Search PubMed⌕ Search

Biomedical subjects

C L Lee

Publications and source records attributed to C L Lee.

At least 91 records · Page 5Linked to original sources
PubMed1997

Life table analysis of pregnancy rates in women with moderate or severe endometriosis comparing danazol therapy after carbon dioxide laser laparoscopy plus electrocoagulation or laparotomy plus electrocoagulation versus danazol therapy only.

STUDY OBJECTIVE: To assess the effectiveness, in terms of pregnancy rates, of isotopic 13CO2 laser laparoscopy versus traditional laparoscopy or laparotomy in the treatment of infertile women with moderate or severe endometriosis. DESIGN: Prospective 5-year study. SETTING: Medical school-affiliated hospital. PATIENTS: Three hundred nine infertile women with moderate to severe endometriosis. INTERVENTIONS: The patients were treated with one of four options: operative laparoscopy with the 13carbon dioxide (13CO2) laser vaporization and/or resection, operative laparoscopy with simple electrocoagulation and sharp dissection, laparotomy with electrocoagulation and sharp dissection, and medical treatment with danazol. Estimated cumulative pregnancy rates using life table analyses were indicators of treatment of success and compared among treatments. A subgroup of 192 women considered to have endometriosis as the only infertility factor was also evaluated. MEASUREMENTS AND MAIN RESULTS: Pregnancy rates in the laparoscopy group were equal to or higher than those of the laparotomy group, for both the entire population and the endometriosis-only subset. When the CO2 laser was used as an adjuvant option, the rates were better, especially in patients with advanced disease and with endometriosis as the only infertility factor. CONCLUSION: In women with endometriosis as the only infertility factor, laparoscopic surgery with the 13CO2 laser was more effective than nonlaser treatment.

Adult↗
PubMed1997

Food-borne disease outbreaks due to bacteria in Taiwan, 1986 to 1995.

Between 1986 and 1995, 852 outbreaks of food-borne disease involving 26,173 cases and 20 deaths were reported in Taiwan. About 80% of the outbreaks occurred in the warmer months, i.e., between April and October. Of the 852 reported outbreaks, 555 (65%) were caused by bacterial pathogens. The three most common bacteria involved were Vibrio parahaemolyticus (35%, 197 of 555 outbreaks), Staphylococcus aureus (30%, 169 of 555 outbreaks), and Bacillus cereus (18%, 104 of 555 outbreaks).

Bacillus cereus↗
PubMed1997

Hepatitis B vaccination and hepatocellular carcinoma in Taiwan.

OBJECTIVE: In 1984, Taiwan started a large-scale hepatitis B vaccination program, enabling us to test the hypothesis that prevention of hepatitis B virus infection eventually decreases the incidence of hepatocellular carcinoma. METHODS: Groups aged 0 to 9 years and 10 to 100 years in each calendar year were defined as the study group and the reference group, respectively. The percentage of children vaccinated in the study group increased during recent years. The study group and the reference group were divided into 5-year age strata (0 to 4, 5 to 9, ..., 80 to 84, and 85 and over). Poisson regression was used to estimate age- and gender-adjusted liver carcinoma mortality rate ratios for 1974 through 1993, relative to 1974. RESULTS: The adjusted mortality rate ratios of liver carcinoma in the study group decreased significantly for 1992 and 1993, whereas in the reference group it did not show the same result. A significantly declining trend of liver carcinoma mortality rate ratios was observed in the study group after 1984, whereas the same trend was not found in the reference group. CONCLUSIONS: Our results support the hypothesis that hepatitis B vaccination can decrease the incidence of hepatocellular carcinoma.

Carcinoma, Hepatocellular↗
PubMed1997

[Pathogenic strains of Escherichia coli in Taiwan].

From July 1994 through June 1996, 28 strains of Escherichia coli were isolated from 1,260 patients with acute diarrhea. These strains were further differentiated with serotypes and virulence factors. Enterotoxigenic E. coli (ETEC), enteropathogenic E. coli (EPEC), enterohemorrhagic E. coli (EHEC), and enteroinvasive E. coli (EIEC) were accounted for 53.6 (15 of 28 strains), 28.6 (8 of 28), 10.7 (3 of 28) and 7.1% (2 of 28), respectively. Therefore, ETEC and EPEC are playing an important role in food-borne illness in Taiwan. Escherichia coli O157:H7, a new emerging pathogen of food-borne disease, has not been isolated in this study.

Diarrhea↗
PubMed1997

Twenty-four-hour ambulatory esophageal pH monitoring in patients with symptoms of gastroesophageal reflux.

We investigated the relationship between gastric acid reflux patterns and esophageal mucosal damage in 142 patients with symptoms suggestive of gastroesophageal reflux and esophagitis. Each patient underwent endoscopy of the esophagus and 24-hour ambulatory esophageal pH monitoring. Endoscopy revealed varying degrees of esophagitis in 37 patients and a normal esophagus 105 patients. No significant difference in symptoms was found between patients with and without esophagitis. Sixteen of the 37 patients with esophagitis had a normal composite score on pH monitoring, whereas 24 of the 105 patients without esophagitis had an abnormal composite score (p < 0.001). Comparison of individual pH parameters during the study showed more reflux episodes (pH < 4), a higher percentage of reflux time, and more reflux episodes longer than 5 minutes in the group with esophagitis than in the without (p < 0.05). Both the percentage of reflux time and the number of reflux episodes longer than 5 minutes/hour were significantly higher (p < 0.05) in the group with endoscopically proven esophagitis in the supine period, but not in the upright period. There was a positive correlation between the severity of endoscopic esophagitis and the percentage of reflux time in the supine period (r = 0.64; p < 0.001), and the number of reflux episodes longer than 5 minutes/hour in the supine period (r = 0.56; p < 0.001). In conclusion, our patients with peptic esophagitis had significant gastric acid reflux and impaired acid clearance by the esophagus in the supine position. We advocate that 24-hour ambulatory esophageal pH monitoring should be considered in Chinese patients with normal endoscopy findings but with symptoms suggestive of gastroesophageal reflux disease.

Adult↗
PubMed1996

Coculture of human spermatozoa with reproductive tract cell monolayers can enhance sperm functions better than coculture with Vero cell monolayers.

PURPOSE: In order to develop a better system for support of human sperm function in vitro, we conducted studies to evaluate whether reproductive tract cells are better than non-reproductive tract cells as an adjunt in that regard. METHODS: Human spermatozoa were cocultured with Vero cells, with human oviduct cells and endometrial cells, and without cells (control) for either 1, 4, or 24 hr. Sperm motility was then analyzed with a computer-aided sperm analyzer (CASA-Hamiliton Thron, HTM IVOS Motility Analyzer). Aliquots of spermatozoa incubated for 24 hr were also stained with Hoechst 33258 and FITC-PNA to evaluate the status of acrosome in live cells. RESULTS: Significant differences (P < 0.05) between the oviduct cell and the control groups after 24 hr were evident in the curvilinear velocity (VCL) (81.4 +/- 13.4 vs 60.0 +/- 14.1 microns/sec) and amplitude of lateral head displacement (ALH) (5.2 +/- 0.6 vs 4.1 +/- 0.5 microns). The incidence of acrosome reaction of live sperm was significantly higher in the endometrial cell group than in the controls (25.4 +/- 9.9 vs 6.6 +/- 2.4%; P < 0.001). CONCLUSIONS: Coculture with human reproductive tract cells seems to improve some functional parameters of human spermatozoa. Coincubation with such cell lines, especially oviduct cells, might be a feasible approach to optimization of human spermatozoa for assisted fertilization using subfertile or frozen-thawed samples. We think coincubating human spermatozoa with a human reproductive tract cell line, especially oviduct cells, might be a feasible approach in preparing human spermatozoa for assisted fertilizatioin in subfertile and frozen-thawed semen samples.

Acrosome↗
PubMed1996

The impact of the total motile sperm count on the success of intrauterine insemination with husband's spermatozoa.

PURPOSE: The purpose of this study was to evaluate the relationship between the total motile sperm count and the success of IUI treatment cycles with postwashed husband spermatozoa in couples with infertility in a large patient population. PATIENTS: When 939 couples underwent 1375 cycles of IUI with varying etiologies of infertility which included male factor, endometriosis, tubal factor, ovulatory dysfunction, uterine factor, cervical factor, and unexplained infertility, the results were 207 pregnancies. RESULTS: The overall pregnancy rate per cycle was 15.1% (207/1375). The total motile sperm count were significantly increased in the pregnant group than the nonpregnant group (38.7 x 10(6) versus 28.6 x 10(6); P < 0.001). There was a trend toward an increased success rate with increased total motile sperm count. Significance was reached when the total motile sperm count exceeded 5 x 10(6). Life table analysis was performed and the curve representing a cumulative chance of pregnancy calculated from our data reached 72%. CONCLUSIONS: Our findings suggest that a final postwashed total motile sperm count used for IUI may be considered predictive of the success for pregnancy and allow couples to be informed of the chances of success.

Female↗
PubMed1996

Glutathione S-transferase and glutathione peroxidase are essential in the early stage of adriamycin resistance before P-glycoprotein overexpression in HOB1 lymphoma cells.

We have previously established Adriamycin-resistant HOB1 cell lines showing the multidrug resistance (MDR) phenotype. For further study, we analyzed the free-radical scavengers glutathione S-transferase (GST) and glutathione peroxidase (GPX) by enzyme assays and Northern blots. Three cell lines, HOB1/ADR0.1, HOB1/ADR1.0, and HOB1/ADR5.0, represented HOB1 cells resistant to 0.1, 1.0, and 5.0 microM Adriamycin, respectively. The mdr1 transcript was overexpressed in HOB1/ADR0.1 cells, and the amount of its expression reached a maximum between HOB1/ADR1.0 and HOB1/ADR5.0 cell lines. The increases in GST activity and GST-pi expression were observed only in high-level-resistant cell line (HOB1/ADR1.0 and HOB1/ADR5.0), which also showed increased GPX activity and expression. For investigation of the cytotoxic effect of Adriamycin on HOB1 cells prior to the mdr1 overexpression, an appropriate number of parental HOB1 cells were treated with 0.1 microM Adriamycin for 7 days, and the viable cells (HOB1/ADR) were isolated and subjected to analyses for mdr1, GST-pi, and GPX expression and for GST and GPX activity. In comparison with HOB1/ADR0.1 cells, HOB1/ADR cells did not show mdr1 overexpression but had significant increases in the activity and expression of GST and GPX. The current study suggests that in the early phase of Adriamycin treatment, GST and GPX are more important than P-glycoprotein for the development in HOB1 cells of resistance against Adriamycin.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1996

Comparison of hysterosalpingography and hysteroscopy in female infertility.

STUDY OBJECTIVE: To determine the diagnostic value of hysterosalpingography (HSG) and diagnostic hysteroscopy in infertility evaluations. DESIGN: Comparative 2-year study. SETTING: Outpatient infertility clinic of a tertiary medical center. PATIENTS: Two hundred sixteen women being investigated for infertility. INTERVENTIONS: An HSG was followed by a diagnostic hysteroscopy. MEASUREMENTS AND MAIN RESULTS: The HSGs were interpreted as normal in 79 (36.9%) women and as showing some abnormalities of the uterine cavity in 135 (63.1%). In the former group, 51 patients had a normal uterine cavity, but 28 had abnormal findings on hysteroscopy, a false negative rate of 35.4%. Of 135 women with an abnormal HSG, hysteroscopy found a normal uterine cavity in 21, a false positive rate of 15.6%. The sensitivity of HSG was 80.3% in revealing intrauterine abnormality and its specificity was 70.1%. Although some abnormalities were identified by both methods in 114 women, findings of both procedures were similar in only 88 (77.2%). In 75 (35.0%), the findings of HSG differed from those of hysteroscopy. In only 139 (65%) patients were the findings (normal and abnormal) similar for both methods. CONCLUSIONS: We advocate hysteroscopy in the investigation of female infertility for its accuracy, safety, simplicity, and convenience.

Adolescent↗
PubMed1996

Hysteroscopic extraction of a vaginal foreign body in a child.

A 3.5-year-old girl had a persistent, foul-smelling, blood-tinged vaginal discharge. She was initially treated for recurrent and persistent vulvovaginitis, which resulted in no improvement. Vaginoscopy revealed an intravaginal foreign body, which was removed successfully by hysteroscopy. We believe hysteroscopy is safe, convenient, effective, and easy to perform, even in a child.

Endoscopy↗
PubMed1996

Results of modified laparoscopically assisted neovaginoplasty in 18 patients with congenital absence of vagina.

Construction of a neovagina using pelvic peritoneum via a laparoscopically assisted approach was used in 18 patients with congenital absence of the vagina. A better operative procedure is reported, which was modified from our preliminary technique, and the results of treatment are evaluated. Pelvic peritoneum was used for construction of a vagina, replacing a laparotomy by a minimally invasive laparoscopic approach. During follow-up, the advantages of our procedures are: (i) minimal likelihood of 'poor take' or later contraction because an autograft peritoneal epithelial line is used; (ii) minimal short and long term care is required; (iii) the technique is simple in experienced hands and has all the well-recognized benefits of minimal invasive surgery; (iv) the average length of neovagina is adequate and patency and depth can be maintained with minimal dilatation; (v) the neovagina, with epithelial lining resembling that of a normal vagina, facilitates comfortable sexual intercourse; (vi) the procedure is unaccompanied by dyspareunia or scarring, which are frequently associated with other techniques; (vii) less emotional stress and better cosmetic and economic benefits are noted.

Adult↗
PubMed1996

Insulin-like growth factor-binding proteins produced by Vero cells, human oviductal cells and human endometrial cells, and the role of insulin-like growth factor-binding protein-3 in mouse embryo co-culture systems.

Co-culturing embryos on helper cells can mimic the in-vivo environment, thereby enhancing embryo development in vitro. Insulin-like growth factors (IGF) and their binding proteins (IGFBP) also enhance embryo development. To investigate the kinds of IGFBP produced by various cell monolayers and the effects of IGFBP-3 on mouse embryo co-culture systems, 2-cell ICR mouse embryos were cultured in either human tubal fluid medium alone or in the presence of Vero cells, human oviductal cells or endometrial cells. The helper cells were analysed immunohistochemically to investigate the types of IGFBP produced by various cell monolayers. The concentrations of IGF-I and IGFBP-3 in media obtained from the culture of embryos alone, cells alone or cells plus embryos were determined by radioimmunoassays. On day 7, more blastocysts hatched in the co-culture groups (73% in the Vero cell group, 76% in the endometrial cell group and 74% in the oviductal cell group) than in the control group (43%) (P < 0.0001). The results of immunohistochemistry revealed that (i) all three cell groups produced a lot of IGFBP-1, -2 and -3, but only a little of IGFBP-4 and -5; and (ii) IGFBP-1, -2, and -3 were present in blastocysts in either the presence or absence of helper cells. The IGF-I secreted by cell monolayers or embryos was undetectable (detection limit 0.83 microg/l). The IGFBP-3 concentrations in media obtained from co-cultured embryos and cells were significantly higher than in media without embryos (median values in oviductal cell culture medium, 165 versus 127 microg/l, P = 0.04; median values in endometrial cell culture medium, 277.5 versus 183.5 microg/1, P = 0. 0002; median values in Vero cell culture medium, 219 versus 120 microg/l, P = 0.011). Although IGFBP-3 concentration in the medium that contained embryos alone was undetectable by radioimmunoassay (detection limit 1.1 microg/l), immunohistochemistry demonstrated the presence of IGFBP-3 in the embryos. Co-culture in systems in which there was an increased production of IGFBP-3 led to an improved development of mouse embryos. IGFBP can improve the binding of IGF to cell surface receptors of target tissue, and thus enhance the effect of limited IGF concentrations in promoting embryo development in a co-culture system. We conclude that Vero cells, human endometrial cells and oviductal cells produce IGFBP-1, -2, -3, -4 and -5. IGFBP-3 may play a role in embryotrophic potential by either regulating the action of IGF or directly enhancing embryo development.

Animals↗
PubMed1996

Laparoscopic myomectomy of large symptomatic leiomyoma using airlift gasless laparoscopy: a preliminary report.

Despite the expanding role of laparoscopic surgery in many gynaecological fields, some discrepancies still exist regarding the efficacy of laparoscopic myomectomy in treating patients with large symptomatic leiomyoma. In this report, a better operative procedure and the results of treatment are evaluated. Patients (n = 14) presenting with infertility, menorrhagia, pressure symptoms or pelvic mass associated with a large leiomyoma were managed with laparoscopic myomectomy using airlift gasless laparoscopy. Uterine size ranged from 14 to 24 weeks gestational age and the weight of the myoma ranged from 246 to 669 g (mean 454); operative time ranged from 78 to 165 min (mean 104) and blood loss from 90 to 580 ml (mean 201). No major complication occurred during the operation or follow-up. All except one patient were discharged within 72 h of the operation and resumed normal activity within 1 week. When myomectomy is indicated, the airlift gasless laparoscopic approach appears to offer a better alternative to abdominal or pneumoperitoneum laparoscopic surgery in selected cases. Airlift gasless laparoscopy has several advantages: (i) small abdominal incisions and minimal endoscopic equipment are required; (ii) the excised leiomyomata mass can be easily cut into strips and removed through the small abdominal incision; (iii) the uterine defect can be more efficiently repaired using easily performed suture techniques; (iv) high-pressure irrigation and large-volume suction devices can be used without fear of decompressing the pneumoperitoneum; and (v) the potential risk of metabolic and haemodynamic derangements during pneumoperitoneum laparoscopy are obviated. Gasless laparoscopy also has some disadvantages. The exposure obtained with gasless laparoscopy is not as good, under some circumstances, as that achieved by pneumoperitoneum. For patients who are thin, and even those with moderate obesity, the exposure obtained with airlift mechanical suspension is adequate; however, morbidly obese patients with previous abdominal surgery with suspected pelvic adhesions can incur some problems during the operation because of a poor operative field.

Adult↗
PubMed1996

Subspecies typing of Vibrio parahaemolyticus by pulsed-field gel electrophoresis.

Vibrio parahaemolyticus is one of the most important food-borne pathogens in Taiwan, Japan, and other costal regions. We report on the development of a pulsed-field gel electrophoresis (PFGE) method for the molecular typing of this pathogen. Genomic DNA was digested with SfiI, and the fragments were resolved on 1% agarose with a contour-clamped homogeneous electric field apparatus set at 190 V and a pulse time of 3 to 80 s. A total of 130 selected isolates obtained from outbreaks during 1993 and 1994 on Taiwan were also characterized by this PFGE method. These isolates were grouped into 14 PFGE types which consisted on one to six patterns, and a total of 39 patterns were identified. Most of these domestic clinical isolates could be clustered into several major types (types A, B, C, and G). These major types showed relatively low degrees of similarity to several foreign strains and other domestic but environmental strains. Strain CCRC12863, which originated from Japan, was close to the group consisting of F, G, and H PFGE types, suggesting a clonal relationship between this Japanese strain and other domestic isolates.

Bacterial Typing Techniques↗
PubMed1996

Management of urinary bladder injuries in laparoscopic assisted vaginal hysterectomy.

BACKGROUND: To illustrate our experience and evolution in management of urinary bladder injury in laparoscopically assisted vaginal hysterectomy. METHODS: Four hundred and twenty-two women underwent laparoscopically assisted vaginal hysterectomy with or without adnexectomy during the period March 1991-September 1994. The indicators for hysterectomy included adenomyosis, myoma uteri, intractable menorrhagia, endometriosis and severe pelvic adhesion. There are six cases of urinary bladder injuries resulting from our 422 cases of laparoscopically assisted vaginal hysterectomy. RESULTS: The first two cases of urinary bladder injuries were repaired through exploratory laparotomy. The third case was repaired through laparoscopic intracorporeal suture. The technique of the automatic linear stapler through laparoscopy was used in case 4. The last two cases were repaired vaginally. All these patients recovered well after primary repair with an indwelling catheter for five to seven days regardless of the method of repair. The operation time for repairing the injuries is shortest in vaginal approach. CONCLUSIONS: The urinary bladder injury is one of the most common complications associated with laparoscopically assisted vaginal hysterectomy. Early detection and treatment enable complications to be overcome easily. As the laparoscopist acquires further experience in dealing with these complications, the urinary bladder injury may be managed laparoscopically. However, vaginal approach may be an easier way in dealing with this complication. Thus, most laparotomy or high technique laparoscopically repair could be avoided.

Female↗
PubMed1996

Food-borne disease outbreaks in Taiwan, 1994.

In 1994, 102 outbreaks of food-borne disease involving 4,726 cases were reported to the Taiwan Department of Health. This is the highest number of outbreaks and cases in recent years in Taiwan. Of these outbreaks, 72.5% (74/102) were caused by bacterial pathogens, with Vibrio parahaemolyticus responsible for 56.7% (42/74), Staphylococcus aureus 20.3% (15/74), Bacillus cereus 14.9% (11/74) and Salmonella spp other than S. typhi and S. paratyphi 8.1% (6/74). V. parahaemolyticus has been a leading cause of problems in Taiwan for many years. Contamination of seafood with this organism has been reported frequently, particularly in the warmer months. In 1994, small outbreaks (fewer than 5 cases) and large outbreaks (more than 50 cases) represented 31.4% (32/102) and 12.7% (13/102), respectively, of the total. The median outbreak size was 10 cases. A high proportion (54%, 7/13) of the large outbreaks was associated with commercial lunch-boxes supplied to elementary and junior high schools. Health education to improve food sanitation and supervision of food sanitation practices need to be strengthened.

Bacillus cereus↗
PubMed1996

Legionella pneumophila infection in Taiwan: a preliminary report.

Legionella pneumophila infection has been recognized as an important cause of pneumonia. However, epidemiologic baseline data about the occurrence of legionella-related pneumonia and the distribution of legionellae in aquatic environments are still not available in Taiwan. A survey conducted by the National Institute of Preventive Medicine found that 8.6% of 487 pneumonia patients studied were positive for the L. pneumophila serologic test (indirect fluorescent test, IFA) and 32.0% of the 25 water samples were positive for isolation of legionellae. In conclusion, this survey supported the existence of Legionnaires' disease in Taiwan, indicated a preliminary prevalence of L. pneumophila antibodies among pneumonia patients and identified the prevalence of legionellae in water environments.

Adult↗