute Disease↗
PubMed1995

Comparison of serum CA15-3 and CEA in breast cancer.

The monoclonal antibodies CA15-3 were developed against the two antigens 115D8 of the human milk fat globule membrane and DF3 of breast cancer. CA15-3 was assayed radioimmunologically and CEA was analysed using the enzyme immunoassay. Normal control was achieved in 32 healthy women, the mean values for CA15-3 were 11.5 +/- 3.0 u/ml, range from 7.9 to 16.9 u/ml. We compared serum levels of CA15-3 and CEA in 121 patients with histologically proved breast carcinoma. CA15-3 levels above 25 u/ml and CEA levels above 5 ng/ml were considered positive values. 31 of 121 patients studied had elevated CA15-3 levels (sensitivity: 25.6%) and 21 of 121 patients had positive CEA levels (sensitivity 17.4%). 92 of the breast cancer patients (76%) did not have metastatic disease. In this group CA15-3 sensitivity was 7.6%, while CEA sensitivity was 6.5%. Mean values were 15.1 +/- 6.6 u/ml for CA15-3 and 1.78 +/- 2.47 ng/ml for CEA. 29 patients (24%) had metastatic disease. In this group, CA15-3 sensitivity was 82.8% and CEA sensitivity was 51.7% (P < 0.05). Mean values for CA15-3 were 147.5 +/- 175.9 u/ml and 16.9 +/- 24.0 ng/ml of CEA. With regard to the correlation of two tumor markers with clinical course patients had significantly higher levels of CA15-3 than of CEA in metastatic breast cancer. This result suggests CA15-3 to be the more sensitive and more specific of the two for metastatic breast cancer detection and monitoring.

Adult↗
PubMed1995

Features of centipede bites in Taiwan.

In order to define characteristics that would help differentiate a centipede bite from a viper bite, we designed a prospective study using the data collection system of a Poison Control Center. The clinical goal is to rapidly distinguish envenomations for which antitoxin may be indicated (viper) from those for which palliative care only is appropriate (centipede). During a year period, 31 cases, including two cases receiving double bites in each event, were reported. Centipede lengths were estimated to range from 3 to 20 cm. Ninety-two per cent of the bite marks were pointed in shape. A local reaction developed at the bitten site, but usually remaining localized to a 10 x 10 cm area of involvement. The length of the biting animal, the bite mark characteristics, the presence of haemorrhagic vesicles, the wound size and the progression of local reactions are useful in the rapid clinical differentiation between centipede bites and viper bites.

Adolescent↗
PubMed1994

DNA cleavage by NaeI: protein purification, rate-limiting step, and accuracy.

NaeI endonuclease must bind two DNA sites for cleavage to occur. NaeI was purified to apparent homogeneity and used to determine the rate-limiting step for DNA cleavage and to measure NaeI's specificity for its cognate recognition site. Steady-state cleavage by NaeI in the presence of effector DNA (activated) gave values of 0.045 s-1 and 10 nM for kcat and KM for M13 DNA substrate, respectively, but values of 0.4 s-1 and 170 nM, respectively, for an M13 DNA fragment substrate. Single-turnover cleavage of M13 DNA demonstrated that DNA strand scission is not rate-limiting for turnover of NaeI. Transient kinetic analysis of M13 DNA cleavage by NaeI showed an initial burst of substrate cleavage that was proportional to NaeI concentration, implying that product release is rate-limiting for turnover of NaeI. The NaeI effector and substrate binding sites were found to prefer cognate over noncognate sequences by 10(3)-fold and at least 40-500-fold, respectively. kcat for noncognate recognition sequence was at least 10(6)-fold lower than that for cognate. The specificity of activated NaeI, as measured by kcat/KM, for noncognate recognition sequence was 10(8)-fold lower than that for cognate, and over 10(11)-fold lower when the decreased affinity for noncognate sequence at the effector binding site was taken into account. This specificity is approximately 10(4)-fold larger than for any other restriction enzyme measured.

Base Sequence↗
PubMed1994

Differential neuronal responses to angiotensin III from the subfornical organ of normotensive and spontaneously hypertensive rats.

We previously reported that chronic central administration of angiotensin III (AIII) fails to produce sustained drinking behavior in spontaneously hypertensive rats (SHR), possibly because of the development of early desensitization of the angiotensin receptors. The present study extended these findings to the cellular level, using brain-slice preparation from Wistar-Kyoto rats (WKY) and SHR, in conjunction with single-neuron recording in the subfornical organ (SFO), a target site for angiotensin II-induced drinking. We found that a majority of the SFO neurons studied (13/18 in WKY, 20/28 in SHR) responded in a dose-related manner to AIII, given in the range of 10(-6)-10(-5) M. This excitation was receptor-specific, since it was reversed by Ile7-AIII (10(-4)-10(-3) M), the selective AIII antagonist. Bestatin (10(-5)-10(-4) M), an aminopeptidase B inhibitor, did not discernibly affect basal spike frequency when delivered alone. Nevertheless, given in combination with the heptapeptide, bestatin reduced the intensity and duration of SFO neuronal response in WKY to the higher dose (10(-5) M), and in SHR to both doses (10(-6) or 10(-5) M), of AIII. These data suggest that the SFO may also be a central site of action for AIII. Moreover, prolonging the action of AIII by protecting it from being metabolized with bestatin may produce desensitization of the angiotensin receptors on SFO neurons. This was particularly so in the SHR, which are thought to be defective in the degradation of the heptapeptide in the brain.

Aminopeptidases↗
PubMed1994

Specific protein phosphorylation induced in Xanthomonas campestris pv. oryzae by bacteriophage Xp12.

We have investigated the endogenous phosphorylation patterns of phosphorylated proteins of Xanthomonas campestris pv. oryzae induced by its bacteriophages. For bacteriophage Xp12-infected cells, at least three phosphoproteins with apparent molecular weights of 28, 28.5 and 45 kDa were detected by in vitro labeling with [gamma-32P]-ATP. These Xp12-specific phosphoproteins only occurred with Xp12 infection, and were not shown in uninfected or Xp10-infected cells. The protein kinase(s) responsible could use either ATP or GTP as the nucleotide substrate with nearly the same efficiency. Magnesium was proved to be an essential factor for the phosphorylation. EGTA treatment excluding the possibility that the presumed protein kinase was calcium-dependent. Under our reaction conditions, the optimal phosphorylation occurred at pH 7 to 8, for 30 to 40 min at 25 to 37 degrees C. The Xp12-specific protein phosphorylation hint the existence of a physiological regulation mechanism involved in the life cycle of bacteriophage Xp12. Furthermore, the presumed protein kinase was shown to be encoded by the genome of Xp12 rather than indirectly induced by Xp12 infection.

Adenosine Triphosphate↗
PubMed1994

The essentiality of B chain in stabilizing the structure of the A chain in beta 1-bungarotoxin from Bungarus multicinctus venom.

The dynamic of Trp residue in beta 1-bungarotoxin (beta 1-Bgt), the A chain of beta 1-Bgt and phospholipase A2 (PLA2) was assessed by fluorescence measurement. Acrylamide quenching studies showed that the exposure degree of the Trp in PLA2 is higher than the Trp in beta 1-Bgt. The Trp of beta 1-Bgt had a higher accessibility for iodide, reflecting that the basic nature of the B chain might exert an attractive electrostatic force for iodide and increase the susceptibility of Trp in the A chain to iodide. Removal of the B chain of beta 1-Bgt did not significantly affect the exposure degree of Trp in the A chain. Alternatively, the polarity of the environment around the Trp and the hydrophobic character of ANS and substrate binding sites in the separated A chain changed. Measurement of Trp fluorescence with increasing temperature showed that the stability of structure of beta 1-Bgt was higher than those of the separated A chain and PLA2. These results suggest that the B chain might interact with the A chain and stabilize the conformation of the A chain in beta 1-Bgt.

Animals↗
PubMed1994

Unconjugated bilirubin inhibits the oxidation of human low density lipoprotein better than Trolox.

Oxidative modification of human low density lipoprotein (LDL) has been implicated in plaque formation in blood vessels leading to atherogenesis. Conversely, there is increasing evidence that prevention of LDL oxidation reduces the incidence of coronary artery disease. Here, we have compared the effect of unconjugated bilirubin (Bu) and Trolox (a vitamin E analogue) on the oxidation of LDL after treatment with Cu2+ under defined conditions. We observed that Bu, at or near the normal serum level (i.e. 17 microM) effectively inhibits oxidation of LDL, while it takes at least 500 microM Trolox to achieve a similar effect. This means that, on a per mole basis, Bu is > 20 times more effective than Trolox in preventing LDL oxidation. The oxidation of LDL was assessed by agarose gel electrophoresis. This was further corroborated by assaying the malondialdehyde formed upon reacting the presumptive peroxidation product(s) of LDL with thiobarbituric acid. Thus, we have directly verified that Bu and, less so, Trolox, can each prevent the oxidative damage of LDL in vitro. Our result supports the contention that Bu as an endogenous antioxidant can prevent LDL oxidation and hence reduce the risk of atherogenesis.

Antioxidants↗
PubMed1994

Pretransplant urologic evaluation.

OBJECTIVE: Although a number of pretransplant urologic evaluations have been recommended in the literature, their efficacy has not been validated. This study was undertaken to evaluate a standardized urologic diagnostic protocol for potential adult transplant recipients. METHODS: One hundred consecutive adult transplant candidates were prospectively evaluated with a complete history and physical examination, renal ultrasonography (US), voiding cystourethrography (VCUG), urinalysis, and urine culture. Other diagnostic studies including cystoscopy and retrograde pyelography were performed as indicated. RESULTS: Urologic malignancies were diagnosed in 3 patients that included Stage A2 prostate cancer, Stage TA transitional cell carcinoma of the bladder, and Stage II renal cell carcinoma. The only significant abnormality detected by renal US was renal cell carcinoma in 1 patient. Twenty-six individuals had VCUG abnormalities, but these could not be predicted based on patient characteristics. However, VCUG was normal in all nondiabetic patients without voiding symptoms or a history of urinary tract infections. Thirteen patients had hematuria and were evaluated with cystoscopy and retrograde pyelography. One individual (7.6%) had a significant abnormality (bladder tumor) detected during cystoscopy. Retrograde pyelography demonstrated no clinically significant abnormalities in this patient group. Eighteen patients had sterile pyuria and underwent similar endoscopic evaluation. Cystoscopic examination was normal in all these individuals, and retrograde pyelography showed either normal or clinically insignificant papillary necrosis. CONCLUSIONS: Although renal US has a low diagnostic yield, all adult transplant candidates should undergo this study because of the high prevalence of renal cell carcinoma in this cohort. VCUG also should be performed prior to transplantation, but it may be omitted in nondiabetic patients without voiding symptoms or a history of urinary tract infection. Transplant candidates with hematuria warrant an endoscopic evaluation, although this may not be necessary in individuals with sterile pyuria.

Adult↗
PubMed1994

Hemorrhagic cystitis in bone marrow transplantation.

OBJECTIVES: Patients undergoing bone marrow transplantation are at risk for hemorrhagic cystitis despite appropriate preventive measures. This complication could have an impact on patient survival and other outcome variables. METHODS: A retrospective study of patients subjected to bone marrow transplantation was conducted to determine risk factors for hemorrhagic cystitis and evaluate the impact of hemorrhagic cystitis on certain outcome variables. Patients who experienced hemorrhagic cystitis received various forms of therapy, at the discretion of the treating physician. RESULTS: Hemorrhagic cystitis occurred more frequently in younger patients and those undergoing allogeneic transplantation. The occurrence of hemorrhagic cystitis was associated with increased hospital costs, length of hospitalization, and mortality. Gender, race, type of malignancy, other pretransplantation comorbidity, and the occurrence of other peritransplantation complications were not associated with occurrence of hemorrhagic cystitis. CONCLUSIONS: Hemorrhagic cystitis is a significant complication of bone marrow transplantation, which influences economic and survival outcome. Since the number of bone marrow transplants being performed is increasing, urologists should be prepared to play an active role in treating patients who experience this complication.

Adolescent↗
PubMed1994

Bleeding peptic ulcer--risk factors for rebleeding and sequential changes in endoscopic findings.

From September 1991 to December 1992, a prospective study was conducted to determine the risk factors and residual risk of rebleeding, and the evolutionary endoscopic changes in peptic ulcers that rebled. Emergency endoscopies were performed on 452 patients with haematemesis or a melaena, or both within 24 hours of admission. If the lesions were actively bleeding, then the patients were treated with injection sclerotherapy. A multivariate analysis of clinical, laboratory, and endoscopic variables of 204 patients with ulcer bleeding showed that hypovolaemic shock, a non-bleeding visible vessel, and an adherent clot on the ulcer base were independently significant in predicting rebleeding (p < 0.05). Considering these three factors according to the estimates of their regression coefficients showed that a non-bleeding visible vessel was the strongest predictor of rebleeding. The study of the residual risk of rebleeding after admission showed that most rebleeding episodes (94.1%), including all associated with hypovolaemic shock, surgical treatment, and death, occurred within 96 hours of admission. After this time, the residual risk of rebleeding was less than 1%. Study of the changes in endoscopic findings before and after rebleeding illustrated that all ulcers with a visible vessel or adherent clot showed at follow up endoscopy were derived from ulcers with initial major stigmata. It is concluded that hypovolaemic shock, a non-bleeding visible vessel, and an adherent clot on an ulcer base are of independent significance in predicting rebleeding. Observation for 96 hours is sufficient to detect most rebleeding episodes after an initial bleed from peptic ulcer.

Blood Vessels↗
PubMed1994

The climate and the occurrence of carbon monoxide poisoning in Taiwan.

Taiwan is an island situated in the subtropics. The lowest average temperature is around 15 degrees C (59 degrees F) during winter). Despite the mild climate, carbon monoxide intoxication still occurs frequently, especially during the winter. We studied which meteorological factor(s) affected the occurrence of carbon monoxide poisoning in Taiwan. Retrospective data over a period from December 1, 1986, to December 31, 1991, from patients who reported with carbon monoxide poisoning to the Poison Control Center, together with meteorological data were analysed. We found that a lower daily average temperature, especially while a special regional circulation pattern, called a 'cold front' or 'cold surge' (during winter) covers the Taiwan area, is strongly related to the occurrence of CO poisoning.

Adult↗
PubMed1994

Adult respiratory distress syndrome and late death following imipramine overdose: a case report.

Adult respiratory distress syndrome (ARDS) after tricyclic antidepressant (TCA) overdose has been reported, but has not received as much attention in the literature as hemodynamic instability, cardiac arrhythmias or seizures. This report concerns a 33-year-old female who ingested a large amount of imipramine in an attempted suicide. She developed deep coma, hypotension, cardiac dysrhythmias and seizures. Although she survived initially, ARDS developed and she died of severe hypoxia nine days later. Her lung injury may have been the result of a variety of factors including prolonged hypotension, aspiration pneumonia, sepsis or a direct action on the lung parenchyma by imipramine. The literature pertaining to etiology, epidemiology, pathophysiology and management of TCA-induced lung injury has been reviewed. In one series of severe TCA overdose, an ARDS rate of 9% was reported. The risk of developing pulmonary edema and ARDS should be considered in severe TCA-poisoned patients. To try to prevent this complication, early intubation should be considered to avoid aspiration, and cautious volume loading, plus judicious use of alpha-adrenergic agonists, is indicated to prevent protracted hypotension.

Adult↗
PubMed1994

Adult Fanconi syndrome with proximal muscle weakness and hypophosphatemic osteomalacia: report of a case.

A 42-year-old female presented with progressive proximal muscle weakness, generalized hyperreflexia, marked bone pain, severe lumbago and knee arthralgia. Electromyographic study showed short-duration (5-10 msec), variable amplitude (200-2500 microV) polyphasic potentials. A muscle biopsy specimen revealed non-specific type II fiber atrophy. After a comprehensive laboratory work-up, adult Fanconi syndrome was diagnosed. The patient's symptoms, including bone pain and proximal muscle weakness, were relieved after a six-week supplement of tricalcium phosphate, vitamin D3 and sodium bicarbonate. The hyperreflexia also became less brisk.

Adult↗
PubMed1994

Prenatal diagnosis of dicephalic conjoined twins: report of a case.

Dicephalus is one of the rarest types of conjoined twins. In such cases, the twins are usually stillborn or die shortly after birth. Termination of the pregnancy is recommended if conjoined twins are diagnosed early in the second trimester. A case of dicephalic conjoined twins with cystic hygroma diagnosed prenatally by ultrasound at 16 weeks' gestation is presented. The ultrasonographic findings, management and pathology are discussed.

Adult↗
PubMed1994

Hepatitis B and hepatitis C virus infection among chronic alcoholic patients with liver disease in Taiwan.

The prevalence of the anti-hepatitis C virus (anti-HCV) antibody and hepatitis B surface antigen (HBsAg) among 123 alcoholic patients with liver disease from our hospital and 44 alcoholic subjects from the local community was evaluated. By radio-immunoassay HBsAg was detected in 30.1% of alcoholic patients with liver disease, compared with 11.4% of alcoholic subjects from the local community (p < 0.05). The prevalence of HBsAg was 40.7% (11/27) in patients with cirrhosis and hepatocellular carcinoma (HCC), 31.5% (17/54) in patients with cirrhosis only, and 29.4% (5/17) in patients with other liver diseases. By enzyme-linked immunosorbent assay, anti-HCV antibody was detected in 30.9% of alcoholic patients with liver disease, compared with 2.3% of alcoholic subjects from the local community (p < 0.0005). The prevalence of anti-HCV antibody was 44.4% in alcoholic patients with cirrhosis and HCC, 29.6% in alcoholic patients with cirrhosis only, and 17.6% in alcoholic patients with other liver diseases. As the degree of liver damage advanced, the prevalence of either HBsAg or anti-HCV antibody, or both, being detected in these alcoholic patients increased significantly (p < 0.05). The serum ALT level was higher among alcoholic patients who had either HBsAg or anti-HCV antibody than those having neither (151 +/- 204 vs 62 +/- 47 IU/L; p < 0.005). All three alcoholic patients with chronic hepatitis had positive HBsAg or anti-HCV antibody. Histologic findings, except cells within sinusoids, were comparable between the alcoholic patients with or without superimposed hepatitis viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Active, bleeding marginal ulcer of Billroth II gastric resection: a clinical experience of 18 patients.

OBJECTIVES: From July 1988 to April 1993, 18 patients with active, marginal ulcer bleeding were investigated for their clinical presentation, endoscopic findings, and successful rate of therapeutic endoscopy. METHODS: Through endoscopic survey, data on the ulcer number, ulcer location, and prevalence rate of each major stigmata of recent hemorrhage were obtained. Therapeutic methods used include heater probe thermocoagulation and local injection with diluted epinephrine (0.01%) or 95% alcohol through the endoscope. RESULTS: All patients were male with a mean age of 65.3 years. Tarry stool passage (15/18; 83.3%) was the most common clinical presentation. Fifteen patients (15/18; 83.3%) had single marginal ulcer. Ulcerations were located in the jejunal site (12/18; 66.6%) and gastro-jejunal anastomosis (5/18; 27.7%). There were two patients with spurting artery, six with nonbleeding visible vessel, two with blood clot adhesion, four with oozing, three with visible vessel-associated oozing and three, with blood clot adhesion accompanying oozing. The rate of therapeutic endoscopy to successfully stop bleeding or prevent rebleeding was 94.4% (17/18). Sixteen cases (16/17) received one session of endoscopic therapy, and one patient (1/17) accepted two sessions. One patient with multiple underlying diseases died of persistent bleeding after three sessions of therapy. No complication was found to be related to the endoscopic procedure. CONCLUSIONS: Marginal ulcer bleeding exhibits the same endoscopic findings as peptic ulcer hemorrhage. Most marginal ulcers are single and located at the saddle area of the jejunal site. Endoscopy can be useful in diagnosing marginal ulcer, and it is safe and effective in managing active marginal ulcer bleeding.

Aged↗