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Biomedical subjects

C L Chen

Publications and source records attributed to C L Chen.

At least 361 records · Page 20Linked to original sources
PubMed1992

[The efficacy of intravenous fentanyl patient-controlled analgesia for postoperative pain relief].

The safety and efficacy of patient-controlled analgesia used for postoperative pain relief were evaluated. Cumulative 24-hour requirements were analyzed for possible correlation with patient characteristics. All patients who used a patient-controlled analgesia device for postoperative pain relief were reviewed from June to October 1991. The device Baxter's basal/bolus infusor with patient control module, was used to deliver fentanyl in 379 patients. The fentanyl requirement, verbal analog pain score, first passage of flatus, side effects, sedative score, and degree of satisfaction were examined. The fentanyl requirement during the first 24 hours after operation was analyzed with regard to age, body weight, and sex. The daily fentanyl consumption in the first three postoperative days was 928 +/- 352 micrograms (n = 338), 553 +/- 259 micrograms (n = 220), and 490 +/- 222 micrograms (n = 71), respectively. The requirement for fentanyl during the first 24 hours after surgery was significantly higher than for the next two days (p-value < 0.001). Fentanyl consumption correlated well with body weight, and inversely with age. No difference was found between fentanyl consumption and sex (p-value = 0.4687). The mean time to the first passage of flatus in patients with abdominal surgery was 54.6 +/- 26.4 hours. The incidence of nausea, vomiting, and dizziness was similar, about 20% of patients. Itching was noted in 7% of patients. Oversedation (class 4) was found in three patients during the first operative day, the sedative score for other patients were around class 1-3. No patient exhibited signs of respiratory depression or withdrawal syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1992

Breast milk beta-glucuronidase in breast milk jaundice.

Breast milk jaundice (BMJ) is the most common etiology of prolonged unconjugated hyperbilirubinemia in a newborn infant. The pathogenesis of BMJ has been studied by many investigators, yet the etiology still remains uncertain. A prospective study was done to examine the role of breast milk beta-glucuronidase in BMJ in healthy full-term Chinese newborns. There were 71 infants in the formula-fed group (FF group), 28 in the breast-fed group (BF group) and 27 in the mixed feeding group (MF group). Study infants were followed at the well-baby clinic for at least two months. Enzyme activity in maternal breast milk and infants' stools decreased significantly during the first week postpartum. There was no intergroup difference in fecal enzyme activity for the different age groups. Significantly more infants in the BF group (35.7%) developed prolonged unconjugated hyperbilirubinemia than did infants in the FF group (2.8%) and the MF group (0%). We did not find higher enzyme activity in breast milk or stools of infants with BMJ than in infants without BMJ. We, therefore, conclude that breast milk beta-glucuronidase is not related to the development of BMJ.

Adult↗
PubMed1992

Diffuse panbronchiolitis: report of a case.

A 33-year-old male presented with a productive cough of yellowish sputum which he had had for several years and progressive dyspnea on exertion that had been present for one year. Physical examination on admission disclosed clubbing of the fingers, diffuse inspiratory crackles and some rhonchi on auscultation. Plain chest film showed diffuse fine nodular lesions in both lungs. Pulmonary function tests demonstrated obstructive ventilatory impairment with a positive bronchodilator response. A CT scan of the chest showed diffuse fine nodular infiltrations in both lung fields. Arterial blood gas analysis of the patient, while breathing room air, revealed mild hypoxemia. The histologic findings of an open lung biopsy specimen were compatible with a diagnosis of diffuse panbronchiolitis. The patient was treated with erythromycin and a bronchodilator, and was regularly followed at the outpatient department. In this report, clinical manifestations, diagnostic criteria and recent advances in the treatment of diffuse panbronchiolitis are discussed.

Adult↗
PubMed1992

Expression and localization of the small and large delta antigens during the replication cycle of hepatitis D virus.

To study the expression and localization of delta antigen during the replication cycle of hepatitis D virus, we cotransfected HuH-7 hepatoma cells with a hepatitis B virus expression plasmid and plasmids expressing the small or large delta antigen or the entire HDV genome. The transfected cells and culture medium were analyzed on double immunofluorescence staining for delta antigen and HBsAg, on Western blotting and on Northern-blot hybridization from 4 hr to 9 days after transfection. In cells transfected with the expression plasmid carrying the small delta antigen open reading frame, only the small delta antigen was expressed; it was localized in the nucleolus and was not released into the medium during the culture period. In cells transfected with the large delta antigen expression plasmid, the large delta antigen expressed was localized in the nucleolus at the initial stage; this was followed by relocalization in nucleoplasm. Finally, large delta antigen was released in HBsAg-enveloped particles within 1 day of transfection. In cells cotransfected with hepatitis B virus and hepatitis D virus expression plasmids, the small delta antigen was expressed 4 hr after transfection, whereas the large form was expressed 3 days after transfection. Expression of the large delta antigen coincided with the localization changes from nucleolar to mixed stage and, finally, to nucleoplasm and release of the hepatitis D virus particles. The large delta antigen appears to play a key role in relocalization of the delta antigen and packaging of the hepatitis D virus virions.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Viral↗
PubMed1992

Disappearance of Kayser-Fleischer rings following liver transplantation.

1. Four cases of Kayser-Fleischer rings of Wilson's disease were observed to disappear after liver transplantation. 2. The disappearance of Kayser-Fleischer rings was in reverse order from that in which they appear. 3. The duration of disappearance was variable. 4. The density of Kayser-Fleischer rings correlated with the duration of clinical symptoms.

Adolescent↗
PubMed1992

Respiratory changes and pulmonary complications following orthotopic liver transplantation.

In conclusion, we observed a worsening of LIS post-OLT, especially on the fourth postoperative day. The drop in this score implies a complicated course accompanied by a high mortality rate and increased medical expenses. Among the four components, oxygenation index and chest roentgenography score play an important and practical role. Measuring the AaD(O2) has its clinical merit, while the PEEP score and compliance of the respiratory system are of limited usefulness in this setting. The pleural effusions developed after OLT showed a trend towards increasing in amount until the sixth day and then gradually decreasing, except those cases with complications.

Blood Volume↗
PubMed1992

The effect of total intravenous propofol on spontaneous respiration during anesthesia for minor surgery.

To evaluate adequate anesthetic depth without unacceptable respiratory consequences during total propofol intravascular anesthesia without intubation, the respiratory response was studied in 20 healthy patients (ASA class I or II), aged 20-50, premedicated with fentanyl 2 micrograms/kg. Anesthesia was induced in all patients with propofol 2.5 mg/kg, subsequently maintained by continuous propofol infusion at 12 mg/kg/h. An additional bolus of 20-60 mg propofol was given when anesthesia was considered inadequately. Assisted ventilation with 100% oxygen through a face mask was applied when apnea time was longer than 60 s. The mask was removed when patients regained spontaneous breathing. During induction stage, 7 patients developed apnea which required ventilatory support, although the period of apnea was short. Among them four regained spontaneous breathing within 5 min, and three within 10 min. PaCO2 significantly increased at both 10 min and 20 min after induction as compared with those before induction (p less than 0.05), while the change between 10 min and 20 min after induction was not statistically different. PaO2 showed little change and also it was not statistically significant. During maintenance of anesthesia spontaneous ventilation was stable and adequate. Though mild hypercapnia was noted, no medication was necessary. There was no episode of arterial oxygen desaturation throughout the course of maintenance. All patients could be adequately anesthetized except for six patients who required additional dose for insufficient anesthetic depth. No major adverse reactions occurred during or after induction. We concluded that the respiratory effect of propofol in total intravenous anesthesia could be divided into two stages: the induction stage and the maintenance stage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Two distinct alpha beta T-cell lineages can be distinguished by the differential usage of T-cell receptor V beta gene segments.

Avian T cells can be divided into three subpopulations based on their expression of distinct T-cell receptors (TCR1, TCR2, and TCR3), ontogeny, and tissue distribution. The TCR1 cells appear to be the equivalent of mammalian gamma delta cells, but the derivation of cells expressing TCR2 and TCR3 has been unclear. Here we report that chickens contain two families of TCR beta variable (V) gene segments, V beta 1 and V beta 2. Furthermore, TCR2 and TCR3 represent subsets of alpha beta cells that are defined by mutually exclusive usage of these two families of V beta gene segments. Sequence comparisons of V beta 1 and V beta 2 with mammalian TCR beta V segments reveal that V beta 1 gene segments encode the conserved amino acids used to define the mammalian V beta consensus subgroup I, while V beta 2 encodes the amino acids used to define the mammalian V beta subgroup II. Although the beta chains of TCR2 and TCR3 cells are encoded by the same diversity (D), joining (J), and constant (C) region segments, V beta 1 gene segments undergo rearrangement before V beta 2 gene segments during T-cell development. This may result from the fact that TCR2 cells undergo V-DJ joining by deletional rearrangement, whereas TCR3 cells undergo V-DJ joining by inversional rearrangement. These data suggest that the TCR alpha beta cells can be divided into two distinct and evolutionarily conserved lineages based on V beta gene segment usage. The clear-cut separation of these lineages in the chicken may help to define their immunologic role.

Aging↗
PubMed1991

A randomized clinical trial of inpatient family intervention: VI. Mediating variables and outcome.

In a randomized clinical trial of Inpatient Family Intervention (IFI) for 169 inpatients with schizophrenia, affective disorder, and a residual group of other diagnoses, results suggested significant effects favoring IFI for patients and their families. The treatment effects were limited to females and to two diagnostic groups: chronic schizophrenia patients and the bipolar subgroup of affective disorders.

Analysis of Variance↗
PubMed1991

Transformation of T-lymphocyte subsets by Marek's disease herpesvirus.

Marek's disease herpesvirus (MDV)-transformed lymphoblastoid tumor cell lines were characterized for the presence of the surface markers. Monoclonal antibodies were used for CD3 (T-cell receptor [TCR] complex), TCR1, TCR2, and TCR3, CD4, CD8, and Ia antigen by indirect fluorescence staining followed by microscopic examination or flow cytometry. The lymphoblastoid cell lines were obtained from tumors from chickens infected with MDV (n = 44) or from local lesions induced by inoculation of allogeneic, MDV-infected chick kidney cells (n = 56). Lymphocytes were harvested from these lesions between 4 and 16 days postinoculation and cultured in vitro to establish cell lines. All cell lines expressed Ia antigen and CD3 and/or TCR and thus are activated T cells. Most of the cell lines developed from tumors were CD4+ CD8-; only one cell line was negative for both markers. Sixteen percent of the cell lines were TCR3+, while the remainder were TCR2+. The cell lines developed from local lesions were much more heterogeneous: 45% were CD4- CD8+, 34% were CD4- CD8-, and only 21% were CD4+ CD8-. The number of TCR3+ cell lines was larger than expected for the CD4- CD8+ and CD4- CD8- cell lines, as judged from the presence of these cells in the blood. These results indicate that several subsets of T lymphocytes can be transformed by MDV, depending on the pathogenesis of infection. Activation of T cells as a consequence of the normal pathogenesis or by allogeneic stimulation seem to be a first important step in the process of transformation.

Animals↗
PubMed1991

Acute poisoning with a glyphosate-surfactant herbicide ('Roundup'): a review of 93 cases.

Between 1 January 1980, and 30 September 1989, 93 cases of exposure to herbicides containing glyphosphate and surfactant ('Roundup') were treated at Changhua Christian Hospital. The average amount of the 41% solution of glyphosate herbicide ingested by non-survivors was 184 +/- 70 ml (range 85-200 ml), but much larger amounts (500 ml) were reported to have been ingested by some patients and only resulted in mild to moderate symptomatology. Accidental exposure was asymptomatic after dermal contact with spray (six cases), while mild oral discomfort occurred after accidental ingestion (13 cases). Intentional ingestion (80 cases) resulted in erosion of the gastrointestinal tract (66%), seen as sore throat (43%), dysphagia (31%), and gastrointestinal haemorrhage (8%). Other organs were affected less often (non-specific leucocytosis 65%, lung 23%, liver 19%, cardiovascular 18%, kidney 14%, and CNS 12%). There were seven deaths, all of which occurred within hours of ingestion, two before the patient arrived at the hospital. Deaths following ingestion of 'Roundup' alone were due to a syndrome that involved hypotension, unresponsive to intravenous fluids or vasopressor drugs, and sometimes pulmonary oedema, in the presence of normal central venous pressure.

Adolescent↗
PubMed1991

Regulation of the uteroferrin gene promoter in endometrial cells: interactions among estrogen, progesterone, and prolactin.

Expression of the gene for the porcine transplacental iron transport protein uteroferrin (UF) is largely restricted to the uterus, where it is differentially regulated by estrogen (E) and progesterone (P). To study the regulatory mechanisms subserving these effects, a 2-kilobase genomic fragment corresponding to -2005 to 48 nucleotides of the UF gene was ligated up-stream to the reporter gene chloramphenicol acetyltransferase (CAT). This construct (UF-CAT) was transiently transfected into rabbit endometrial (HRE-H9), mouse fibroblastic (AKR-2B), and human choriocarcinoma (JEG-3) cells. The basal gene promoter activity of UF-CAT was exhibited in H9 cells, but not in AKR-2B or JEG-3 cells. In contrast, a simian virus-40 early promoter (SV2) was functional in all three cell lines. The H9 cells were used to examine steroid regulation of the UF gene promoter. The CAT expression in H9 cells primed with E and PRL, but not with E or PRL alone, was stimulated by P. In contrast, basal activity of SV2 in these cells was unaffected by hormones, singly or in combination. To examine the basis for the E/PRL-dependent response to P, levels of P and E receptors in H9 cells were quantified. PRL and E plus PRL increased the number of high affinity sites for P, but had little effect on levels of high affinity sites for E in treated vs. untreated H9 cells. In vivo administration of PRL to cyclic gilts had no effect on levels of endometrial UF mRNA and secreted UF protein; however, E- plus PRL-treated gilts had higher (P less than 0.05) levels of endometrial UF mRNA and luminal UF than PRL-treated gilts. These results demonstrate in vitro functional activity of the UF gene promoter and associated 5' flanking region and suggest that sequences within this region may mediate tissue-specific and steroid hormone-regulated expression of the UF gene. Moreover, interactions among E, PRL, and P modulate UF gene expression in vivo and in vitro.

Acid Phosphatase↗
PubMed1991

Heterotopic heart transplantation--a life-saving procedure with a size-mismatched donor.

A 32-year-old B-type male weighing 60 kg suffered from end-stage dilated cardiomyopathy. Although aggressive medical treatment with dobutamine 21 micrograms/kg/min, dopamine 17 micrograms/kg/min, digoxin 0.25 mg i.v. once daily, furosemide 40 mg i.v. every 6 h, and bumetanide 0.5 mg i.v. every 6 h were given, he was finally ventilator dependent for the last 3 weeks until a B-type donor weighing 42.5 kg was found. Because of the 29.2% weight mismatch, a heterotopic heart transplantation was performed. Posterior plication mitral annuloplasty was also performed to correct the severe mitral regurgitation of the recipient heart. Postoperatively the patient remained respirator dependent for 17 days and was finally discharged in good condition on the 46th postoperative day.

ABO Blood-Group System↗