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Biomedical subjects

C L Lu

Publications and source records attributed to C L Lu.

At least 73 records · Page 4Linked to original sources

Levels of immunoreactive dynorphin A1-13 during development of morphine dependence in rats.

AIM: To study the relationship between the levels of immunoreactive dynorphin A1-13 (ir-dynorphin A1-13) and the degree of morphine dependence. METHODS: The levels of ir-dynorphin A1-13 in discrete brain regions, spinal cord, and plasma in rats were determined by radioimmunoassay, and the degree of morphine dependence was assessed by scoring withdrawal signs on d 3, d 6, and d 12. RESULTS: Morphine injection s.c. decreased the levels of ir-dynorphin A1-13 in spinal cord, pituitary, and plasma. The levels of ir-dynorphin A1-13 in hippocampus and hypothalamus were increased. No changes in cortex, midbrain, cerebellum, pons, and medulla were observed. With continuous injection of morphine, withdrawal signs scores were increased on d 6, but there was no difference between the scores of d 6 and d 12. CONCLUSION: The changes of the levels of endogenous ir-dynorphin A1-13 in pituitary, spinal cord, and plasma were compatible with the degree of morphine dependence.

Animals↗

Characteristics of small bowel motility in patients with irritable bowel syndrome and normal humans: an Oriental study.

1. Small bowel dysmotility may be one of the clinical manifestations in Occidental patients with irritable bowel syndrome. Here we studied the characteristics of small bowel motility in Oriental patients with irritable bowel syndrome and identified the factors responsible for disturbed small bowel motility. 2. We enrolled 90 patients with irritable bowel syndrome and 45 healthy controls to the study. The patients with irritable bowel syndrome were further divided according to their predominant bowel habits. Of those, 45 were constipation-predominant and 45 were diarrhoea-predominant. Small bowel transit was measured by the non-invasive hydrogen breath test in the fasting state. 3. The transit times obtained in constipation-predominant and diarrhoea-predominant patients with irritable bowel syndrome and in controls were 108.4+/-34.3, 67. 4+/-19.6 and 85.3+/-37.3 min respectively (P<0.05). Delayed transit characterized constipation-predominant patients with irritable bowel syndrome, whereas accelerated transit was observed in diarrhoea-predominant patients with irritable bowel syndrome. The ages of constipation-predominant and diarrhoea-predominant patients with irritable bowel syndrome and of controls displayed a significant positive correlation with their small bowel transit times (r=0.34, 0.31 and 0.39 respectively; P<0.05) and body mass indexes also demonstrated a positive correlation (r=0.31, 0.41 and 0. 30 respectively; P<0.05). Other demographic characteristics did not influence the small bowel transit times. 4. Accelerated or delayed small intestinal transit is exhibited in Oriental patients with irritable bowel syndrome showing either diarrhoea-predominant or constipation-predominant symptoms. Age and body mass index must be taken into consideration to study patients with suspected small intestinal dysmotility.

Aged↗

Clinical response of localized recurrent periodontitis treated with scaling, root planing, and tetracycline fiber.

The purpose of this study was to compare the clinical efficacy of scaling and root planing alone versus tetracycline fiber therapy used adjunctively with scaling and root planing in the treatment of nonresponsive active periodontitis in patients under supportive periodontal therapy. Thirty patients who were receiving supportive treatment and had at least two nonadjacent periodontitis sites with a probing depth of between 4 and 8 mm and bleeding on probing, or had aspartate aminotransferase (AST) levels above 800 microIU in the gingival crevicular fluid in separate quadrants participated in this study. For each patient, the test sites were treated with scaling and root planing plus tetracycline fibers while the control site was treated with scaling and root planing only. Probing depths, clinical attachment levels, gingival recession, AST levels, and bleeding on probing were recorded and subgingival plaque samples were collected at baseline and 1, 3, and 6 months following treatment. At 3 months after treatment, there was a reduction of bleeding on probing and probing depth, and a gain of clinical attachment in both test and control sites. The mean reduction in probing depth of the test sites was 1.38 mm and the attachment gain was 0.8 mm after 6 months. The clinical response obtained at 3 months following therapy was maintained throughout the 6-month follow-up period. However, there were no statistically significant differences between sites treated with scaling and root planing alone and those treated with combined tetracycline therapy. Most of the reductions of probing depths in the fiber group were attributed to gingival recession. The present study did not confirm the efficacy of adjunctive tetracycline fibers in treating nonresponsive sites in maintenance subjects with regard to probing depth reduction or clinical attachment gain. Reinfection of the pockets from untreated sites and extra-crevicular regions may explain the insignificant response to local tetracycline therapy.

Adult↗

Lower gastrointestinal bleeding from a hepatocellular carcinoma invading the colon.

Bleeding from the gastrointestinal tract due to hepatocellular carcinoma invasion is unusual. We describe a 71-year-old man who had bloody stools caused by a hepatocellular carcinoma that directly invaded the transverse colon. The diagnosis was confirmed by colonoscopy and tissue examination. Our patient is the first with lower gastrointestinal bleeding from a hepatocellular carcinoma during the natural course of the tumor.

Aged↗

A prospective clinical study of isoniazid-rifampicin-pyrazinamide-induced liver injury in an area endemic for hepatitis B.

In order to evaluate the incidence, predisposing factors and clinical course of antituberculous drug-induced liver injury in hepatitis B surface antigen (HBsAg)-positive carriers and non-carriers, in an area endemic for hepatitis B, we prospectively followed 240 patients (154 male, 86 female; mean age 40 years) who had received daily isoniazid, rifampicin, ethambutol and pyrazinamide for the treatment of pulmonary tuberculosis. Patients with heavy alcohol consumption, with pretreatment serum alanine aminotransferase (ALT) elevation and who had less than 3 months post-treatment follow-up were excluded from the study. Thirty-one (13%) patients were positive for serum HBsAg before treatment. Sixty-three (26%; 95% CI: 21-32%) patients developed antituberculous drug-induced liver injury. The incidence of drug-induced liver injury was significantly more frequent in patients > 35 years of age than in patients < or = 35 years of age (33 vs 17%; P < 0.05), but was not different between HBsAg carriers and non-carriers (29 vs 26%; P > 0.05). Using step-wise logistic regression analysis, patient age > 35 years was the only independent variable for predicting antituberculous drug-induced liver injury, while sex, acetylator phenotype, HBsAg carrier status and severity of tuberculosis were not. The peak serum ALT levels in antituberculous drug-induced liver injury were not significantly different between HBsAg carriers and non-carriers. Only one 61-year-old HBsAg carrier developed severe jaundice after 6 months antituberculous therapy; he subsequently died of hepatic failure. In conclusion, the incidence of antituberculous drug-induced liver injury was significantly higher in patients > 35 years of age than in patients < or = 35 years of age, but was not different between HBsAg carriers and non-carriers. Mortality occurred in an aged HBsAg carrier superimposed with antituberculous drug-induced liver injury.

Adult↗

Hepatocellular carcinoma in the caudate lobe: early diagnosis and active treatment may result in long-term survival.

Hepatocellular carcinoma (HCC) in the caudate lobe is rare and the prognosis of patients with HCC in the caudate lobe has been reported to be poor. Resection for HCC in the caudate lobe has carried a higher rate of surgical risk and early recurrence. The effect of transcatheter arterial embolization (TAE) in treating HCC in the caudate lobe remains unknown. With the wide application of modern diagnostic modalities, we can now detect HCC at an earlier stage for active treatment (surgery or TAE). The aim of the present study was to analyse the effect of different treatments for HCC in the caudate lobe. From 1985 to 1994, 15 patients with HCC in the caudate lobe were retrospectively studied. Another 264 consecutive patients with newly diagnosed HCC treated by TAE were selected as the control group. Two patients underwent surgical resection and survived well without recurrence after 43 and 136 months, respectively. Ten patients underwent TAE and their survival rate was similar to that of the 264 consecutively TAE-treated controls with HCC not in the caudate lobe (P = 0.19). The 1, 3 and 5 year survival rates for TAE-treated patients in the caudate lobe were 67.7, 31.1 and 12.6%, respectively, while in controls these figures were 53.0, 18.4 and 9.1%, respectively. Two of the three patients receiving supportive treatment died within 1 month after diagnosis. Those patients having a smaller solitary tumour without intrahepatic metastasis tended to survive longer. In conclusion, HCC in the caudate lobe does not always indicate a poor prognosis so long as early detection and active treatment (surgery or TAE) are available. Transcatheter arterial embolization may act as an alternative treatment modality for patients with HCC in the caudate lobe.

Adult↗

Hepatitis B infection and changes in interferon-alpha and -gamma production in patients with systemic lupus erythematosus in Taiwan.

According to previous reports, the prevalence of hepatitis B virus (HBV) infection in patients with systemic lupus erythematosus (SLE) is varied. There has been no report on Taiwan, a hyperendemic area for HBV infection. Furthermore, impaired production of interferon (IFN) in peripheral blood mononuclear cells (PBMC) has been reported to be potentially pathogenic to both chronic HBV infection and SLE. However, the production of IFN in patients with both diseases coexisting is unknown. The aims of this study were to evaluate the prevalence of HBV infection in lupus patients in Taiwan and to measure the production of IFN in patients with both diseases coexisting. One hundred and seventy-three consecutive lupus patients and a control group of 692 age- and sex-matched healthy subjects were included for evaluation of the prevalence of HBsAg. Four groups of subjects (patients with SLE and HbsAg, SLE, chronic hepatitis B and normal controls) were selected for evaluation of the in vitro production of IFN-alpha and -gamma. Six (3.5%) of the 173 SLE patients were positive for HBsAg, which was significantly lower than that of controls (14.7%; P < 0.0001). Patients with coexistent SLE and chronic HBV infection had less lupus activity, including less proteinuria (P = 0.02) and a lower serum titre of anti-double stranded DNA antibodies (anti-dsDNA; P = 0.04), than HBsAg-negative lupus patients. The in vitro production of IFN-alpha in patients with chronic hepatitis B was significantly lower than in those patients with SLE or in the normal control group (P < 0.01). The yields of IFN-alpha and -gamma in patients with coexistent SLE and chronic HBV infection were significantly different from those patients with SLE alone (P < 0.05), but close to those of patients with chronic HBV infection. In conclusion, the prevalence of HBsAg carriers is significantly lower in lupus patients in Taiwan. Patients with coexistent SLE and chronic HBV infection had less lupus activity. Interferon-alpha and -gamma may play a role in the above phenomenon.

Adult↗

Case report: life-threatening haematochezia from a jejunal leiomyoma.

Leiomyoma is a common benign intestinal tumour. Melaena is not rare in this tumour. Recently, rectal haematochezia has been considered as one of the very rare manifestations of leiomyoma. We report a case of jejunal leiomyoma showing life-threatening rectal bleeding. This 76-year-old man was admitted to hospital because of continuous rectal bleeding for 2 days. Haemorrhagic shock occurred and transfusion of 27 units of packed red blood cells failed to correct the shock. Emergent superior mesenteric angiography revealed a distal jejunal tumour showing evidence of active oozing. Segmental intestinal resection was performed to remove this jejunal tumour. Final pathological examination disclosed a jejunal leiomyoma with a ruptured artery responsible for the life-threatening bleeding. The patient recovered after tumour resection. Our presenting case was probably the second case of jejunal leiomyoma showing haematochezia. The diagnostic priority is discussed.

Aged↗

Subtalar joint stability. Talocalcaneal interosseous ligament function studied in cadaver specimens.

We used 6 fresh-frozen foot specimens to evaluate the contribution of the talocalcaneal interosseous ligament (IOL) in stabilizing the subtalar (talocalcaneal) joint. The tibia and ankle joint were secured, and the calcaneus was subjected to a bending and axial force applied circumferentially. The position of the calcaneus relative to the talus was monitored with a magnetic tracking system. Motion was recorded at every half degree in the 0 degree to 360 degrees arc before and after sectioning of the IOL. The results in the intact feet indicated that, with circumferential loading of the subtalar joint, there were two stable zones (supination stable zone, pronation stable zone) during which little displacement occurred and two transition zones during which the supination and pronation movement occurred. There was a greater degree of supination displacement after IOL sectioning (p = 0.008), but no pronation displacement. The IOL contributed substantially to subtalar joint stability, particularly in supination.

Aged↗

[Myotrophic factors].

A variety of substances have been found to show myotrophic effect and are named myotrophic factors. Myotrophic factors provided a new means to the research and treatment of motor neuron diseases and muscle degenerating diseases. In this article, we reviewed the studies of various myotrophic factors, and indicated the clinical significance and direction of their studies.

Amyotrophic Lateral Sclerosis↗

Influences of cane length on the stability of stroke patients.

The purpose of this study was to investigate the influence of cane length on the standing and walking stability of stroke patients. Ten stroke patients were used as subjects and evaluated by using two different cane lengths based on the measurements of the distance from distal wrist crease to the ground (WC cane), and the distance from greater trochanter to ground (GT cane). Force plates were used to determine the center of pressure (COP). The maximum sways, the total travel distances, and the mean travel speeds of the COP were analyzed for each patient standing and walking with and without canes. It was found that the total travel distance and the mean travel speed of the COP in the medial-lateral (M-L) direction were significantly lower when standing with a cane than when standing without one. It was also found that the values of these parameters and the maximum sways of the COP in both anterior-posterior (A-P) and M-L directions were significantly lower when standing with the WC cane than when standing with the GT cane. No significant difference was found in the maximum M-L sway, the total travel distance, and the mean travel speed of the COP in walking. These results suggest that the standing stability of stroke patients is improved by using canes, especially by using a WC cane, although no significant influence of using canes on the walking stability was detected. Based on the results of this study, the vertical distance from the wrist crease to ground is recommended as the appropriate cane length for stroke patients.

Adult↗

Primary biliary cirrhosis associated with mixed type autoimmune hemolytic anemia and sicca syndrome: a case report and review of literature.

A case presenting with an unusual association of primary biliary cirrhosis and mixed type autoimmune hemolytic anemia plus sicca syndrome is described. The 49-yr-old female primary biliary cirrhosis patient had a confirmed sicca syndrome and presented with jaundice and life-threatening anemia. Laboratory tests revealed positive Coombs' test with coexisting cold and warm autoantibodies. She was successfully treated by blood transfusion with packed red cells lacking any red cell antigens corresponding to serum alloantibodies and pulse methylprednisolone therapy. The patient remained stable under maintenance treatment using oral steroids and ursodeoxycholic acid. This case is probably the first reported showing an association between primary biliary cirrhosis and mixed type autoimmune hemolytic anemia plus sicca syndrome and was probably induced by heterogenous and complicated autoimmune reactions.

Administration, Oral↗

Expression of CD44 and variant isoforms in cultured human retinal pigment epithelial cells.

PURPOSE: CD44 is a major hyaluronic acid receptor that exists as a number of isoforms, generated by alternative splicing of 9 "variant" exons in humans (v2 to v10) and 10 exons in rodents. Little is known about the expression and function of CD44 in human retinal pigment epithelium (RPE) cells. Therefore, the authors determined whether human RPE cells express CD44, and whether the expression differs depending on the proliferative status of the cells. METHODS: Human RPE cells were harvested from normal donor eyes and propagated in culture. Total RNA was extracted from cultured cells. mRNA expression of CD44 was determined by reverse transcription-polymerase chain reaction (RT-PCR), followed by cloning and sequencing of the PCR products, and by Southern hybridization. CD44 cell surface expression was measured by flow cytometry. Western hybridization and immunohistochemistry were used to determine the CD44 immunoreactivity of cultured human RPE cells and normal human RPE cells in situ. RESULTS: The standard form of CD44 mRNA and variant isoforms containing exon v6 or v10 were expressed in cultured human RPE cells. CD44 mRNA and protein levels were increased in proliferating human RPE cells compared with density-arrested counterparts. Addition of 1 microM retinoic acid enhanced the cell density-induced downregulation of CD44 mRNA, but did not significantly affect the CD44 cell surface protein expression. As previously reported, CD44 immunoreactivity was not detected in normal human RPE cells in situ. CONCLUSIONS: Cultured human RPE cells express CD44 standard form and variant isoforms containing exon v6 or v10, which are preferentially expressed by proliferating human RPE cells.

Blotting, Western↗

Risk factors for gallbladder polyps in the Chinese population.

OBJECTIVES: To assess the prevalence of and risk factors for gallbladder (GB) polyps in the Chinese population. METHODS: A prospective ultrasonographic study of GB polyps was conducted in 3647 Chinese subjects who received a paid physical checkup at this hospital. Their demographic characteristics and biochemical parameters were recorded. Ultrasonographic diagnosis revealed a normal GB in 2946 subjects (1838 men, 1108 women), polyps in 243 (174 men, 69 women), gallstones in 286 (196 men, 90 women), a history of cholecystectomy in 100 (56 men, 44 women), mixed gallstones/GB polyps in 17 (10 men, seven women), and miscellaneous results in 35. RESULTS: Excluding subjects with cholecystectomy and mixed gallstones/GB polyps, the overall prevalence of GB polyps in the study group was 6.9%. The studied risk factors manifesting an increased odds ratio (OR) for the development of GB polyps were glucose intolerance (OR 1.506, p < 0.05) and male gender (OR 1.723, p < 0.05) in multivariate analysis. Other demographic characteristics and biochemical parameters, such as age, body mass index, cigarette smoking, alcohol consumption, blood pressure, lipid profile, hepatitis B virus carrier, liver function, and parity, did not exhibit any correlation to GB polyps. CONCLUSIONS: Among Chinese of higher socioeconomic status, men and individuals with glucose intolerance tend to have a high risk for developing GB polyps.

Adult↗

Factors responsible for computed electrogastrographic parameters in humans.

OBJECTIVES: Clinical knowledge about myoelectrical frequency is well known, but the factors responsible for recorded myoelectrical amplitude remain less clear. METHODS: We assembled an electrogastrographic system that could automatically compute the dominant myoelectrical frequency and power and power ratio. We enrolled 50 healthy volunteers (25 men and 25 women) to study their myoelectrical characteristics. Three surface electrodes were placed in the fundic, stomach body, and antral positions for two 30-min recordings in the fasting and postprandial states. RESULTS: The three different electrodes recorded similar dominant frequencies of about 3 cpm before and after a meal. The fasting dominant powers from these electrodes were 52.9 +/- 14.7, 44.6 +/- 11.5, and 50.1 +/- 15.1 dB, respectively (p < 0.01), whereas the postprandial dominant powers were 61.6 +/- 28.8, 54.3 +/- 26.6, and 61.9 +/- 27.8 dB, respectively (p < 0.01). Meal ingestion did increase the power (p < 0.05). Women had a lower dominant power than men (p < 0.001). Moreover, the dominant powers of each electrode were significantly correlated with body mass index (r = 0.3-0.36, p < 0.05) regardless of meal ingestion. The postprandial power ratio was not influenced by electrode position, gender, or body mass index. CONCLUSIONS: Myoelectrical dominant frequencies and power ratios are similar throughout the whole stomach area, whereas a lower power area exists on the stomach body. Gender-related variation in dominant power seems to be an effect of body size. The power ratio is the only reliable parameter for expressing myoelectrical amplitude.

Adult↗

The effects of ursodeoxycholic acid in patients with severe obstructive jaundice after drainage procedure.

BACKGROUND: The aim of this study is to evaluate the therapeutic effect of ursodeoxycholic acid (UDCA) for patients with severe obstructive jaundice after drainage procedure. METHODS: From September 1993 to December 1994, patients admitted with severe obstructive jaundice (serum bilirubin > 15 mg/dl) and successful drainage were enrolled into our study. They were randomly divided into two groups to receive UDCA 600 mg per day (UDCA group) or a placebo (placebo group) until operation or discharge. Bile drainage amount, clinical symptoms and signs and adverse effects of drugs were recorded daily. Biochemical tests, including albumin, total bilirubin, cholesterol, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase and prothrombin time, were checked first, on the third and seventh days, and then two weeks after drainage. RESULTS: Thirty-eight patients (M/F = 36/ 2, mean age 66.6 +/- 6.4 years) completed the study, 18 in the UDCA group and 20 in the placebo group. There were no differences in age, sex, causes of obstructive jaundice or methods of drainage procedure between the UDCA and placebo groups. Improvement in biochemical test results were noted in both groups. However, bile drainage amount and changes in liver biochemical test, especially the decrement of serum bilirubin, were not significantly different between both groups. CONCLUSIONS: UDCA seemed not to benefit patients with severe obstructive jaundice after successful drainage.

Aged↗