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Biomedical subjects

C H Yang

Publications and source records attributed to C H Yang.

At least 145 records · Page 8Linked to original sources
PubMed1997

Clinical experience of HIV/AIDS in a municipal hospital in Taiwan.

To describe the spectrum of epidemiological and major clinical manifestations of patients infected by human immunodeficiency virus type 1 (HIV-1) in a municipal hospital, a retrospective review was done of 53 HIV-1-infected patients who had been admitted to Taipei Municipal Jen-Ai Hospital between January 1990, and July 1996. The majority (94.3%) of the patients in the cohort were male. Peak incidence was found in the fourth decade (28.3%). Forty-four (83%) patients presented in the first hospital stay with acquired immunodeficiency syndrome (AIDS). The mean duration between establishment of diagnosis of HIV-1 infection and that of AIDS was 11.2 (0-84) months. Heterosexual transmission accounted for 54.7% of the infections in the study group, and bi-/homosexual men made up another 32%. Psychosis of new onset was noted in two patients. In all AIDS indicator conditions, Pneumocystis carinii pneumonia (PCP) was the leading opportunistic infection among AIDS patients. PCP was also on the top of initial manifestations of HIV-1 infection. One patient with Penicillium marneffei infection was diagnosed to have AIDS. The mean CD4 count at admission of AIDS patients was much lower than that of non-AIDS patients (32 vs. 297/microliter, p < 0.0005). During the follow-up period 24 of 53 patients died. Mean survival time of 23 expired patients after establishment of diagnosis of AIDS was 6.4 (0-29) months. The results indicated that males outnumbered females greatly in the number of cases. Sexual activity remained the most important route of infection. Psychosis of new onset may be an early manifestation of HIV-associated encephalopathy and requires more attention. In addition, the outcome was poor as most patients in this area did not become aware of risk of HIV-1 infection until they were seriously illed with full-blown AIDS that they would seek medical help. PCP was the most common incentive for medical consultation. Penicillium marneffei infection is endemic in southeast Asia, and should be classified as an AIDS indicator condition in Taiwan.

AIDS-Related Opportunistic Infections↗
PubMed1997

Haplotyping of mitochondrial DNA in the D-loop region by PCR: forensic application.

A rapid and simple method using restriction enzymes to detect the restriction fragment length polymorphism (RFLP) pattern of hypervariable segment 1 in the D-loop region of human mitochondrial DNA (mtDNA) was developed. We first focused on the investigation of variations of DNA sequence in the D-loop region among Chinese subjects, as well as on the determination of RFLP patterns of each restriction enzyme. Seven restriction enzymes were used to digest a 618 bp polymerase chain (PCR) reaction product of the D-loop region of mtDNA. Frequency distribution of RFLP patterns of each restriction enzyme among 145 unrelated Chinese subjects in Taiwan was also established. For the purposes of practical forensic application, a routine typing system was designed on the basis of the RFLP data. Two short hypervariable, mtDNA fragments, which were contained within the 618 bp region, were selected for this purpose. In this haplotyping system, a 281 bp PCR-amplified DNA product was analyzed by five restriction enzymes: Mnl I, Nla III, Rsa l, Mse I and Hinf I, and a 237 bp fragment was analyzed by Kpn I. The RFLP patterns were determined by agarose gel electrophoresis of the restriction enzyme-digested DNA fragments. Six restriction enzymes. Mul I, Nla III, Rsa I. Msc I, Hinf I and Kpn 1, defined eight, four, four, five, two and four polymorphic patterns, respectively among the 145 Chinese subjects. The RFLP patterns of restriction fragments for each individual were systematically analyzed and the mtDNAs of the 145 Chinese subjects were grouped into 52 haplotypes. This PCR-RFLP haplotyping system revealed a high degree of variability and diversity of segment I in the D-loop region of human mtDNA. The power of discrimination and allelic diversity values were 0.923 and 0.929, respectively. Successful application of this haplotyping system in a murder case is also discussed.

DNA, Mitochondrial↗
PubMed1997

MVP (mitomycin-C, vinblastine, cisplatin) salvage chemotherapy for relapsed and refractory metastatic breast cancer.

Salvage chemotherapy for relapsed and refractory metastatic breast cancer is a challenging issue for oncologists. At our institution, the combination of mitomycin-C, vinblastine and cisplatin (MVP) is used for treatment. The records of 19 consecutive patients with refractory metastatic breast cancer treated with MVP between April 1992 and October 1995 were reviewed. The regimen consisted of mitomycin-C 6 mg/m2, vinblastine 6 mg/m2 and cisplatin 60 mg/m2, repeated every 3 to 4 weeks. The median age of patients was 49 years (range, 35-71 yr). All patients had clinically measurable or evaluable disease and a Karnofsky's performance status greater than or equal to 50%. The median number of prior chemotherapy regimens was two (range, 1-4). Eighteen (94.7%) patients had previously received an anthracycline/anthracenedione-containing regimen, and seven (36.9%) had progression of disease during these therapies. Sixteen patients had two or more sites of metastasis and 17 patients had visceral disease. The median duration of follow-up was 26 months. A mean of 3.5 courses (range, 1-7) was administered. One patient was lost to follow-up after one course of treatment. Of the remaining 18 patients, two complete and five partial responses were observed, for a total response rate of 37% (range, 17-61%, 95% CI). One of the partial responders had disease progression during anthracycline treatment. Treatment-related toxicities were relatively well tolerated. There were no treatment-related deaths. The median duration of response was 3 months (range, 2-11 mo). The median overall survival was 7 months (range, 1-32 mo). Our data suggest that the MVP regimen is an effective palliative treatment for patients with refractory metastatic breast cancer.

Adult↗
PubMed1997

Impact of aging on rat urinary bladder fatigue.

PURPOSE: Little is known about the fatigability of the urinary bladder. In these experiments, we characterized contractile and bioenergetic changes in bladder fatigue and investigated the impact of aging on these changes. MATERIALS AND METHODS: Whole urinary bladders from 3-month-old (n = 17) and 24-month-old (n = 12) SD rats were isolated and individually mounted in organ baths. The bladders were electrostimulated repeatedly (50 volts, 32 Hz, 1 MS; every 2.5 minutes). The pressure generation, rate of pressure generation and the emptying ability (% volume emptied) of the isolated bladders were measured with each stimulation. After the 20th electrostimulation, the bladders were immediately stimulated with 500 microM bethanechol. Upon completion of their series of stimulations, some of the bladders were quickly frozen in liquid nitrogen. Tissue phosphocreatine and ATP content of the frozen bladders and a group (six 3-month-old and six 24-month-old rats) of fresh bladder tissues was determined using high performance liquid chromatography (HPLC). RESULTS: The results can be summarized as follows: (1) Pressure generation, rate of pressure generation and emptying ability were gradually reduced in both young and aged bladders as repeated stimulation proceeded. (2) The final bethanechol stimulation emptied the same intravesical volume as the 20th electrostimulation emptied (in both groups), indicating that bladder fatigue is due to a post-synaptic mechanism. (3) As compared to their own first responses, aged rats exhibited significantly greater rates of reduction in both pressure generation and emptying ability than did young rats. (4) Analysing fresh bladder tissues, the phosphocreatine and ATP concentration of the aged bladders were significantly less than those of the young bladders-13.2 +/- 2.0 and 1.2 +/- 0.3 nmol/mg. protein respectively in the aged bladders vs. 21.2 +/- 1.8 and 7.5 +/- 1.0 nmol/mg. protein respectively in the young bladders. After repeated stimulation, phosphocreatine and ATP concentration were reduced in both groups (1.4 +/- 0.3 and 0.43 +/- 0.1 nmol./mg. protein in the aged bladders, 7.5 +/- 1.4 and 4.1 +/- 0.5 nmol./mg. protein in the young bladders), with a greater degree of reduction in the aged bladders. CONCLUSION: These observations indicate that, in response to repeated electrostimulation, aged rat bladders became fatigued faster than young bladders. Decreased capability in energy production might be one contributing factor for faster fatiguability of the aged urinary bladders.

Aging↗
PubMed1997

Capgras' syndrome in a patient with vascular dementia: a case report.

Capgras' syndrome is characterized by a subjective certainty that a familiar person has been replaced by an identical double. This syndrome has been observed in psychiatric and neurological diseases, and has been reported in several cases of dementia of the Alzheimer type. Here, we present a patient with vascular dementia in whom Capgras' syndrome developed in the early stages of dementia, and who exhibited violence. This case suggests that Capgras' syndrome can occur in vascular dementia. In older patients with this syndrome, dementia should also be considered in its differential diagnosis. In addition, patients with Capgras' syndrome should be evaluated for violent potential.

Aged↗
PubMed1997

Major depressive disorder with delusion of having AIDS: a case report.

Acquired immune deficiency syndrome (AIDS) has become a topic of increasing public concern. Several conditions have been described in patients who are afraid that they have acquired AIDS, including depression, somatization disorders, hypochondriasis, adjustment disorders and various psychoses. This paper presents a case study of a young man with persistent fear of having AIDS. In spite of negative HIV test results, the patient still insisted that he suffered from AIDS. The psychiatric diagnosis was major depressive disorder with delusion of having AIDS. The patient was treated with fluoxetine 40 mg qd and sulpiride 400 mg qn. After two weeks on medication, his fear of AIDS subsided and he improved remarkably. The most important intervention in patients with delusion of having AIDS is to identify and treat the underlying psychopathology. The following case is representative of our experience.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Low-flow anesthesia in adult orthotopic liver transplantation: a preliminary clinical experience.

BACKGROUND: Anesthesia in orthotopic liver transplantation (OLT) may carry with complex hemodynamic, body temperature, and metabolic alterations. Although OLT cases increased in recent years in Taiwan, experiences remained limited. Notable advantage of low flow anesthesia may include reduced consumption of anesthetic gases and vapors, reduced environmental pollution and cost-saving. This study investigated patient profiles and the feasibility of low-flow rebreathing technique for adult orthotopic liver transplantation. METHODS: Since June 1996, there were six OLT patients who received low flow anesthesia with isoflurane. All patients received hepatic veno-venal anastmosis (so-called piggy back procedure). Two patients were excluded from this study because of different surgical procedure (total occlusion of inferior vena cava and inferior vena cava veno-venal anastmosis). During maintenance of anesthesia, isoflurane was carried by a mixture of oxygen and air at a total fresh gas flow of 0.6 L/min. Alongside with the standard anesthesia machine and physiologic monitors, a newly designed Swan-Ganz catheter was introduced to measure and record cardiac output, systemic vascular resistance, pulmonary artery pressure, central venous pressure, and core temperature in a real-time manner. Blood samples were collected at 6 predetermined time-points in each patient for analysis of arterial blood gases, electrolytes, lactate and glucose concentrations. RESULTS: The anesthetic time was 916 +/- 26 min (900 to 930 min). All patients regained their consciousness within 30 min after completion of surgery. The hemodynamics were relatively stable except after reperfusion of the liver. There was a significant decrease in mean arterial blood pressure, which occurred with accompaniment of a reduction of systemic vascular resistance and increased cardiac output. Arterial blood gas, electrolyte, and glucose were, however, maintained within acceptable limits. Blood lactate was progressively increased and reached its peak after reperfusion of the liver until the end of surgery. The core temperature was well maintained above 34 degrees C. No patient developed hypoxia or hypercapnia. CONCLUSIONS: Low-flow rebreathing anesthetic technique maintained acceptable patient profiles and good body temperature preservation in orthotopic liver transplantation. These characteristics make it a promising method in maintenance of anesthesia for OLT.

Adult↗
PubMed1997

Propofol anesthesia in a patient with Isaacs syndrome--report of a case and literature review.

Isaacs syndrome is an unusual lower motor neuron disease characterized by myokymia (muscle twitching), muscular stiffness, and decreased tendon reflexes. We reported a patient who was affected with this rare disease, with manifestation of involuntary muscular contractions and required general anesthesia for bilateral tonsillectomies. Understanding the presentation and characterization of this unusual disease may be helpful in making choice of anesthetics or anesthetic techniques. Its possible mechanisms of action and its specific considerations in anesthesia in the literature are reviewed and discussed.

Adult↗
PubMed1996

A chromosomal locus required for copper resistance, competitive fitness, and cytochrome c biogenesis in Pseudomonas fluorescens.

A chromosomal locus required for copper resistance and competitive fitness was cloned from a strain of Pseudomonas fluorescens isolated from copper-contaminated agricultural soil. Sequence analysis of this locus revealed six open reading frames with homology to genes involved in cytochrome c biogenesis in other bacteria, helC, cycJ, cycK, tipB, cycL, and cycH, with the closest similarity being to the aeg-46.5(yej) region of the Escherichia coli chromosome. The proposed functions of these genes in other bacteria include the binding, transport, and coupling of heme to apocytochrome c in the periplasm of these Gram-negative bacteria. Putative heme-binding motifs were present in the predicted products of cycK and cycL, and TipB contained a putative disulfide oxidoreductase active site proposed to maintain the heme-binding site of the apocytochrome in a reduced state for ligation of heme. Tn3-gus mutagenesis showed that expression of the genes was constitutive but enhanced by copper, and confirmed that the genes function both in copper resistance and production of active cytochrome c. However, two mutants in cycH were copper-sensitive and oxidase-positive, suggesting that the functions of these genes, rather than cytochrome c oxidase itself, were required for resistance to copper.

Amino Acid Sequence↗
PubMed1996

Alagille syndrome with interstitial 20p deletion derived from maternal ins(7;20).

We present a 6-year-old Chinese boy with Alagille syndrome and an interstitial 20p deletion, with a karyotype of 46,XY,der(20)dir ins(7;20)(q11.23;p11.23p12.2 or p12.2p13)mat. He had a peculiar face and suffered from congenital heart disease, growth retardation, severe cholestasis, hepatosplenomegaly, and impaired renal function. The karyotype of his mother showed a balanced translocation, 46,XX,dir ins(7;20)(q11.23; p11.23p12.2 or p12.2p13), and her phenotype was normal. His dead elder brother was highly suspected as another victim of Alagille syndrome. The findings in the present family suggested that if Alagille syndrome is a single gene defect, the putative gene responsible for the syndrome would not be located at the insertion breakpoints but located within the deletion extent.

Alagille Syndrome↗
PubMed1996

Direct association of STAT3 with the IFNAR-1 chain of the human type I interferon receptor.

Based on the reports of the activation of the transcription factor known as STAT3 (for signal transducers and activators of transcription) or APRF (for acute phase response factor) by various cytokines, we investigated the possible role of STAT3 in type I interferon (IFN) receptor signaling. We show that STAT3 undergoes IFNalpha-dependent tyrosine phosphorylation and IFNalpha treatment induces protein-DNA complexes that contain STAT3. In addition, STAT3 associates with the IFNAR-1 chain of the type I receptor in a tyrosine phosphorylation-dependent manner upon IFNalpha addition. The binding of STAT3 to the IFNAR-1 chain occurs through a direct interaction between the SH2 domain-containing portion of STAT3 and the tyrosine-phosphorylated IFNAR-1 chain. Furthermore, tyrosine-phosphorylated STAT3 bound to the IFNAR-1 chain also undergoes a secondary modification involving serine phosphorylation. This phosphorylation event is apparently mediated by protein kinase C, since it was blocked by low concentrations of the protein kinase inhibitor H-7. The biological relevance of IFN activation of STAT3 is further illustrated by the finding that STAT3 is not activated by IFN in a cell line resistant to the antiviral and antiproliferative actions of IFN alpha but in which other components of the JAK-STAT pathway are activated by IFNalpha.

Base Sequence↗
PubMed1996

p150TSP, a conserved nuclear phosphoprotein that contains multiple tetratricopeptide repeats and binds specifically to SH2 domains.

Src homology 2 (SH2) domains are structural modules that function in the assembly of multicomponent signaling complexes by binding to specific phosphopeptides. The tetratricopeptide repeat (TPR) is a distinct structural motif that has been suggested to mediate protein-protein interactions. Among SH2-binding phosphoproteins purified from the mouse B cell lymphoma A20, a 150-kDa species was identified and the corresponding complementary DNA (cDNA) was molecularly cloned. This protein encoded by this cDNA, which we have termed p150TSP (for TPR-containing, SH2-binding phosphoprotein), is located predominantly in the nucleus and is highly conserved in evolution. The gene encoding p150TSP (Tsp) was mapped to chromosome 7 of the mouse with gene order: centromere-Tyr-Wnt11-Tsp-Zp2. The amino-terminal two-thirds of p150TSP consist almost entirely of tandemly arranged TPR units, which mediate specific, homotypic protein interactions in transfected cells. The carboxyl-terminal third of p150TSP, which is serine- and glutamic acid-rich, is essential for SH2 binding; this interaction is dependent on serine/threonine phosphorylation but independent of tyrosine phosphorylation. The sequence and binding properties of p150TSP suggest that it may mediate interactions between TPR-containing and SH2-containing proteins.

Amino Acid Sequence↗
PubMed1996

Prenatal diagnosis in a Chinese family with type Ia glycogen storage disease by PCR-based genetic analysis.

Type Ia glycogen storage disease (GSD), an autosomal recessive metabolic disorder, is caused by a deficiency in glucose-6-phosphatase (G6Pase). We had previously identified the nature of the causative mutations in a Chinese family whose first two children were affected with type Ia GSD. Two different point mutations in the G6Pase gene, a guanine to adenine substitution at base position 327 in exon 2 and a thymine to adenine substitution at base position 1101 in exon 5, change the restriction sites for the enzymes Fok I and Hinc II. Family study revealed that both parents were heterozygous carriers: the father with a mutant G6Pase allele at exon 2 and the mother with another mutant G6Pase allele at exon 5. This paper deals with a prenatal diagnosis on the fetus of this family who is at risk of type Ia GSD. Genomic DNA was extracted from a chorionic villus biopsy sampled at the tenth week of gestation. Exons 2 and 5 of the G6Pase gene were amplified by the polymerase chain reaction (PCR) followed by restriction enzyme digestion and direct sequence analysis. DNA analysis indicated that the fetus was a heterozygous carrier of type Ia GSD with a mutant G6Pase allele at exon 2 and a normal G6Pase allele at exon 5. The diagnosis was further confirmed by the same method with cultured amniocytes and with a blood sample after the baby was born. This is the first report of prenatal carrier detection of type Ia GSD at the gene level.

Chorionic Villi Sampling↗
PubMed1996

Overexpression of p53 is not a feature of ovarian granulosa cell tumors.

The p53 tumor suppressor gene has been extensively studied in various human tumors including epithelial ovarian cancers. However, little is known about the expression of this gene in ovarian granulosa cell tumors, the most common histologic type of sex cord-stromal tumors. We investigated whether overexpression of the p53 gene product occurs in this specific ovarian tumor. Nineteen patients with ovarian granulosa cell tumors were recruited in this study. Immunohistochemical staining for the p53 protein with monoclonal antibody PAb 1801 was performed in the paraffin-embedded tissue of each case to screen for p53 overexpression. Among the 19 ovarian granulosa cell tumors, there was only one well-differentiated tumor found to have nuclear immunoreactivity in a small fraction of tumor cells. Polymerase chain reaction--single-stranded conformation polymorphism was used to study the tumor showing focal p53 positivity, but no mobility shift was noted from exon 4 through exon 9 of the p53 gene. On the basis of this observation, we propose that alteration of the p53 tumor suppressor gene is not a common finding in ovarian granulosa cell tumors.

Adolescent↗
PubMed1996

High complete response rate of concomitant chemoradiotherapy for locally advanced squamous cell carcinoma of the uterine cervix.

A prospective study with a newly designed schedule of concomitant chemoradiotherapy was initiated for 42 patients with previously untreated squamous cell carcinoma of the uterine cervix. Their ages ranged from 34 to 77 years, median 57 years. There were 13 FIGO stage IIB, 1 IIIA, 27 IIIB, and 1 IVA. Radiotherapy was administered using 1.8 Gy/day, 5 days a week, to the whole pelvis (50.4 Gy/28 fractions) with local boost if indicated. Intracavitary brachytherapy of 5 Gy for five times was delivered after 1-2 weeks of rest. The first 21 patients received concomitant chemotherapy of biweekly PEB regimen (100 mg/m2 etoposide + 50 mg/m2 cisplatin + 50 mg/m2 bleomycin) for two to three cycles during external irradiation. The chemotherapy for the latter 21 patients was modified to weekly PEBF (50 mg/m2 etoposide + 20 mg/m2 cisplatin + 10 mg/m2 bleomycin + 800 mg/m2 5-FU, mixed in normal saline, 24-hr continuous iv infusion) for five to six cycles. All except 1 patient achieved complete response (97.6%) and sustain so after a median follow-up time of 30 months. There were three relapses--one with persistent pelvic disease and two with distant metastasis. Two-year overall survival and disease-free survival rates were 97.6 and 92.9%, respectively. Myelosuppression was moderate but fully recovered. Other acute toxicities were tolerated except for 1 patient who encountered grade IV radiation colitis with cecum perforation and required surgery. As to late morbidity, the incidence of radiation proctitis was high (21.4%) but of a mild degree, with 1 patient needing repeated transfusion. One patient developed chronic cystitis with an acontractile bladder. Our preliminary results show that concomitant chemoradiotherapy for advanced cervical carcinoma is both feasible and effective with acceptable toxicities. Further follow-up is mandatory to ensure whether this high complete response protocol will translate into long-term local control and survival.

Adult↗
PubMed1996

Carbachol induces inward current in neostriatal neurons through M1-like muscarinic receptors.

The effects of carbachol on rat neostriatal neurons were examined in the slice and the freshly dissociated neuron preparations using intracellular and whole-cell voltage-clamp recording methods. Superfusion of carbachol (30 microM) produced a depolarization concomitant with an increase in the rate of spontaneous action potentials. This depolarization was associated with an increase in the input resistance. The carbachol-induced membrane depolarization was blocked by pirenzepine (1 microM), a selective M1 muscarinic receptor antagonist. In other experiments, we observed that carbachol induced a transient inward current on the freshly dissociated neostriatal neuron at a holding potential of -60 mV in a concentration-dependent manner underlying the whole-cell voltage-clamp mode. The inward current caused by carbachol was not reduced by tetrodotoxin (1 microM), calcium-free recording solution or Cd2+ (100 microM). However, it was blocked by Ba2+ (100 microM). In addition, the carbachol-induced inward current reversed polarity at about the potassium equilibrium potential. The whole-cell membrane inward current in response to voltage-clamp step from -90 to -140 mV was reduced by 30 microM carbachol. With stronger hyperpolarization beyond the potassium equilibrium potential, carbachol produced a progressively greater reduction in membrane current. This inhibitory effect was also abolished by Ba2+ (100 microM). A concentration of 30 microM carbachol-induced inward current could be reversibly antagonized by the M1 muscarinic receptor antagonist pirenzepine (0.1-1 microM), with an estimated IC50 of 0.3 microM. However, other muscarinic receptor subtype (M2 or M3) antagonists could also block the carbachol-induced inward current. The rank order of antagonist potency was: pirenzepine (M1 antagonist) > 4-diphenylacetoxy-N,N-methyl-piperidine methiodide (M3/M1 antagonist) > gallamine (M2 antagonist). Based on these pharmacological data, we concluded that carbachol can act at M1-like muscarinic receptors to reduce the membrane K+ conductances and excite the neostriatal neurons.

Animals↗