Biomedical subjects

C S Lu

Publications and source records attributed to C S Lu.

At least 55 records · Page 3Linked to original sources

PubMed1997

Presynaptic and postsynaptic striatal dopaminergic function in patients with manganese intoxication: a positron emission tomography study.

We performed PET on four patients with chronic industrial Mn intoxication; presynaptic and postsynaptic dopaminergic function were measured with [18F]6-fluoro-L-dopa (6FD) and [11C]raclopride (RAC). All patients had a rigid-akinetic syndrome; they had no sustained benefit from L-dopa. Influx constants (Ki) of 6FD were normal in the caudate and putamen. RAC binding was mildly reduced in the caudate and normal in the putamen. We conclude that nigrostriatal dopaminergic dysfunction is not responsible for the parkinsonism caused by chronic Mn intoxication. The pathology is likely to be downstream of the dopaminergic projection.

Adult↗

PubMed1997

Salmonella typhimurium brain abscess in a six-month-old infant: a case report and review of the literature.

We report the case of a six-month-old male infant with brain abscess caused by Salmonella typhimurium. Upon admission, he was suffering from fever, diarrhea, drowsiness and convulsion. Salmonella meningitis was identified by CSF examination. Following failure of antibiotic therapy to control his fever, brain computerized tomography (CT) was ordered 5 days later and revealed a brain abscess. He received surgical excision of the abscess and recovered completely after receiving ceftriaxone therapy for 8 weeks. The case of our patient, together with 11 cases of Salmonella brain abscess from the English literature are reviewed. There was a male preponderance among these patients (male: female = 2.67 : 1) and the majority were less than one year old. Salmonella typhimurium, typhi, and enteritidis occurred most frequently. Fever, seizure, signs and symptoms of increased intracranial pressure and change in mental status were the most common clinical features. Purulent meningitis was a major predisposing factor. Successful treatment was associated with early identification, prompt surgical intervention, high dose, long-term antibiotic therapy, and close follow-up for possible recurrence and to determine the presence of neurological sequelae.

Anti-Bacterial Agents↗

PubMed1996

Dopa-responsive dystonia: clinical and family study in Taiwanese.

We report the clinical features of four female patients with dopa-responsive dystonia (DRD), and the survey of the family members. The patients were 2 sisters and 2 sporadic patients from 3 families. Their age of onset ranged between 5 and 13 years. The clinical manifestation was characterized by limb dystonia which was relieved by L-dopa treatment. Diurnal fluctuation disappeared 15 years later in one patient. There was a wide spectrum of Parkinsonian features and variability of dystonia. Response of L-dopa was still excellent 20 years later. In survey of the family members, there was neither bradykinesia, rigidity, tremor nor dystonia.

Adult↗

PubMed1996

Botulinum toxin A injection in the treatment of hemifacial spasm.

UNLABELLED: There are conflicting reports concerning the variation in duration of symptoms relief for patients with hemifacial spasm who have undergone several injections of botulinum A toxin (BOTX-A). We present our experience of BOTX-A injections in Taiwanese patients to analyze this issues, and to inspect whether the efficacy of treatment depends on the pre-injection severity. MATERIAL AND METHOD: From July 1992 to December 1994, 137 patients received injections of BOTX-A. We used objective and subjective score system to evaluate the efficacy and side effects of BOTX-A injection. RESULTS: The overall successful rate of substantial relief of spasm was 88%. The mean duration of response was 20 weeks. Patents with more severe spasm tended to have shorter duration of improvement. The effects of consecutive injections remained fairly constant over the first 4 injections. CONCLUSION: The BOTX-A injection is an effective and safe treatment for patients with hemifacial spasm and the effect could be sustained over the consecutive injections.

Adult↗

PubMed1996

Ventrolateral thalamotomy for dyskinesia following levodopa therapy of Parkinson's disease.

We report a 65-year-old male parkinsonian patient who developed dominantly unilateral choreic movements over his right-side extremities after a daily dosage of up to 1,000 mg of carbidopa-levodopa (carbidopa 200 mg, levodopa 800 mg) for 12 years. The disabling choreic movement appeared as a pattern of peak-dose dyskinesia and was so severe that he was unable to sit or stand still to suppress the involuntary movements. It started about 20 minutes after each dose of levodopa and lasted for about 2 hours. Although the dyskinesia could be reduced by decreasing the levodopa dosage, he could not tolerate the severe parkinsonian disabilities. The dyskinesia did not respond to baclofen, diazepam or clozapine. The chorea was successfully treated surgically using stereotactic left ventrolateral thalamotomy. This is an important treatment for patients with intractable dyskinesia after prolonged levodopa therapy.

Humans↗

PubMed1995

Reciprocal inhibition in writer's cramp.

We studied the inhibition of median H-reflexes by conditioning stimuli on the radial nerve in 13 patients with writer's cramp, eight of the simple type and five of the dystonic type, and in 14 normal volunteers. The patients and controls were right-handed, and their right arms were studied. Asymptomatic left arms were also studied in nine of 13 patients. In the control group we identified three periods of inhibition, with maximum peaks at conditioning-test intervals of 0 ms (41 +/- 17%), 20 ms (40 +/- 13%), and 100 ms (36 +/- 20%). In the patient group, the amplitudes of inhibition of these three periods in both arms were significantly less than those in the control group. However, there were no significant differences in the amplitudes of inhibition of these three periods between symptomatic and asymptomatic arms. There were also no significant differences between simple and dystonic writer's cramps. Our results indicate that the attenuation of reciprocal inhibition was present not only in symptomatic arms but also in asymptomatic arms of patients with writer's cramp. The defect of reciprocal inhibition in the asymptomatic hand has never been documented. We suggest that the preexistent electrophysiological abnormality may provide an explanation for the development of hand cramp after shifted writing.

Adult↗

PubMed1995

Double-blind, placebo-controlled study of botulinum toxin injections in the treatment of cervical dystonia.

Botulinum toxin injections were given to 23 patients with cervical dystonia in a double-blind, placebo-controlled, crossover study. Each patient was randomly given 100 units of botulinum A toxin and placebo in two respective sets of injections into the two most active contracting neck muscles at least 3 months apart. Before and 3 weeks after each set of injections, the cervical dystonia was "blindly" scored by the investigator. Each patient was also asked to independently score the improvement of the dystonia and neck pain. Four patients dropped out and one patient showed spontaneous remission. The remaining 18 patients completed the study and showed a significant improvement after the injections of botulinum toxin in comparison with that of the placebo. The effect started about 1 week after injection and the maximal effect lasted about 11 weeks in patients with a satisfactory response. The neck pain was satisfactorily relieved in 9 of 10 patients affected. There were no significant side effects. Thus, botulinum toxin injection is effective in treating cervical dystonias; injection of a higher dose of botulinum toxin in a greater number of neck muscles is required for those patients with complex cervical dystonia.

Adult↗

PubMed1995

Stiff-man syndrome: report of a case.

A 40-year-old Taiwanese farmer developed progressive stiffness and pain in the lower back with intermittent cramps over a 3-year period. The cramps were extremely painful and the patient was sensitive to any sudden movement or external stimulation. His lower back was so stiff that the patient had great difficulty performing daily activities and walked with a rigid and straight back. The stiffness of the muscles subsided during normal sleep. Except for a left S1 radiculopathy, no other neurologic abnormalities were noted. Electromyography showed spontaneous continuous muscle fiber activity which was markedly suppressed after a trial with 20 mg intravenous diazepam. The muscular stiffness disappeared during treatment with oral diazepam 80 mg daily, which was tapered to 15 mg daily without any recurrence of spasm for 20 months. This is the first report of stiff-man syndrome in a Taiwanese patient and emphasizes the importance of recognizing this treatable disease.

Adult↗

PubMed1995

[Experimental study on anti-atherosclerotic effect of tongmai jiangzhi oral liquor].

27 Japanese white male rabbits were divided into 3 groups for evaluation of Tongmai Jiangzhi Oral Liquor (TMJZ) in reducing the serum cholesterol, the level of plasma lipid peroxidation (LPO), the plasma TXB2 and suppressing of atherosclerotic plaque formation in atherogenesis. The results indicated that TMJZ not only decreased significantly the levels of serum cholesterol, triglyceride, LPO and TXB2, but also increased markedly blood glutathion peroxidase (GSH-Px) activity and regulated the balance of TXB2/6-keto-PGF1 alpha. The area of atherosclerotic plaque coverage in aorta and the thickness of plaque after oral TMJZ were much smaller than those of high cholesterol-fed rabbits. It is suggested that the effect of TMJZ on above-mentioned indexes might be important mechanism of its anti-atherosclerotic effect.

6-Ketoprostaglandin F1 alpha↗

PubMed1994

Transient neurological disturbances induced by the chemotherapy of high-dose methotrexate for osteogenic sarcoma.

Temporary neurologic abnormalities were observed in one out of 23 patients undergoing chemotherapy with high-dose methotrexate (HD-MTX) for osteogenic sarcoma. This patient developed sequential symptoms including alternative hemiparesis, dysarthria and altered consciousness 5 days after the second course of HD-MTX (8 gm/m2 by 6 h continuous infusion) with leucovorin rescue. Laboratory evaluations disclosed normal electrolytes, hemograms and non-toxic serum MTX levels at the onset of the symptoms. Computed tomography of the brain was normal but electroencephalography showed focal theta and delta slow waves over the right temporal-parietal-occipital area. The neurological symptoms resolved completely within 72 h.

Adolescent↗

PubMed1994

Manganism and idiopathic parkinsonism: similarities and differences.

From the comparison we have made between PD and manganism, we draw the following conclusions: 1. There are similarities between PD and manganism, notably the presence of (a) generalized bradykinesia and (b) widespread rigidity. 2. There are also dissimilarities between PD and manganism, notably the following in manganism: (a) less-frequent resting tremor, (b) more frequent dystonia, (c) a particular propensity to fall backward, (d) failure to achieve a sustained therapeutic response to levodopa, and (e) failure to detect a reduction in fluorodopa uptake by PET. Further studies are likely to yield more discriminants between PD and manganism. For example, PET with raclopride may be useful in early cases of manganism, and MRI may be helpful in patients with advanced manganism.

Brain↗

PubMed1994

Levodopa failure in chronic manganism.

We report a placebo-controlled study of levodopa in four patients with extrapyramidal deficits caused by chronic manganese intoxication. Their parkinsonism and dystonia had progressed slowly over a period of 5 years after they left the site of exposure. Initially the patients appeared to respond to levodopa in open observations, but this apparent benefit was not sustained. This short-term, double-blind study indicates that their parkinsonism and dystonia failed to respond to levodopa.

Adult↗

PubMed1994

Magnetic resonance imaging in a multiple sclerosis patient with progressive ataxia.

A 23-year-old female developed progressive cerebellar ataxia as the only presentation of multiple sclerosis for 6 years. Abnormal evoked potentials, an increased oligoclonal band of IgG-K in the cerebrospinal fluid and disseminated white matter lesions in magnetic resonance images (MRI) were compatible with a diagnosis of clinically definite multiple sclerosis. After cyclosporine treatment, the ataxia became stable without further deterioration. A follow-up MRI six months later did not reveal any active lesions. The importance of MRI in the confirmation of the clinical diagnosis and the evaluation of therapeutic effects in patients with atypical multiple sclerosis is emphasized.

Adult↗

PubMed1994

Cognitive dysfunction in early onset parkinsonism.

Cognitive functions of 24 patients with early onset parkinsonism (age of onset before 40 years) and 24 controls were investigated by a battery of neuropsychological tests. Patients were shown to be impaired in performance IQ (PIQ), conceptual ability and regulation behavior, memory, visuospatial perception, and manual dexterity. Patients were also shown to have a higher Zung Depression score. However, analysis of the testing scores appeared to indicate that only a small portion of poor performance on neuropsychological tests are depression related. The results demonstrated that patients with early onset parkinsonism, in whom the factor of aging is not as important, still show cognitive dysfunction and suggested that Parkinson's disease itself can cause cognitive impairment.

Adult↗

PubMed1993

Progression after chronic manganese exposure.

We report a longitudinal follow-up study on six patients with chronic manganese-induced parkinsonism following cessation of manganese exposure. Compared with the 1987 study, their parkinsonian symptoms showed a slow progression, particularly in gait disturbances such as freezing during turning and walking backward with retropulsion. The mean disability scores on the King's College Hospital Rating Scale were 15.0 +/- 4.2 in 1987 and 28.3 +/- 6.7 in 1991 (p = 0.003, paired t test). Review of the video records also confirmed a worsening of parkinsonism, especially in difficulty turning. Three of six patients receiving levodopa treatment had an initial improvement. The response decreased after 2 to 3 years. During the therapy, they did not develop on-off fluctuation or dyskinesia. We conclude that patients with manganese-induced parkinsonism may develop increasing neurologic dysfunction long after cessation of exposure and that their responses to levodopa are different from those of patients with Parkinson's disease.

Adult↗

PubMed1993

Type C Niemann-Pick disease: report of a Chinese case.

We report on a 12-year-old Chinese child with type C Niemann-Pick disease, who presented primarily with neurologic symptoms. He started to develop ataxia and dysarthria at the age of six years. Dementia, dysphagia, dystonia and seizures, in that sequence, followed within a couple of years. He was anarthric and bedridden five years after onset. Supranuclear vertical gaze palsy was found at the beginning of the illness. However, no hepatosplenomegaly or other physical abnormality was noted. Bone marrow aspirates revealed foamy storage cells and sea-blue histiocytes. However, sphingomyelinase activity in the cultured skin fibroblast was normal. The characteristic clinical presentations and typical pathologic and histochemical findings meet the diagnostic criteria of type C Niemann-Pick disease. We report the first Chinese case of type C Niemann-Pick disease and review 73 cases reported previously.

Child↗

PubMed1993

Case of Isaacs syndrome successfully treated with phenytoin.

We herein report on an 18-year-old Taiwanese man who developed acute onset of generalized continuous contractions of the muscles. The involuntary cramps caused a dystonic posture of the neck and limbs. Opisthotonos was noted when the cramps were exacerbated. The cramps were painful and sensitive to movement, so the patient limited movement of his body. External stimulation, such as a pin prick or a loud noise, would aggravate them. The contractions of the muscles persisted during sleep. No other neurologic abnormalities were noted. Electromyography showed spontaneous continuous muscle fiber activity. The symptoms did not respond to baclofen or diazepam; however, remarkable improvement was noted after giving phenytoin. The clinical presentation, electromyographic findings, and the patient's beneficial response to phenytoin fulfilled the diagnostic characteristics of Isaacs syndrome.

Adolescent↗

PubMed1992

Pseudoathetosis as a presenting symptom of spinal multiple sclerosis.

We report on a 38-year-old female patient with acute proprioceptive sensory impairment and pseudoathetosis in the four limbs, particularly in the fingers of both hands. She had great difficulty in buttoning, unbuttoning, using chopsticks and writing, because she was no longer able to feel her fingers in space. There was a profound loss of position and vibration sensation in all limbs, especially in both hands. Pseudoathetoid movement, a rare presentation of multiple sclerosis, was observed in the outstretched hands and extended fingers. T1- and T2-weighted magnetic resonance imaging (MRI) of the spinal cord revealed an inactive intramedullary lesion in the C2-C5 segments. Gadolinium-enhanced MRI revealed an active lesion in the posterior columns of the cervical cord at the C3 vertebral level, which is very likely responsible for pseudoathetoid movement. Based on the disseminated lesions in the spinal cord verified by MRI the four neurologic manifestations, and the abnormal somatosensory-evoked potentials, we made a definitive diagnosis of multiple sclerosis of the spinal cord.

Adult↗