Hepatic artery reconstruction using microsurgical technique in liver transplantation.
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Adolescent↗
Biomedical subjects
C L Chen
Publications and source records attributed to C L Chen.
Postoperative morbidity and mortality of pancreaticoduodenectomy for periampullary cancer.
OBJECTIVE: To find out factors that may influence the mortality after Whipple's operation, whether duct to mucosa anastomosis is better than classic "dunking" pancreaticojejunostomy and whether age over 70 is a contraindication for this procedure. DESIGN: Prospectively randomised study. SETTING: Teaching hospital, Taiwan, R.O.C. PATIENTS: 93 patients with periampullary cancer undergoing Whipple's operation were randomly divided into two groups. Forty-six with periampullary cancer underwent invaginating pancreaticojejunostomy, and 47 patients underwent duct to mucosa anastomosis for reconstruction. MAIN OUTCOME MEASURES: Mortality and morbidity were compared between two groups. RESULTS: The over all mortality was 8% (7/93). An albumin concentration of less than 30 g/L before operation and operative blood loss influenced the surgical mortality both in the univariate and multivariate analysis. Age over 70 years was not a factor. Patients with duct to mucosa anastomoses had a leak rate of 4% (2/47), morbidity of 21% (10/47) and mortality of 6% (3/47). Patients with an invaginated pancreaticojejunostomy had a leak rate of 15% (7/46), morbidity of 33% (15/46), and mortality of 9% (4/46). The need for total parenteral nutrition in the invaginated group (33%) was statistically greater than in the other group (11%) (p = 0.01). CONCLUSIONS: The morbidity and mortality of pancreaticoduodenectomy for periampullary cancer although slightly greater for patients over the age of 70 are acceptable. The factors that may influence the mortality are an albumin concentration of less then 30 g/L and the amount of blood lost during operation. The duct to mucosa anastomosis is a safe procedure, which has a lower leak rate and less need for total parenteral nutrition than pancreaticojejunostomy.
Adult↗
[The study on the in-vitro stability of Tc(V)-99m dimercaptosuccinic acid].
Tc(V)-99m DMS, developed by Yokoyama et al. in 1981, has been recognized to be advantageous for the scintigraphic diagnosis of various malignant tumors and their metastasis, the aim of this study is to assess the in-vitro stability of Tc(V)-99m DMS. Thin-layer chromatography, including paper chromatography and silica gel thin layer chromatography, is performed to determine the change of radiochemical species presented in the reconstituted solution of Tc(V)-99m DMS prepared from the DMS kit (Institute of Nuclear Energy Research, Atomic Energy Council R.O.C.) and the commercial DMSA kit (Nephroscint, IRE CELLTARG Radiopharmaceuticals Japan). The bioscan imaging scanner is used to measure the Rf value and labeling efficiency of radiochemical species on the chromatographic strip. The in-vitro stability of Tc(V)-99m DMS prepared from the DMS kit and the commercial DMSA kit is studied by examining various parameters which include temperature(degree C) and time(hr) after reconstitution. The results show that the in-vitro stability of Tc(V)-99m DMS prepared from the DMS kit is actually better than that from the commercial DMSA kit. The one-step labeling method of DMS kit is much simpler than the two-step labeling method of DMSA kit.
Drug Stability↗
Alteration of enteroendocrine and neuropeptides in graft after intestinal transplantation in dogs.
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Animals↗
Etiology of lymphadenopathy in patients with AIDS in Taiwan.
From 1986 to 1995, we retrospectively reviewed the records of 40 of 125 patients (32.0%) with acquired immunodeficiency syndrome (AIDS) who presented with extrainguinal lymphadenopathy. Most of the patients had an advanced stage of HIV infection with a mean CD4 lymphocyte count of 44/mm3. AIDS-defining opportunistic infections and malignancies were present in most patients and the neck region was the most common site of involvement. The etiology of lymphadenopathy was established in 26 patients. Tuberculous lymphadenitis was the most common cause, followed by lymphadenopathic Kaposi's sarcoma, benign reactive hyperplasia, cryptococcal lymphadenitis and disseminated Mycobacterium avium complex infection. Characteristic histopathologic findings were detected in 19 patients and 7 had presumptive tuberculous infections. The remaining 14 patients had no definitive etiology for their lymphadenopathy. As the causes are variable and the number of HIV/AIDS cases is increasing in Taiwan, more patients with lymphadenopathy, especially in the early stages of HIV infection will be encountered. Therefore, it is essential that diagnostic histopathologic and microbiologic studies be performed for appropriate and timely treatment.
Acquired Immunodeficiency Syndrome↗
[Cardiac arrest during transurethral resection of the prostate].
Due to the development of anesthetic drugs and techniques, and the progress of monitor system. The rate of cardiac arrest during anesthesia has declined during the last decades. We report two cases of sudden cardiac arrest which happened during transurethral resection of the prostate, and discuss the mechanism, treatment, and the methods of prevention.
Adult↗
Transposon mutagenesis and cloning of the genes encoding the enzymes of fengycin biosynthesis in Bacillus subtilis.
A total of 20 Bacillus subtilis F29-3 mutants defective in fengycin biosynthesis was obtained by Tn917 mutagenesis. Cloning and mapping results showed that the transposon in these mutants was inserted in eleven different locations on the chromosome. We were able to use the chromosomal sequence adjacent to the transposon as a probe to screen for cosmid clones containing the fengycin biosynthesis genes. One of the clones obtained, pFC660, was 46 kb long. Eight transposon insertion sites were mapped within this plasmid. Among the eleven different mutants analyzed, four mutants had Tn917 inserted in regions which encoded peptide sequences similar to part of gramicidin S synthetase, surfactin synthetase, and tyrocidine synthetase. Our results suggest that fengycin is synthesized nonribosomally by the multienzyme thiotemplate mechanism.
Adenosine Triphosphatases↗
Clinical significance of intratumoral blood flow in cervical carcinoma assessed by color Doppler ultrasound.
BACKGROUND: Much evidence has suggested that vascular density reflects the clinical behavior of cancer. In this study, the intratumoral blood flow in cervical carcinomas was assessed by transvaginal color Doppler ultrasound, and its clinical significance was evaluated. METHODS: Sixty-five patients with Stage Ib-IIb cervical carcinoma exhibiting visible cervical tumor by transvaginal ultrasound were enrolled. All patients were scheduled for radical hysterectomy and pelvic lymph node dissection. Transvaginal color Doppler ultrasound was performed before surgery to search for blood flow signals from the tumor and the main uterine artery. The corresponding arterial resistance index (RI) was calculated. Clinical and pathologic data were recorded. A cytokinetic study was performed by propidium iodide staining and flow cytometry. The human papillomavirus (HPV) status was assessed by polymerase chain reaction. RESULTS: Intratumoral blood flow was detected by color Doppler ultrasound in 46.2% (30/65) of the tumors. Patients with detectable intratumoral blood flow exhibited significantly more pelvic lymph node metastasis (10/30 vs. 2/35, P = 0.005), a higher percentage of cancer cells in the S- + G2M-phase (30.02 +/- 18.54% vs. 19.35 +/- 11.21%, P < 0.005), and a higher prevalence of HPV infection (30/30 vs. 25/35, P = 0.001) when compared with those without intratumoral blood flow. No significant difference was observed concerning the patient's age, tumor size, clinical staging, histologic type, and DNA ploidy status between these two groups. Regression analysis of the intratumoral RI value on the S- + G2M-phase fraction showed linear regression (n = 30, r2 = 0.501, P < 0.01). The RI values of the main uterine artery showed no significant difference between these two groups. CONCLUSION: The intratumoral blood flow by transvaginal color Doppler ultrasound correlated well with a higher proliferation index, higher incidence of HPV infection, and pelvic lymph node metastasis in cervical carcinoma.
Adult↗
Identification and analysis of the expression of CD8 alpha beta and CD8 alpha alpha isoforms in chickens reveals a major TCR-gamma delta CD8 alpha beta subset of intestinal intraepithelial lymphocytes.
Expression screening has been used to clone cDNAs encoding the alpha- and beta-chains of chicken CD8. Amino acid sequence similarities with the mammalian sequences were about 30%. Many amino acid residues of structural or functional importance were more highly conserved, as were the overall structures of both chains. Like human CD8 alpha, the chicken alpha-chain lacked sites for N-linked glycosylation, but the beta-chain contained three such sites. In COS cells transfected with CD8 beta cDNA, surface expression of the beta-chain was dependent on co-transfection of the alpha-chain cDNA, indicating that, as in mammals, chicken CD8 can be expressed as a CD8 alpha alpha homodimer or as a CD8 alpha beta heterodimer. Immunofluorescence analysis with mAbs that were shown to identify the CD8 alpha- and CD8 beta-chains revealed that the vast majority of the CD8+ cells in the thymus, spleen, and blood of adult chickens express both CD8 alpha- and CD8 beta-chains. However, a relatively large proportion of the CD8+ TCR-gamma delta cells in the spleens of embryos and young chicks express only the alpha-chain of CD8. Among intestinal epithelial lymphocytes the major CD8+ T cell populations present in mice are conserved, but there is a population of TCR-gamma delta CD8 alpha beta cells that is not found in rodents. This observation is important in interpretation of experiments examining the pathways of development of intestinal intraepithelial lymphocytes in chickens.
Amino Acid Sequence↗
Cloning and identification of amino acid residues of human phospholipase C delta 1 essential for catalysis.
In vitro single point mutagenesis, inositol phospholipid hydrolysis, and substrate protection experiments were used to identify catalytic residues of human phosphatidylinositide-specific phospholipase C delta 1 (PLC delta 1) isolated from a human aorta cDNA library. Invariant amino acid residues containing a functional side chain in the highly conserved X region were changed by in vitro mutagenesis. Most of the mutant enzymes were still able to hydrolyze inositol phospholipid with activity ranging from 10 to 100% of levels in the wild type enzyme. Exceptions were mutants with the conversion of Arg338 to Leu (R338L), Glu341 to Gly (E341G), or His356 to Leu (H356L), which made the enzyme severely defective in hydrolyzing inositol phospholipid. Phospholipid vesicle binding experiments showed that these three cleavage-defective mutant forms of PLC delta 1 could specifically bind to phosphatidylinositol 4,5-bisphosphate (PIP2) with an affinity similar to that of wild type enzyme. Western blotting analysis of trypsin-treated enzyme-PIP2 complexes revealed that a 67-kDa major protein fragment survived trypsin digestion if the wild type enzyme, E341G, or H356L mutant PLC delta 1 was preincubated with 7.5 microM PIP2, whereas if it was preincubated with 80 microM PIP2, the size of major protein surviving was comparable to that of intact enzyme. However, mutant enzyme R338L was not protected from trypsin degradation by PIP2 binding. These observations suggest that PLC delta 1 can recognize PIP2 through a high affinity and a low affinity binding site and that residues Glu341 and His356 are not involved in either high affinity or low affinity PIP2 binding but rather are essential for the Ca(2+)-dependent cleavage activity of PLC.
Amino Acid Sequence↗
Prognostic factors of resectable intrahepatic cholangiocarcinoma.
Intrahepatic cholangiocarcinoma is a rare disease. The prognostic factors of resectable cholangiocarcinoma have not been previously reported. Nineteen patients (10M, 9F) with resectable cholangiocarcinoma were investigated to find factors that might influence prognosis. The cumulative survival rate was measured using the Kaplan-Meier method. The log-rank test was used to compare two survivals. Age, sex, tumor size, and positive tissue carcinoembryonic antigen were factors that had no influence on prognosis. Patients with a positive HLA-DR, a well-differentiated carcinoma, and a clear resective margin had better prognoses but were statistically undifferentiatable from the other patients. Patients with positive hilar lymph nodes had poor prognoses (P < 0.01), whereas patients with positive mucobilia had good prognoses (P < 0.05). Positive staining for HLA-DR on tumor cells was observed in nine of 19 cases of intrahepatic cholangiocarcinoma. The positive HLA-DR staining correlated with a better prognosis, but no significant difference was noted between the positive and negative HLA-DR staining group. A positive hilar lymph node was a grave sign, as almost all patients of positive lymph node died within 9 months after operation. Positive mucobilia was a good prognostic sign that correlated with the long-term survival.
Bile Duct Neoplasms↗
Increased expressions of CD69 and HLA-DR but not of CD25 or CD71 on endometrial T lymphocytes of nonpregnant women.
To investigate lymphocyte subpopulations and the status of T-cell activation at different phases of the menstrual cycle, lymphocytes in endometrial tissue were analyzed by dual-color flow cytometry in 39 patients. Compared with peripheral blood, the lymphocytes in the endometrium had a higher CD3-/(CD56+ or CD16+) ratio (25.2% +/- 6.8% vs 11.1% +/- 7.0%), but an inverted CD3+ CD8-/CD3+ CD8+ ratio (0.5 vs 1.8) and a minimal amount of B cells (3.3% +/- 3.1%). TcR gamma delta + T cells accounted for a minor proportion (7.8% +/- 5.1%) in endometrium. The proportions of TcR alpha beta + (85.0% +/- 6.6%) and CD3+ CD56+ (7.4% +/- 4.4%) endometrial T lymphocytes were found significantly different from those in peripheral blood (89.1% +/- 5.6% and 3.8% +/- 3.4%, respectively). As the endometrium proceeded from proliferative phase to luteal phase, the proportion of CD3+ CD8+ T cells in peripheral blood increased from 35.6% +/- 6.9% to 41.3% +/- 8.4% and CD3+ CD8- T cells decreased from 64.4% +/- 6.9% to 58.7% +/- 8.4%. The endometrial T cells expressed high levels of CD69 (84.1% +/- 18.9%) and DR (75.9% +/- 9.7%), but rarely expressed CD25 (7.0% +/- 5.4%) and CD71 (2.8% +/- 1.8%). The patterns of expression of these activation markers were similar in both proliferative and luteal phases. Our observations suggest that endometrial T lymphocytes are in a state of recent and persistent activation. Lymphocytes expressing the NK cell markers (CD56 or CD16) and CD8+ accounted for a significant proportion, suggesting that they may play important roles in local defense.
Adult↗
Beef tallow, but not corn bran or soybean polysaccharide, reduces large intestinal and fecal bile acid concentrations in rats.
Diets high in fat and low in dietary fiber have been associated with a higher incidence of colon cancer, possibly by increasing bile acid concentration in the colon. Therefore changes in bile acid metabolism due to beef tallow, corn bran (CB), and soy polysaccharide (SP) feeding were studied. Rats were fed one of four diets for six weeks: 5% beef tallow fiber-free (LF), 20% beef tallow fiber-free (HF), 20% beef tallow with CB (HFCB), and 20% beef tallow with SP (HFSP). HF increased fecal output compared with LF, and HFCB and HFSP increased fecal output compared with HF. HF reduced fecal bile acid concentration by two-thirds compared with LF, although daily bile acid excretion was similar. There was a tendency toward a smaller bile acid quantity in the small intestine with HF than with LF. Neither fiber altered total fecal bile acid concentration or small intestinal bile acid quantity compared with HF. However, 7 alpha-dehydroxylase activity in the colon was lower with HFSP than with HFCB. Increasing dietary beef tallow from 5% to 20% in animals fed a fiber-free diet greatly reduced the concentration of bile acids in the large intestine and feces, an effect associated with a reduced risk of colon cancer.
Animals↗
Role of the transcription factor C/EBP beta in expression of a rat pregnancy-specific glycoprotein gene.
Pregnancy-specific glycoproteins (PSGs), which are the major placental proteins, and the carcinoembryonic antigens comprise a subfamily within the immunoglobulin superfamily. To understand the molecular mechanisms underlying the control of PSG expression, we characterized the promoter elements of a rodent PSG gene, rnCGM3, and showed that DNA elements at nucleotides -326 to -185 (PI) relative to the translation start site of rnCGM3 function as a promoter. The rnCGM3 PI promoter contains two placental factor binding sites, PISI and PISII. Both are transcription activation elements. In the present report, we screened a placental expression cDNA library with a rnCGM3-PISII probe (nucleotides -263 to -233) encompassing two overlapping palindromes (TGTTGCTCAACATGTTG) and demonstrated that the PISII-binding factor is C/EBP beta, a leucine zipper family of transcription factor. Gel mobility-shift and transient expression analyses showed that C/EBP beta and C/EBP isoforms, C/EBP alpha and C/EBP delta, bind to the PISII element and trans-activate rnCGM3 gene expression. Deletion of PISII from the rnCGM3 PI promoter greatly reduced the basal as well as the C/EBP-activated rnCGM3 expression. Gel supershift assays demonstrated that C/EBP beta is the placental isoform that binds to the PISII site rnCGM3. Moreover, C/EBP beta is expressed in high levels in the placenta, ovary, liver, lung, heart, and spleen, in contrast to C/EBP alpha, which is expressed primarily in the liver and only low levels in the placenta. Our results demonstrate that C/EBP beta is one of the transcription factors that positively regulate rnCGM3 expression during pregnancy.
Animals↗
Primary malignant lymphoma of common bile duct presenting as acute obstructive jaundice: report of a case.
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Adult↗
The association of syndromic paucity of the interlobular bile ducts and congenital mechanical obstruction of the small intestine.
Three patients with congenital mechanical intestinal obstruction and features of syndromic paucity of the interlobular bile ducts (SPILBD) are presented. Two of them have siblings with syndromic paucity of the interlobular bile ducts. Two patients had jejunoileal atresia, while the other had a meconium plug with intestinal perforation. All subjects underwent surgery for intestinal obstruction within the first 24 h of life. Progressive disappearance of the bile ductules was observed in one case. We believe that an insult such as vascular insufficiency to both bile ductal epithelium and the small intestine may be the cause of this congenital disorder.
Abnormalities, Multiple↗
Is total abdominal hysterectomy with bilateral salpingo-oophorectomy adequate for new FIGO stage I endometrial carcinoma?
OBJECTIVE: The new FIGO staging for endometrial cancer cases complies with other forms of surgical staging and correlates better with clinical outcomes because it includes prognostic factors. This study was done to investigate whether total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH+BSO) is adequate for new FIGO Stage I endometrial carcinoma. SUBJECTS: Sixty-five cases of endometrial carcinoma defined according to the new FIGO Stage Ia (n = 26), Ib (n = 24) and Ic (n = 15) were analysed. They all received TAH+BSO only and were followed up for at least two years. METHODS: The histologic type, grade, depth of myometrial invasion, lympho-vascular tumour emboli and tumour size were analysed by t-test to correlate the risk factors for treatment failure. RESULTS: There were no recurrences after TAH+BSO in Ia and Ib cases. However, recurrences occurred in five cases (33%) of Stage Ic with deep myometrial invasion, high histologic grade, large tumour size and tumour emboli. CONCLUSIONS: TAH+BSO is inadequate in some Ic cases with a high histologic grade, deep myometrial invasion and tumour emboli. Thus, thorough pre-operative and intra-operative staging, adequate operation method and prompt post-operative adjuvant therapy are indispensable for successful treatment.
Adult↗
Tumor angiogenesis correlates with histologic type and metastasis in non-small-cell lung cancer.
This study investigated the clinico-pathologic correlation of tumor angiogenesis in non-small-cell lung cancers. Formalin-fixed, paraffin-embedded surgical specimens of 55 consecutive patients with primary non-small-cell lung cancers were examined. Included were 26 squamous cell carcinomas and 29 adenocarcinomas. Twenty-five patients had stage I disease, eight patients had stage II disease, and 22 patients had stage IIIA or IIIB disease. Among them, 28 had nodal metastasis and 27 did not. The microvessel was demonstrated by immunocytochemical staining for factor VIII and platelet endothelial cell adhesion molecules (PECAM-1). The microvessels in the areas of highest neovascularization were counted under light microscopy in 200x field by two independent observers without knowledge of clinical information. At least three separate fields were counted for each specimen. The Mann-Whitney U test was used for statistical analysis. The microvessel counts in adenocarcinoma were significantly higher than in the squamous cell carcinoma (54.4 +/- 35.65 versus 26.16 +/- 20.46 in factor VIII staining and 80.52 +/- 48.42 versus 40.04 +/- 32.33 in PECAM-1 staining; p < 0.001). The microvessel counts in patients with Stages I-II disease were significantly lower than that of stages IIIA-IIIB disease (23.63 +/- 16.21 versus 65.36 +/- 31.92 in factor VIII staining and 41.85 +/- 36.76 versus 93.00 +/- 43.08 in PECAM-1; p < 0.001). Patients with nodal metastasis had higher microvessel density than those without nodal metastasis (56.67 +/- 35.55 versus 23.44 +/- 15.77 in factor VIII staining and 86.89 +/- 46.46 versus 36.30 +/- 25.83 in PECAM-1 staining; p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Adenocarcinoma↗