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Biomedical subjects

C M Chang

Publications and source records attributed to C M Chang.

At least 37 records · Page 2Linked to original sources
PubMed2001

Lithopedion.

Lithopedion is a rare obstetrical outcome of an undiagnosed and untreated advanced abdominal pregnancy, mostly found incidentally. We present a case of lithopedion. In a 76 year-old female suffering from cervical neoplasm, total abdominal hysterectomy was performed for the lesion and the lithopedion was found incidentally. The patient's history was unremarkable, and laboratory tests were normal. The patient recalled having experienced a severe abdominal pain about 50 years before. Her physician had felt "a benign tumor" in her pelvis at that time, indicating that the stone child had retained in the maternal peritoneal cavity for 50 years.

Female↗
PubMed2001

Klebsiella pneumoniae psoas abscess: predominance in diabetic patients and grave prognosis in gas-forming cases.

Seven cases of psoas abscess caused by Klebsiella pneumoniae were observed at the National Cheng Kung University Hospital within a period of 4.5 years. These cases constituted 25% of a total 28 episodes of non-tuberculous psoas abscess, ranking second to those caused by Staphylococcus aureus (8 cases). Eight cases of psoas abscess caused by K. pneumoniae were identified from Medline, and 5 of which were reported from Taiwan. Of these 8 cases, 1 neonatal case was excluded, and the remaining 7 adult cases were combined with the 7 cases in this series for analysis. The mean age was 53.8 years, and diabetes mellitus was the most common underlying disease. Fever and pain on the flank and back area were the common findings. The interval between the onset of symptoms and diagnosis ranged from 1 to 60 days. The most common sites of concurrent infection were the urinary tract (6 cases; 43%) and bone (3 cases; 21%). All patients received percutaneous or surgical drainage in addition to antibiotic treatment. Gas formation was present in 5 of the 12 patients recorded, and 4 of them died during hospitalization. Only 1 patient had a metastatic infection with osteomyelitis of the left radius and right humerus; he had experienced 5 episodes of recurrent K. pneumoniae infections in different sites. We concluded that K. pneumoniae should be considered as an important endemic pathogen of psoas abscess in diabetics in Taiwan. The high mortality rate in the gas-forming cases should also be highlighted. Early recognition, empiric antimicrobial coverage for K. pneumoniae, and aggressive drainage or debridement are indicated in these patients.

Adolescent↗
PubMed2000

Shark cartilage extract interferes with cell adhesion and induces reorganization of focal adhesions in cultured endothelial cells.

In this study, we examined the effects of shark cartilage extract on the attachment and spreading properties and the focal adhesion structure of cultured bovine pulmonary artery endothelial cells. Treatment with cartilage extract resulted in cell detachment from the substratum. Immunofluorescence staining of those treated cells that remained attached showed that, instead of being present in both central and peripheral focal adhesions as in control cells, both integrin alpha(v)beta(3) and vinculin were found only in peripheral focal adhesion and thinner actin filament bundles were seen. In addition to causing cell detachment, cartilage extract partially inhibited the initial adherence of the cells to the substratum in a dose-dependent manner. Integrin alpha(v)beta(3) and vinculin staining of these cells also showed a peripheral focal adhesion distribution pattern. Vitronectin induced cell spreading in the absence of serum, but was blocked by simultaneous incubation with cartilage extract, which was shown to inhibit both integrin alpha(v)beta(3) and vinculin recruitment to focal adhesion and the formation of stress fibers. Dot binding assays showed that these inhibitory effects on cell attachment and spreading were not due to direct binding of cartilage extract components to integrin alpha(v)beta(3) or vitronectin. Shark cartilage chondroitin sulfate had no inhibitory effect on either cell attachment or spreading of endothelial cells. These results show that the inhibitory effects of cartilage extract on cell attachment and spreading are mediated by modification of the organization of focal adhesion proteins.

Acid Phosphatase↗
PubMed2000

Intravenous amiodarone for prevention of atrial fibrillation after coronary artery bypass grafting.

BACKGROUND: Atrial fibrillation occurs in 10% to 40% of patients who undergo coronary artery bypass grafting. This prospective study assesses the safety and efficacy of low-dose intravenous amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting. METHODS: One hundred forty patients were randomly divided into two groups: an amiodarone group (n = 74) receiving intravenous amiadarone in a loading dose of 150 mg and maintenance dose of 0.4 mg x kg(-1) x h(-1) for 3 days before and 5 days after operation and a control group (n = 76) receiving matching infusions of 5% glucose solution. RESULTS: Atrial fibrillation occurred in 9 (12%) of the amiodarone group patients and in 26 (34%) of the control group patients during hospitalization (p < 0.01). The maximum ventricular rate during atrial fibrillation was significantly slower in the amiodarone group (107 +/- 21) than in the control group (138 +/- 24 beats per minute, p < 0.01). The duration of atrial fibrillation in the amiodarone group (1.1 +/- 1.2 hours) was significantly shorter than that in the control group (3.2 +/- 1.3 hours, p = 0.01). The two groups had no significant differences in incidence of major morbidity (8 of 74 versus 8 of 76 in amiodarone and control groups, respectively) or mortality (4 of 74 versus 5 of 76). However, the control group had significantly longer intensive care unit stays (132 +/- 24 versus 111 +/- 19 hours, p < 0.01). CONCLUSIONS: Perioperative low-dose intravenous amiodarone significantly reduces the incidence, ventricular rate, and duration of atrial fibrillation after coronary artery bypass grafting. Furthermore, low-dose intravenous amiodarone is well tolerated and does not increase the risk of intraoperative or postoperative complications.

Aged↗
PubMed2000

A geometric approach to determine adsorption and desorption kinetic constants.

A geometric method based on Langmuir kinetics has been derived to determine adsorption and desorption kinetic constants. In the conventional procedure, either the adsorption kinetic constant (k(a)c) or desorption kinetic constant (k(d)c) is found from kinetic experiments and the other is calculated by their correlation with the equilibrium constant, i.e, k(d)c = Kcon/k(a)c, where Kcon has been known from equilibrium studies. The determined constants (Kcon, k(a)c, k(d)c), if based only on the conventional procedure, may not be accurate due to their mathematical dependence. Therefore, the objectives of this study are applying a geometric approach to directly determine Langmuir kinetic constants and describe adsorption behavior. In this approach, both adsorption kinetic constant (k(a)g) and desorption kinetic constant (k(d)g) are obtained only from data of kinetic experiments, and a geometric equilibrium constant (Kgeo) is calculated by Kgeo = k(a)g/k(d)g. The deviation between Kgeo and Kcon can prove the accuracy of k(a)g and k(d)g which were determined by this method. This approach was applicable to selenate, selenite and Mg2+ adsorption onto SiO2 regardless of whether the adsorbate formed inner- or outer-sphere complexes. However, this method showed some deviation between Kcon and Kgeo for Mn2+ adsorption because of the formation of surface Mn(II)-hydroxide clusters, which was inconsistent with the basic assumption of this method of monolayer adsorption.

Adsorption↗
PubMed2000

The BH3 domain is required for caspase-independent cell death induced by Bax and oligomycin.

Bax causes apoptosis by associating with mitochondria and triggering cytochrome c release, which activates the caspase cascade. Bax can also kill some cells independently of caspases, but the requirements for such killing are poorly understood. Here we describe an inducible fibroblast line that expresses Bax when tetracycline is withdrawn; the resulting apoptosis can be blocked by the caspase inhibitor zVAD-fmk. Even when caspases are inhibited, however, treating the Bax-expressing cells with the mitochondrial toxin oligomycin efficiently triggers death with features resembling apoptosis. Bax mutants lacking the BH3 domain remain able to cause cytochrome c release and caspase-mediated death, but cannot support this caspase-independent killing. Mutating specific BH3 residues needed for binding Bcl2 does not prevent synergy with oligomycin, implying that no such binding is required. These findings illuminate a caspase-independent pathway of death that depends on the Bax BH3 domain and on effectors emanating from mitochondria.

Amino Acid Chloromethyl Ketones↗
PubMed2000

Ionizing radiation and bacterial challenge alter splenic cytokine gene expression.

Irradiation increases susceptibility to bacterial infection. Exogenous proinflammatory cytokines can alter the response of mice to gamma radiation, but the role of endogenous inflammatory cytokines after bacterial infection in irradiated animals is not known. Gene expression of hematopoietic (GM-CSF) and proinflammatory (IL-1 beta, IL-6 and TNF-alpha) cytokines were examined in spleens of B6D2F1/J female mice after irradiation alone (1.0- and 7.0-Gy), and after irradiation followed by Klebsiella pneumoniae s.c. challenge 4 days postirradiation by using the reverse transcription-polymerase chain reaction (RT-PCR) and Southern blot hybridization. At 4, 8, and 24 h after bacterial challenge in 7.0-Gy-irradiated mice, GM-CSF mRNA increased (p < 0.05). TNF-alpha mRNA in irradiated mice were slightly decreased, whereas after bacterial challenge, TNF-alpha mRNA elevated at 30 h in 7.0-Gy-irradiated mice; at 4, and 8 h in 1.0-Gy-irradiated mice, and at 1 h in sham-irradiated mice (p < 0.05). IL-6 mRNA displayed a biphasic response in 7.0-Gy-irradiated mice, and, after bacterial challenge, in both irradiated mice (1.0- and 7.0-Gy) and sham-irradiated mice. IL-1 beta mRNA remained at or below normal for 8 h and increased at 24 h after bacterial challenge on day 4 in 7.0-Gy-irradiated mice. These results indicate that sublethal gamma radiation alters the patterns of the hematopoietic and proinflammatory cytokine responses to bacterial challenge in vivo. Consequently, treatment protocols may need to take into account changes in cytokine gene responses to resolve infection after irradiation.

Animals↗
PubMed2000

Pathogenicity and gene analysis of adenovirus from pigeons with inclusion body hepatitis.

The pathogenicity of an adenovirus isolated from pigeons (Pigeon adenovirus, PA) with inclusion body hepatitis in Taiwan was investigated in specific-pathogen-free (SPF) chicks and in racing pigeons. One-day-old SPF chicks were inoculated subcutaneously with 10(4) 50% tissue culture infective dose (TCID50, low dose) and 10(8) TCID50 (high dose) of the virus, respectively. The chicks began to die three days post inoculation (DPI) with high dose of the virus and the mortality reached 100%; the chicks began to die 6 DPI and the mortality reached 90% at 14 DPI with low dose. The adult pigeons seemed to be resistant to the PA. However, this virus decreased the production of antibody against Newcastle disease virus in pigeons. It is found that this PA belongs to genetic group D from the restriction patterns produced by BamH I and Hind III.

Animals↗
PubMed2000

Efficiency and effectiveness of stroke rehabilitation after first stroke.

PURPOSE: To investigate predictive variables of rehabilitation efficiency and achievement of rehabilitation potential following stroke rehabilitation. METHODS: We prospectively studied 110 first-stroke patients consecutively admitted to the inpatient rehabilitation department of our university hospital from 1 January to 31 December 1997. Functional recovery was measured as improvement in the ability to perform the Functional Independence Measure (FIM) instrument. Major medical (side of paralysis, stroke etiology, risk factors, Brunnstrom motor recovery stage, etc.), rehabilitative (initial FIM subscore, interval from stroke onset to rehabilitation commencement, rehabilitation stay, etc.), and demographic (age, years of education, occupation, marital and living status, care-giver, etc.) variables were examined. RESULTS: The mean FIM score was 57.7 +/- 24.5 at admission and 77.3 +/- 26.3 at discharge. The mean rehabilitation efficiency (0.7 +/- 0.7) and effectiveness (30.6 +/- 24.0%) of stroke rehabilitation were determined. Rehabilitation efficiency and rehabilitation effectiveness were significantly predicted by length of stay and arm motor recovery stage, and by age and arm motor recovery stage, respectively. The variance explained only 21% of the rehabilitation efficiency and 24% of the achievement of rehabilitation potential. CONCLUSIONS: The results of this study suggest that the large proportion of the unexplained variance in rehabilitation efficiency and effectiveness is due to nonmedical factors influencing the selection of patients for rehabilitation.

Adult↗
PubMed2000

Factors influencing functional independence outcome in stroke patients after rehabilitation.

The purpose of this study was to identify predictive variables relevant to functional independence outcomes for stroke patients following rehabilitation therapy. We prospectively studied 150 stroke patients consecutively admitted to the inpatient rehabilitation department of a university hospital from January 1 to December 31, 1997. Functional ability was assessed with the Functional Independence Measure (FIM) instrument on admission, on discharge of inpatient rehabilitation program, and at the 6 months follow-up visit after discharge. Severity of stroke was determined by using the Canadian Neurological Scale (CNS) on admission. In addition, major medical and sociodemographic factors were documented during hospitalization as independent variables. Of the 142 subjects surveyed, 23 (16.2%) stroke patients achieved functional independence at home when re-visited. Univariate test and multiple logistic regression analyses indicated that the significant factors affecting functional independence included age of onset, occupation, prior heart problems, the presence of medical complications, bilateral hemiplegia, and the functional ability (FIM score) and the severity of stroke (CNS score) on admission. The results of this study suggest that the admission CNS and FIM scores are useful in the prediction of functional independence outcome for stroke survivors following rehabilitation therapy.

Activities of Daily Living↗
PubMed1999

The role of P wave in prediction of atrial fibrillation after coronary artery surgery.

Atrial fibrillation (AF) is a common arrhythmia after coronary artery bypass surgery (CABG). The purpose of this study was to determine the role of P wave duration, amplitude and dispersion in the prediction of AF after CABG. This study included 120 patients undergoing elective CABG. Clinical characteristics, 12-lead electrocardiogram (ECG), echocardiogram and coronary angiogram were obtained in all patients. We measured P wave duration, amplitude and dispersion from 12-lead ECG in each patient. After CABG, all patients were continuously monitored for AF attacks in the intensive care unit and ordinary ward. Our results showed that age greater than 60 years was the strongest predictor of postoperative AF (p<0.01), with a 3.7-fold greater likelihood of developing postoperative AF compared to ages less than 60 years. Gender was another independent predictor of postoperative AF, with men being 3.0 times more likely to develop postoperative AF compared to women (p = 0.03). The presence of prolonged P wave duration (> or =100 ms in lead II) was also an independent predictor (p = 0.04), with 2.9-fold greater risk of developing postoperative AF compared to a P wave duration of less than 100 ms. The P wave dispersion was similar between patients with and without postoperative AF (29+/-15 vs. 33+/-15 mm, p = NS). In conclusion, old age, male gender and prolonged P wave duration were independent predictors of AF after CABG. However, P wave dispersion and amplitude did not provide significant information in the prediction of postoperative AF.

Age Factors↗
PubMed1999

Cytomegalovirus colitis in individuals without apparent cause of immunodeficiency.

Cytomegalovirus infection is usually reported in immunocompromised patients. In this study, apparently immunocompetent patients with cytomegaloviral colitis were reviewed. Records with a diagnosis of cytomegaloviral colitis from January 1989 to June 1996 were retrieved for analysis. Ten patients were included (median age 70 yr). The major presenting symptoms were diarrhea and hematochezia. Ulceration was the main macroscopic finding. Rectal bleeding was mostly self-limiting. Three patients developed local complications (rectovaginal fistula in two; rectal stricture in one). In the two patients with rectovaginal fistula, lymphocytes subsets and proliferative response were entirely normal. In the other patient, low B lymphocyte count and low response to mitogen were demonstrated. However, the immunoglobulins were not suppressed and rectal biopsies revealed noncaseating granulomas, suggesting activated cell-mediated immunity. In conclusion, a high index of suspicion is crucial for early diagnosis of cytomegaloviral colitis in patients with bloody diarrhea, even though obvious evidence of immunodeficiency is lacking.

Aged↗
PubMed1999

Coherence of multiscale features for enhancement of digital mammograms.

Mammograms depict most of the significant changes in breast disease. The primary radiographic signs of cancer are related to tumor mass, density, size, borders, and shape, and local distribution of calcifications. We show that each of these features can be well described by coherence and orientation measures and provide visual cues for radiologists to identify possible lesions more easily without increasing false positives. In this paper, an artifact-free enhancement algorithm based on overcomplete multiscale representations is presented. First, an image was decomposed using a fast wavelet transform algorithm. At each level of analysis, energy and phase information are computed via a set of separable steerable filters. Then, a measure of coherence within each level was obtained by weighting an energy measure with the ratio of projections of local energy within a specified window. Each projection was computed onto the central point of a window with respect to the total energy within that window. Finally, a nonlinear operation, integrating coherence and orientation information, was applied to modify transform coefficients within distinct levels of analysis. These modified coefficients were then reconstructed, via an inverse fast wavelet transform, resulting in an improved visualization of significant mammographic features. The novelty of this algorithm lies in the detection of directional multiscale features and the removal of aliased perturbations. Compared to existing multiscale enhancement techniques, images processed with this method appeared more familiar to radiologists due to localized enhancement of features.

Algorithms↗
PubMed1998

Effects of a water-soluble extract of Cordyceps sinensis on steroidogenesis and capsular morphology of lipid droplets in cultured rat adrenocortical cells.

Cordyceps sinensis contains a factor that stimulates corticosteroid production in the animal model. However, it is not known whether this drug acts directly on the adrenal glands or indirectly via the hypothalamus-pituitary axis. In the present study, we used primary rat adrenal cell cultures to investigate the pharmacological function of a water-soluble extract of Cordyceps sinensis (CS) and the signaling pathway involved. Radioimmunoassay of corticosterone indicated that the amount of corticosterone produced by adrenal cells is increased in a positively dose-dependent manner by CS, reaching a maximum at 25 microg/ml. This stimulating effect was seen 1 h after CS treatment and was maintained for up to 24 h. Concomitantly, the lipid droplets in these cells became small and fewer in number. Immunostaining with a monoclonal antibody, A2, a specific marker for the lipid droplet capsule, demonstrated that detachment of the capsule from the lipid droplet occurs in response to CS application and that the period required for decapsulation is inversely related to the concentration of CS applied. The mechanism of CS-induced steroidogenesis is apparently different from that for ACTH, since intracellular cAMP levels were not increased in CS-treated cells. However, combined application with calphostin C, a PKC inhibitor, completely blocked the effect of CS on steroidogenesis, suggesting that activation of PKC may be responsible for the CS-induced steroidogenesis.

Adrenal Cortex↗
PubMed1997

Swelling of and drug release from monoglyceride-based drug delivery systems.

Depending on the water content, unsaturated monoglycerides form various liquid crystalline phases, which can be used as sustained-release carriers. The aim of this study was to investigate the water uptake of and drug release from melt-congealed monoglyceride-based drug carriers. The water uptake of the unsaturated monoglycerides monoolein and monolinolein followed second-order swelling kinetics and levelled off at about 50% water content, at which a highly viscous cubic phase was formed. The rapid formation of the cubic phase suggested that the drug release occurred mainly from this phase. The drug release followed the square-root of time relationship during the initial release phase. Chlorpheniramine maleate, an amphiphilic drug was not completely released because of binding to the cubic phase. The rate of water uptake increased and the maximum water uptake decreased with increasing temperature. The drug release could be controlled by varying the surface-to-volume ratio, the drug loading, and the water content of the lipid matrix. It was independent of the source of monoolein.

Calorimetry, Differential Scanning↗
PubMed1997

Two new puriniums and three new pyrimidines from Heterostemma brownii.

Two new puriniums, heteromines D (4) and E (5), and three new pyrimidines, heteromines F (6), G (7), and H (8), were isolated from the aerial parts of Heterostemma brownii Hay. Their structures were determined as 7,9-dimethyl-2-(N,N-dimethylamino)guaninium chloride, 7,9-dimethyl-2-(N-methylamino)guaninium chloride, 6-methoxy-4-(N-methylamino)-2-(N,N-dimethylamino)-5- (N-methylformamido)pyrimidine, 6-methoxy-2,4-bis(N-methylamino)-5-(N-methylformamido)pyrimidine, and 2-amino-6-methoxy-4-(N-methylamino)-5-(N-methylformamido)-pyrimidi ne, respectively.

Animals↗