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Biomedical subjects

C S Wang

Publications and source records attributed to C S Wang.

At least 73 records · Page 4Linked to original sources
PubMed1997

mdr1 mRNA expression by RT-PCR in patients with primary breast cancer submitted to neoadjuvant therapy.

mdr1 expression by reverse transcription and polymerase chain reaction (RT-PCR) has been compared to P-glycoprotein (Pgp) expression by immunohistochemistry (IHC) and correlated with clinical response to neoadjuvant therapy. RNA has been recovered from glass slide smears of fine-needle aspiration from 57 untreated primary breast cancers prior to neoadjuvant chemotherapy (33 cases), hormone therapy (23 cases), or both (1 case). Furthermore, mdr1 mRNA has been analyzed in 6 cases after 2 months of treatment. The neoadjuvant therapy consisted of 4 cycles of adriamycin and cyclophosphamide or tamoxifen. Of 57 tumor specimens, an interpretable result was obtained in 52 cases, indicating the feasibility of the analysis by RT-PCR with very small tumor specimens. The presence of mdr1 mRNA has been documented in 44/52 (84%) tumor samples with a spectrum of expression levels. The expression of mdr1 mRNA was compared with P-glycoprotein (Pgp) expression by IHC using JSB-1, 4E3, and C494 monoclonal antibodies in 48 of the 52 interpretable tumor samples. 12/48 (25%) expressed Pgp by IHC. All tumors expressing Pgp by IHC were also positive by RT-PCR. The results confirm the higher prevalence of mdr1 mRNA compared to the protein expression. However, mdr1 mRNA expression was found to correlate significantly with resistance to neoadjuvant hormone therapy only while Pgp expression detected by JSB-1 immunostaining only correlated with chemoresistance. The lack of convincing correlation with chemoresistance suggests that mRNA and Pgp may not be directly or solely responsible for clinical response to drugs. Further studies should focus on the post-translational modulation of P-glycoprotein and other mechanisms of drug resistance.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1997

Serum alanine aminotransferase level in relation to hepatitis B and C virus infections among blood donors.

To assess the serum alanine aminotransferase (ALT) activity in relation to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among blood donors, antibodies to HCV (anti-HCV) and hepatitis B surface antigen (HBsAg) were detected in 400 blood donors with normal ALT level (< or = 750 mumol/s per liter), and 76 blood donors with raised ALT level. The prevalence of anti-HCV (10.5%) and HBsAg (28.9%) in the latter was higher than that (2.0% and 17.5%, respectively) in the former (p < 0.001 and p < 0.03, respectively). There was a trend that indicated that the risk of anti-HCV positivity increased with increasing age (p < 0.001). Thirty of 76 (39.5%) donors with raised ALT level were positive for anti-HCV or HBsAg. Compared with HBsAg-positive donors, donors with anti-HCV had higher serum ALT levels (p < 0.01) and greater mean age (p < 0.01). Multivariate analysis indicated that both anti-HCV (odds ratio: 6.2; 95% confidence interval: 2.2-17.8) and HBsAg (odds ratio: 2.2; 95% confidence interval: 1.3-3.9) were significantly associated with raised serum ALT activity. The estimated population-attributable risk was 8.6% for anti-HCV, and 13.8% for HBsAg. In conclusion, although HBV and HCV infections are independent risk factors of raised ALT activity among blood donors, they play a minor role in the etiology of raised ALT activity.

Adult↗
PubMed1997

Enteric intussusception due to metastatic intestinal tumors.

Enteroenteric intussusception caused by metastatic tumors is a very rare condition. Because of its rarity and rather mild abdominal physical presentation, preoperative diagnosis is not easily made. Two cases of enteric intussusception due to metastatic intestinal tumors, with the main symptom of melena, are reported. Intussusception was caused by metastatic liposarcoma in one patient and metastatic melanoma in the other. Both patients had long histories of malignant disease, for 15 and 8 years, respectively. They had undergone repeated surgical treatment for metastatic lesions. The diagnosis of enteric intussusception was initially made by computed tomographic scans and small bowel series and was confirmed by laparotomy and pathologic findings. We suggest that tumor metastasis to the small intestine with intussusception should be considered in patients with recurrent tumors and tarry stools.

Adult↗
PubMed1997

Role of hepatic resection in surgery for bilateral intrahepatic stones.

BACKGROUND: Hepatic resection is the treatment of choice for unilateral intrahepatic stones. The availability of the flexible choledochoscope has greatly changed the management of intrahepatic stones. Little has been reported regarding hepatic resection for bilateral intrahepatic stones. METHODS: Fifty-nine (15.1 per cent) of 392 patients with bilateral intrahepatic stones underwent hepatic resection. The indications and results were reported. Surgical outcome and long-term follow-up were analysed, and results were compared with those in patients not undergoing hepatectomy. RESULTS: Fifty-nine patients underwent hepatic resection because of destruction of the left liver by repeated infection (n = 40), multiple cholangitic liver abscesses (n = 18) or associated intrahepatic cholangiocarcinoma (n = 1). The hospital mortality rate was 1.7 per cent. The majority of complications were wound infection (9 per cent), haematobilia (5 per cent) and biliary fistula (3 per cent). The incidence of residual stones after surgery was 60 per cent. One year after postoperative choledochoscopic stone extraction, the rate of complete stone clearance was 84 per cent. In patients who did not have hepatectomy the respective rates were 90.1 and 52.9 per cent. The recurrence rate for stones in the hepatectomy and no-hepatectomy groups was 12 and 33.0 per cent respectively. CONCLUSIONS: Compared with patients not undergoing hepatectomy, those having hepatic resection had similar operative risks, fewer residual stones and a low incidence of recurrent stones (P < 0.05).

Adult↗
PubMed1996

Isolation and characterization of recombinant human apolipoprotein C-II expressed in Escherichia coli.

A full-length recombinant human apolipoprotein C-II (ApoC-II) has been successfully expressed in Escherichia coli using the T7 expression system. The recombinant ApoC-II. which was expressed intracellularly in the inclusion bodies, was solubilized with 8 M urea and purified using Sephadex G-75 gel permeation chromatography. Four liters of the bacterial culture yielded 16-20 mg of purified recombinant ApoC-II. Sequencing and mass spectrometric analyses indicated that the isolated recombinant ApoC-II contained predominantly (64%) the native form with threonine as the N-terminus, but also contained a minor (36%) molecular form of ApoC-II with an additional methionine at the N-terminus (Met-ApoC-II). Analysis of the recombinant ApoC-II by tryptic digestion and high performance liquid chromatography-electrospray mass spectrometry provides additional conclusive evidence that, with the exception of the N-terminus of Met-ApoC-II, the expressed ApoC-II has the expected peptide sequence. However, this extra N-terminal methionine residue can be excised by further in vitro treatment with methionine aminopeptidase. The purified recombinant ApoC-II was found to be competent in the activation of bovine milk lipoprotein lipase. Thus, the recombinant ApoC-II prepared from E. coli may have a pharmacological application for the treatment of patients with genetic hypertriglyceridemia caused by ApoC-II deficiency.

Amino Acid Sequence↗
PubMed1996

Primary carcinoma of the gallbladder in Taiwan.

To define more precisely the prognostic index for patients with primary carcinoma of the gallbladder in Taiwan, we retrospectively reviewed the data of 74 patients with gallbladder carcinoma treated over a period of 15 years, from 1979 to 1993. Of these patients, 75% had Nevin stage V gallbladder cancer. The most common presenting complaint was abdominal pain, followed by jaundice, fever, and nausea and vomiting. Accurate preoperative diagnosis was made in 29.7% of the patients. Ultrasonography and computed tomography had a diagnostic accuracy of 34.0% and 40.9%, respectively. The most common histologic type was adenocarcinoma. Liver was the organ most commonly invaded (51.9%) by direct extension and/or metastases, followed by regional lymph nodes (38.5%). The overall 5-year survival rate was 4.1%. Age, sex, white cell count, hemoglobulin, SGOT, SGPT, total bilirubin, alkaline phosphatase, and cholelithiasis were not significant prognostic factors. Patients with cancers confined in the gallbladder wall (stages I, II, III) had a better (P < 0.05) cumulative survival rate than did those with regional lymph nodes and distant metastases. Cholecystectomy or extended surgery had a better survival rate than did palliative surgery, but there was no significant difference between cholecystectomy and extended surgery. High index of suspicion of the disease and earlier surgical treatment may improve patient survival.

Adult↗
PubMed1996

Surgical treatment of hepatolithiasis: long-term results.

BACKGROUND: Hepatolithiasis is a common disease in East Asia and is prevalent in Taiwan. Surgical and nonsurgical procedures for management of hepatolithiasis have been discussed, but long-term follow-up results of surgical treatment of hepatolithiasis are rarely reported. METHODS: We conducted a retrospective study of case records of patients with hepatolithiasis who underwent surgical or nonsurgical percutaneous transhepatic cholangioscopy treatment. Of 614 patients with hepatolithiasis seen between January 1984 and December 1988, 427 underwent follow-up after surgical (380) or percutaneous transhepatic cholangioscopy (47) treatment for 4 to 10 years and constituted the basis of this study. RESULTS: Long-term results of 427 patients with hepatolithiasis after surgical and nonsurgical treatment within 4 to 10 years of follow-up were recurrent stone rate 29.6% (105 of 355), repeated operation 18.7% (80 of 427), secondary biliary cirrhosis 6.8% (29 of 427), late development of cholangiocarcinoma 2.8% (12 of 427), and mortality rate 10.3% (44 of 427). The patients with hepatectomy had a better quality of life (symptom-free) with a lower recurrent stone rate (9.5%), lower mortality rate (2.1%), and lower incidence of secondary biliary cirrhosis (2.1%) and cholangiocarcinoma (0%) than did the nonhepatectomy group (p < 0.01). The patients without residual stones after choledochoscopy had a better quality of life than did the residual stone group (p < 0.01). CONCLUSIONS: Long-term follow-up study of hepatolithiasis after surgical treatment revealed a high recurrent stone rate (29.6%) that required repeated surgery and a high mortality rate (10.3%) resulting from repeated cholangitis, secondary biliary cirrhosis, and late development of cholangiocarcinoma. Patients who received hepatectomy or without residual stones after choledochoscopy had a good prognosis and quality of life.

Adolescent↗
PubMed1996

Polymerase chain reaction diagnosis of Helicobacter pylori in gastroduodenal diseases: comparison with culture and histopathological examinations.

Helicobacter pylori has been associated with a variety of upper gastrointestinal diseases. Histopathological examination and culture are considered to be the more specific tests in the diagnosis of H. pylori infection. In the present study, we evaluated the efficiency of a polymerase chain reaction (PCR) assay of the H. pylori urease A gene as a procedure in the diagnosis of gastric H. pylori infection in various gastroduodenal diseases. Biopsy specimens were obtained from the antral mucosa of 83 patients during endoscopic examination and were submitted to three tests for the detection of H. pylori infection. The detection rates of H. pylori using PCR, histopathological examination and culture were 84, 77 and 63%, respectively. When the infection was defined, by the agreement of culture and histopathological examination or by positive culture, the PCR assay had a sensitivity of 98.1% and a specificity of 84.6%. When the infection was defined by a positive result of either two of the three tests or by positive culture, the PCR assay had a sensitivity of 98.6% and a specificity of 85.7%. We conclude that the PCR assay is a valuable test for the diagnosis of H. pylori infection in gastroduodenal diseases.

Adult↗
PubMed1996

The prevalence and motivating factors of adolescent smoking at a rural middle school in Taiwan.

The purpose of this survey is to study the prevalence and motivating factors of smoking among 1,372 students at a rural middle school in Taiwan. The prevalence of smokers for total, male, and female students is 5.7, 11.5, and 0.4%, respectively. Prevalence increased with age and grade among males, but no significant differences were found among females. Prevalence was higher among students from nuclear families than those from extended families (OR = 2.8, 95% C.I. 1.4-5.5). Prevalence was also higher among students from families with very strict parental control or very little parental control (OR = 4.25, 95% C.I. 2.24-8.08). The majority (70-80%) began smoking during primary school. Smokers who had attempted abstinence in the past had a better understanding of the hazards of smoking and smoked less frequently and with lower average consumption (P < .05). For 60% of the students the first source of cigarettes was friends or classmates; only 22% bought them. Health education increased understanding of the hazards of smoking (OR = 2.2, 95% C.I. 1.10-4.45). In conclusion, the primary factors that affect adolescent smoking are age, family structure, abstinence experience, strictness of upbringing, family influence, peer pressure, and health education.

Adolescent↗
PubMed1996

Clinical experience of esophageal ulcers and esophagitis in AIDS patients.

In Taiwan, numbers of patients with the acquired immunodeficiency syndrome (AIDS) have been increasing in recent years. We present esophageal disease of different causes in 5(16%) heterosexual men among 31 AIDS patients over a 5-year period. Major symptoms included mild dysphagia in 4 (80%) patients and odynophagia in 3 (60%) patients. The duration of symptoms varied from 3 days to 6 months. The symptoms occurred before the diagnosis of AIDS in 3 patients. At esophagogastroduodenoscopy (endoscopy), all 5 patients had esophagitis and/or esophageal ulcers proved by histopathologic evaluation. Four had Candida esophagitis, 3 had cytomegalovirus esophagitis/ulcers and 2 had idiopathic esophageal ulcerations (IEU). Three patients had different esophagitis/ulcers at the same time or during follow-up. The median CD4 lymphocyte count at the time of diagnosis of esophageal disease was 12.2 cells/mm3 (range, 3 to 35 cells/mm3). The endoscopic pictures of the different causes of esophagitis/ ulcers lack uniformity in number, size and appearance. These observations make a conclusion that all AIDS patients with an esophageal disease should undergo endoscopy with biopsy to obtain a definitive diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Isolation and characterization of human milk bile salt-activated lipase C-tail fragment.

Glycosylation positions and oligosaccharide characteristics in the proline-rich, mucin-like, C-terminal region (C-tail) of human milk bile salt-activated lipase (BAL) were studied in order to assess the possible physiological functions of this region. A large-scale purification method has been devised to purify the C-tail fragment from human milk BAL. Chymotryptic, tryptic, and cyanogen bromide cleavages of partially purified BAL and subsequent molecular sieve chromatography yielded 20-30 mg of C-tail fragment from 1 L of human milk. The N-terminal sequence and amino acid composition of the purified C-tail fragment establish that it is derived from residues 528-712 of the enzyme. The O-glycosylated carbohydrates of the C-tail fragment contain fucose, galactose, glucosamine, galactosamine, and neuraminic acid in a molar ratio of 1:3:2:1:0.3, respectively. beta-Elimination reaction revealed that nine threonine residues and less than one serine residue were glycosylated. Edman degradation of C-tail fragment and its pronase subfragment suggest a number of glycosylation sites which are flanked by a consensus motif of PVPP. We suggest that this motif may serve as a signal for O-glycosylation in the C-tail region of BAL. Immunochemical studies indicated that the oligosaccharide chains in the C-tail region of BAL contain Lewis x and Lewis a antigens and, less prominently, sialyl Lewis x and sialyl Lewis a antigens. C-tail fragment was also found to bind jacalin lectin. These observations suggest the possibility that the C-tail region may contribute to adhesive activity in the physiological function of BAL.

Amino Acid Sequence↗
PubMed1995

Bone morphogenetic proteins inhibit adipocyte differentiation by bone marrow stromal cells.

The bone morphogenetic proteins were originally identified based on their ability to induce ectopic bone formation in vivo and have since been identified as members of the transforming growth factor-beta gene superfamily. It has been well established that the bone morphogenetic cytokines enhance osteogenic activity in bone marrow stromal cells in vitro. Recent reports have described how bone morphogenetic proteins inhibited myogenic differentiation of bone marrow stromal cells in vitro. In vivo, bone marrow stromal cells differentiate along the related adipogenic pathway with advancing age. The current work reports the inhibitory effects of the bone morphorphogenetic proteins on adipogenesis in a multipotent murine bone marrow stromal cell line, BMS2. When exposed to bone morphogenetic protein-2, the pre-adipocyte BMS2 cells exhibited the expected induction of the osteogenic-related enzyme, alkaline phosphatase. Following induction of the BMS2 cells with adipogenic agonists, adipocyte differentiation was assessed by morphologic, enzymatic, and mRNA markers. Flow cytometric analysis combined with staining by the lipophilic fluorescent dye, Nile red, was used to quantitate the extent of lipid accumulation within the BMS2 cells. By this morphologic criteria, the bone morphogenetic proteins inhibited adipogenesis at concentrations of 50 to 500 ng/ml. This correlated with decreased levels of adipocyte specific enzymes and mRNAs. The BMS2 pre-adipocytes constitutively expressed mRNA encoding bone morphogenetic protein-4 and this was inhibited by adipogenic agonists. Together, these findings demonstrate that bone morphogenetic proteins act as adipogenic antagonists. This supports the hypothesis that adipogenesis and osteogenesis in the bone marrow microenvironment are reciprocally regulated.

Adipose Tissue↗
PubMed1995

Crystallization and preliminary X-ray crystallographic analysis of ImmE7 protein of colicin E7.

The ImmE7 protein, which can bind specifically to the DNase colicin E7 and neutralize its bactericidal activity, has been purified and crystallized in two different crystal forms by vapor diffusion method. The orthorhombic crystals belong to space group I222 or I2(1)2(1)2(1) and have unit cell dimensions a = 75.1 A, b = 50.5 A, and c = 45.4 A. The second form is monoclinic space group P2(1) with cell dimensions a = 29.3 A, b = 102.7 A, c = 53.0 A, and beta = 91.5 degrees. The orthorhombic crystals diffract to 1.8 A resolution, and are suitable for high-resolution X-ray analysis.

Bacterial Proteins↗
PubMed1995

The value of ultrasound measurement of gallbladder wall thickness in predicting laparoscopic operability prior to cholecystectomy.

We prospectively analysed 51 consecutive cases who underwent laparoscopic cholecystectomy from June 1992 to February 1993. There were 35 cases of chronic cholecystitis and 16 cases of acute cholecystitis. All underwent pre-operative ultrasonography, complete blood cell count, liver function test and endoscopic retrograde cholangiopancreatography. Of those 44 had post-operative ultrasound within the first 2 d and again on the seventh day. In 35 cases of chronic cholecystitis, 31 of 32 cases with a pre-operative gallbladder (GB) wall thickness of less than 6 mm were successfully resected laparoscopically. All three cases with a GB wall thicker than 6 mm were converted to open cholecystectomy. In acute cholecystitis, the wall thickness of the laparoscopic cholecystectomy group ranged from 2 to 9 mm (average 4 mm) and the wall thickness of the conversion group was 4-7 mm (average 6 mm). Post-operative fluid accumulation was noted in 28 (63.6%) cases. There was no correlation between post-operative pyrexia, duration of post-operative pain, clinical complications and the presence of fluid accumulation in the GB fossa. However, of four cases with increasing fluid on the seventh day, three developed complications. We conclude that ultrasonography is valuable in chronic cholecystitis for selecting cases for laparoscopic cholecystectomy.

Adult↗
PubMed1995

[Mechanism of tonifying kidney and removing blood stasis recipe in modulation of immune senescence].

This experiment was from 3 aspects to study the relationship between modulating immune senescence and the improvement of free radical metabolism by the recipe of Baweidankun decoction (BWDKD). The results showed that the production of IL-2 decreased, the content of LPO increased and the activity of catalase (CAT) declined in old mice. After medication of BWDKD the above-mentioned indices were modulated. The ozone inhaled mice revealed similar changes of aging in the above indices. After BWDKD administration, the content of LPO decreased, meanwhile, the activity of CAT and IL-2 were strengthened and showed linear correlation. It was discovered that the production of IL-2 decreased significantly after adding H2O2 into the culture of splenic lymphocytes, but when BWDKD was added simultaneously, the IL-2 production was restored to the level of control group, in which no H2O2 was added. The results suggested that the modulating effect of BWDKD on immune senescence was closely related with the improvement of free radical metabolism, and it provided a partial evidence for the viewpoint of "Vitality deficiency with blood stasis is the principal mechanism of senescence".

Aging↗
PubMed1995

Drug-induced liver disease--a review of 14 cases.

The clinical and pathological features of 14 cases of acute drug-induced liver disease (DILD) were analyzed using the French group method for drug reaction assessment. Among them, 8 were of the cytotoxic type, 4 were of the cholestatic type and 2 were of the mixed type. Serum alkaline phosphatase (ALP) levels of the cytotoxic type DILD were all < 1.8 times the normal value, while those of the cholestatic type DILD > 1.8 times (P < 0.05). The alanine aminotransaminase and aspartate aminotransaminase (ALT and AST) levels of the cholestatic type were all < 13.1 times the normal value, while those of the cytotoxic type varied from 2.2 to 118 times the normal value. We found that steatosis was the major feature in the cytotoxic type with ALT and AST < 2.5 times the normal value. Piecemeal necrosis was noted only in all the cases with ALT and AST > 20 times the normal value. In the cholestatic type, the pathological features of the oral contraceptive-related DILD showed mainly cholestasis, whereas chlorpromazine-related DILD revealed additional portal inflammation. Meticulous taking of patient history and clinical assessment are mandatory for the diagnosis of DILD. The ALP levels were helpful in distinguishing different types of DILD. There are some correlations between biochemical changes and pathological features, and both are helpful in distinguishing different etiologies of DILD when the inciting drug is in doubt.

Adult↗
PubMed1995

Clinical experience with hepatic resection for ruptured hepatocellular carcinoma.

BACKGROUND: Spontaneous rupture of a hepatocellular carcinoma (HCC) is an uncommon but fatal complication of this disease. Surgical treatment is aimed at controlling the intraperitoneal hemorrhage, which has been achieved by hepatectomy, hepatic arterial ligation, packing and suturing. However, hemostasis obtained by hepatic arterial ligation, packing and suturing is not particularly effective, and the rebleeding rate is high. Information on hepatectomy for ruptured HCC is sparse, and we therefore reviewed our experience with hepatic resection for this potentially fatal complication. METHOD: The clinicopathological features of 23 patients with ruptured HCC who underwent hepatectomy during the past 15 years were reviewed. Morbidity, mortality and survival rates were analyzed. RESULTS: Effective hemo-stasis was achieved by hepatectomy. Indications for operative treatment were acute abdomen necessitating immediate laparotomy in 12, and spontaneous hemoperitoneum in 11. Types of hepatectomy included left hemihepatectomy in 3, lateral segmentectomy in 6 and local excision in 14. Liver cirrhosis was the concomitant disease in 13 (56.5%). Hospital mortality rate was 4.3%. 1, 2, 3, and 5 year survival rates were 60%, 52%, 40.5% and 26.5%, respectively. CONCLUSIONS: Hepatic resection is the treatment of choice for ruptured HCC. Long-term survival can be observed in a few patients without recurrence.

Adolescent↗