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Biomedical subjects

C Y Lin

Publications and source records attributed to C Y Lin.

At least 235 records · Page 13Linked to original sources

Bleeding peptic ulcer--risk factors for rebleeding and sequential changes in endoscopic findings.

From September 1991 to December 1992, a prospective study was conducted to determine the risk factors and residual risk of rebleeding, and the evolutionary endoscopic changes in peptic ulcers that rebled. Emergency endoscopies were performed on 452 patients with haematemesis or a melaena, or both within 24 hours of admission. If the lesions were actively bleeding, then the patients were treated with injection sclerotherapy. A multivariate analysis of clinical, laboratory, and endoscopic variables of 204 patients with ulcer bleeding showed that hypovolaemic shock, a non-bleeding visible vessel, and an adherent clot on the ulcer base were independently significant in predicting rebleeding (p < 0.05). Considering these three factors according to the estimates of their regression coefficients showed that a non-bleeding visible vessel was the strongest predictor of rebleeding. The study of the residual risk of rebleeding after admission showed that most rebleeding episodes (94.1%), including all associated with hypovolaemic shock, surgical treatment, and death, occurred within 96 hours of admission. After this time, the residual risk of rebleeding was less than 1%. Study of the changes in endoscopic findings before and after rebleeding illustrated that all ulcers with a visible vessel or adherent clot showed at follow up endoscopy were derived from ulcers with initial major stigmata. It is concluded that hypovolaemic shock, a non-bleeding visible vessel, and an adherent clot on an ulcer base are of independent significance in predicting rebleeding. Observation for 96 hours is sufficient to detect most rebleeding episodes after an initial bleed from peptic ulcer.

Blood Vessels↗

Augmented expression of interleukin-6 and interleukin-1 genes in the mesangium of IgM mesangial nephropathy.

IgM mesangial nephropathy (IgMN) is a common pathologic finding in Taiwanese children with nephrotic syndrome. The hallmarks of IgMN are mesangial hypercellularity and IgM immune complex deposition in the mesangial area. In order to investigate whether the interleukin-6 (IL-6) and interleukin-1 (IL-1) protein production and gene mRNA expression are augmented in the local renal tissue of IgMN, we performed histobiochemical and mRNA studies using an immunopathologic technique and in situ hybridization. We also studied the correlation between urinary IL-6 levels and intensity of IL-6 expression in renal tissue. The results show that 15 cases of IgMN had overexpression with the highest score of both IL-6 and IL-1 proteins and mRNA expression in glomerular mesangial cells and diffuse distribution throughout the glomerular mesangium and capillary, Bowman's capsule, interstitium and renal tubule. In contrast, the patients with minimal change nephrotic syndrome and normal controls failed to show IL-6 and IL-1 mRNA overexpression. The urinary IL-6 levels of the patients with IgMN were highly correlated with the intensity of IL-6 protein expression in renal tissue. The higher the IL-6 overexpression, the higher was the rate of steroid resistance with focal sclerosis. These findings suggest that IL-6 and IL-1 mRNA amplification may play important roles in the pathogenesis of IgMN. The urinary level and degree of overexpression of IL-6 may serve as a prognostic parameter.

Child↗

Gene expression and release of interleukin-8 by peritoneal macrophages and polymorphonuclear leukocytes during peritonitis in uremic patients on continuous ambulatory peritoneal dialysis.

Interleukin-8 (IL-8) has been reported to be released by activated peritoneal macrophages (PMs) and a variety of other cell types, and it exhibits potent chemotactic activity for polymorphonuclear cells (PMNs). We have previously shown that IL-8 is detectable in the drain dialysate of uremic patients on continuous ambulatory peritoneal dialysis (CAPD) during peritonitis. The levels of IL-8 in infected drain dialysate caused by different microorganisms were variable. In this study, we evaluated the gene expression and release of IL-8 by PMs and PMNs during peritonitis caused by Staphylococcus aureus in uremic patients on CAPD. IL-8 levels were variable in the drain dialysate at the different episodes of peritonitis, even in the same patient. The IL-8 levels were highly correlated with PMN count in drain dialysate (r = 0.9919, p < 0.001). PMs and PMNs obtained from drain dialysate at the onset of peritonitis increased mRNA expression for IL-8 and the amount of IL-8 mRNA from drainage cells was also highly correlated with PMN count. In contrast, cells isolated from drain dialysate without peritonitis failed to express mRNA for IL-8. These data suggest that increased expression of IL-8 may be a feature of peritonitis. The levels of IL-8 during peritonitis were not only related to the etiological microorganism but also to other unknown factor(s).

Adult↗

Detection of human papillomavirus RNA in ovarian and endometrial carcinomas by reverse transcription/polymerase chain reaction.

The presence of human papillomavirus (HPV) type 16 and 18 transcripts was determined by reverse transcription/polymerase chain reaction (PCR) in ovarian and endometrial carcinoma tissue. HPV-16 DNA sequences were detected in 50.0% (9/18) of the ovarian carcinomas and in 44.4% (8/18) of endometrial carcinomas. HPV-18 DNA sequences were found in 16.7% (3/18) of both the ovarian and endometrial carcinomas. Using RNA-PCR analysis, we found 3 out of 9 (33.3%) of the HPV-16 DNA-positive and 1 in 3 (33.3%) of the HPV-18 DNA-positive ovarian carcinomas were transcriptionally active, contrary to the HPV-16 DNA-positive or HPV-18 DNA-positive endometrial carcinomas. The results suggest that HPV RNA may be detected in ovarian carcinomas though its biological significance remains to be elucidated. HPV RNA is not demonstrable in endometrial carcinoma using the current primer sets. Further investigations are necessary for a final conclusion.

Adult↗

Comparison of high-dose thrombin time with activated clotting time for monitoring of anticoagulant effects of heparin in cardiac surgical patients.

The activated clotting time (ACT) is routinely used for monitoring of heparin effects during cardiopulmonary bypass (CPB). However, ACT is not a specific assay for heparin and may be influenced by several other factors, which may be misleading with regard to the proper administration of heparin and protamine. In this pilot study, we compared a new test, the high-dose thrombin time (HiTT), with the conventional ACT test for both in vitro and in vivo heparin-induced anticoagulation. Our in vitro results showed that there were heparin dose-dependent increases in ACT and HiTT. Data on 30 adult cardiac patients indicated that HiTT correlated well with heparin concentration both after initial heparin administration and during CPB (r = 0.645 and 0.515). Hypothermia and hemodilution occurring during CPB did not alter HiTT results. ACT also correlated well with both heparin concentration and HiTT before CPB, but the linear relationship was lost during CPB. Our results suggest that HiTT is a useful assay for monitoring heparin effects during cardiac surgery, even during hypothermia and hemodilution.

Adult↗

Growth inhibitors against tumor cells in Cordyceps sinensis other than cordycepin and polysaccharides.

Cordyceps sinensis is a parasitic fungus that has been used as a Chinese medicine for a long time. In the present study, inhibitory effects of crude methanolic extracts of C. sinensis fruiting bodies on various tumor cell lines were demonstrated. The crude methanolic extracts were fractionated into 15 fractions by silica gel column chromatography. Two of the 15 fractions (CS-36-39 and CS-48-51) significantly inhibited the growth of K562, Vero, Wish, Calu-1, and Raji tumor cell lines. The inhibitory activities were not due to the polysaccharides, which have been removed in the extracting process. The polarities of these two fractions indicated that they were different from that of cordycepin. Therefore, it is suggested that tumor cell growth inhibitors, other than cordycepin and polysaccharides, are contained in C. sinensis.

Animals↗

The influence of additive and nonadditive gene action on lifetime yields and profitability of dairy cattle.

Additive and nonadditive genetic effects on lifetime yields of milk and milk components and lifetime profitability were estimated from 5070 cattle in a Holstein pureline, an Ayrshire-based pureline, and 10 crossbred groups of these purelines. Lifetime yields of milk, fat, protein, and lactose and lifetime milk value and annualized discounted net returns were analyzed. Lifetime yields, lifetime milk value, and annualized discounted net returns of the Holstein x Ayrshire-based line F1 and an F1 x (F1 x F1) cross were not significantly different from those for the Holstein pureline. Net reproductive rate for F1 females was 9% greater than that of contemporary Holsteins. The Holstein pureline was superior to the Ayrshire-based pureline for direct additive genetic merit for all traits. Heterosis for the lifetime traits ranged from 16.6% for lifetime milk yield to 20.6% for annualized discounted net returns. Cytoplasmic maternal effect on annualized discounted net return was significant and favored the Ayrshire-based line. Potential economic benefit may derive from development of a crossbred cow that is superior to Holsteins. Maximum exploitation of additive and nonadditive genetic effects on lifetime yields and profitability appears to favor a rotational crossbreeding system with two breeds.

Animals↗

Responses of respiratory-modulated facial nerve activity to activation of the ventrolateral subarea of the nucleus of the tractus solitarius.

The purpose of the present study was to examine respiratory-modulated facial nerve activity (FNA) in response to activation of the ventrolateral subarea of the nucleus of the tractus solitarius (vlNTS). The cat was anesthetized with sodium pentobarbital and then vagotomized bilaterally, paralyzed and ventilated artificially. End-tidal fractional concentration of CO2 was maintained at hyperoxic normocapnia. Partial occipital craniotomy was performed to expose the obex. Activities of the phrenic and the facial nerves were simultaneously recorded. The vlNTS was excited by electrical current (80 Hz frequency, 0.5 ms pulse duration and a variety of current from 12.5 to 50 microA) and glutamate (30-100 nl, 0.5 M). Three responsive patterns for both nerves were observed in response to vlNTS activation. First, inspiratory facial nerve activity (iFNA) and phrenic nerve activity (PNA) were decreased (p < 0.01), while expiratory facial nerve activity (eFNA) was not changed. Second, iFNA and PNA were diminished (p < 0.01) but eFNA was enhanced. Third, iFNA was decreased whereas PNA was enhanced. These results suggest that there might be a neural pathway projecting from the vlNTS to the facial nuclei to modulate respiratory-modulated facial nerve activities.

Animals↗

Use of transesophageal echocardiography for evaluation of resectability of lung cancer.

BACKGROUND: When patients with lung cancer are to undergo surgical resection, chest x-ray and computed tomography (CT) are widely used for evaluation of staging and of the resectability of the lesion. Unfortunately, the above methods cannot always provide sufficient information about resectability and some patients undergo unnecessary operations. Transesophageal echocardiography (TEE) has opened a new window for viewing cardiac structure and function. By TEE, one can also image the surrounding tissues and great vessels under continuous monitoring. MATERIALS AND METHODS: We pre-operatively applied the awake TEE method in twenty whose chest CT showed suspected invasion of the heart by the tumor. RESULTS: Our experience showed the following: (1) TEE can clearly identify whether lung cancer has invaded the heart and/or great vessels and therefore avoiding unnecessary operation; (2) Two patients had tumor seen abutting epicardium and/or aorta without invasion (under continuous imaging). Two patients had tumor compressing the right and left atrium with intact but not invading pericardium, and underwent successful surgical resection. CONCLUSION: We concluded that it is useful to apply TEE preoperatively in evaluating the resectability of the lung cancer especially when a chest CT shows suspicion of local invasion of the heart and great vessels; thus unnecessary thoracotomy can be avoided.

Adult↗

Hepatitis B and hepatitis C virus infection among chronic alcoholic patients with liver disease in Taiwan.

The prevalence of the anti-hepatitis C virus (anti-HCV) antibody and hepatitis B surface antigen (HBsAg) among 123 alcoholic patients with liver disease from our hospital and 44 alcoholic subjects from the local community was evaluated. By radio-immunoassay HBsAg was detected in 30.1% of alcoholic patients with liver disease, compared with 11.4% of alcoholic subjects from the local community (p < 0.05). The prevalence of HBsAg was 40.7% (11/27) in patients with cirrhosis and hepatocellular carcinoma (HCC), 31.5% (17/54) in patients with cirrhosis only, and 29.4% (5/17) in patients with other liver diseases. By enzyme-linked immunosorbent assay, anti-HCV antibody was detected in 30.9% of alcoholic patients with liver disease, compared with 2.3% of alcoholic subjects from the local community (p < 0.0005). The prevalence of anti-HCV antibody was 44.4% in alcoholic patients with cirrhosis and HCC, 29.6% in alcoholic patients with cirrhosis only, and 17.6% in alcoholic patients with other liver diseases. As the degree of liver damage advanced, the prevalence of either HBsAg or anti-HCV antibody, or both, being detected in these alcoholic patients increased significantly (p < 0.05). The serum ALT level was higher among alcoholic patients who had either HBsAg or anti-HCV antibody than those having neither (151 +/- 204 vs 62 +/- 47 IU/L; p < 0.005). All three alcoholic patients with chronic hepatitis had positive HBsAg or anti-HCV antibody. Histologic findings, except cells within sinusoids, were comparable between the alcoholic patients with or without superimposed hepatitis viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Rapid and specific detection of the leukotoxin sequences of Actinobacillus actinomycetemcomitans from periodontal pockets by the polymerase chain reaction.

Actinobacillus actinomycetemcomitans (Aa) has been implicated in most cases of localized juvenile periodontitis and some cases of severe adult periodontitis and refractory periodontitis. The Aa leukotoxin plays an important role in the pathogenesis of Aa associated periodontal disease. Rapid detection of Aa in a periodontal pocket is hampered by the slow growth and fastidious nature of this bacterium. In this study, we developed a rapid, sensitive, nonradioactive polymerase chain reaction (PCR) to identify a unique As sequence directly from subgingival plaque samples. Two oligonucleotide primers derived from DNA sequences of the leukotoxin gene were used in the PCR. The Aa-specific DNA fragments were analyzed by agarose gel electrophoresis and then visualized under 302 nm ultraviolet light after staining with ethidium bromide. In the 12 subgingival plaque samples screened, the Aa-specific sequences were found in five out of nine sites with periodontitis. No Aa-specific sequence was found in three healthy sites. The specificity of the amplified DNA fragments was confirmed by direct DNA sequencing. These results indicated that the PCR technique should assist in the rapid detection of Aa in subgingival plaque samples. Moreover, combined with direct DNA sequencing, this method can be used to study the molecular epidemiology of this periodontal pathogen.

Actinobacillus Infections↗

Active, bleeding marginal ulcer of Billroth II gastric resection: a clinical experience of 18 patients.

OBJECTIVES: From July 1988 to April 1993, 18 patients with active, marginal ulcer bleeding were investigated for their clinical presentation, endoscopic findings, and successful rate of therapeutic endoscopy. METHODS: Through endoscopic survey, data on the ulcer number, ulcer location, and prevalence rate of each major stigmata of recent hemorrhage were obtained. Therapeutic methods used include heater probe thermocoagulation and local injection with diluted epinephrine (0.01%) or 95% alcohol through the endoscope. RESULTS: All patients were male with a mean age of 65.3 years. Tarry stool passage (15/18; 83.3%) was the most common clinical presentation. Fifteen patients (15/18; 83.3%) had single marginal ulcer. Ulcerations were located in the jejunal site (12/18; 66.6%) and gastro-jejunal anastomosis (5/18; 27.7%). There were two patients with spurting artery, six with nonbleeding visible vessel, two with blood clot adhesion, four with oozing, three with visible vessel-associated oozing and three, with blood clot adhesion accompanying oozing. The rate of therapeutic endoscopy to successfully stop bleeding or prevent rebleeding was 94.4% (17/18). Sixteen cases (16/17) received one session of endoscopic therapy, and one patient (1/17) accepted two sessions. One patient with multiple underlying diseases died of persistent bleeding after three sessions of therapy. No complication was found to be related to the endoscopic procedure. CONCLUSIONS: Marginal ulcer bleeding exhibits the same endoscopic findings as peptic ulcer hemorrhage. Most marginal ulcers are single and located at the saddle area of the jejunal site. Endoscopy can be useful in diagnosing marginal ulcer, and it is safe and effective in managing active marginal ulcer bleeding.

Aged↗

Endoscopic removal of a large intragastric foreign body with an overtube: a case report.

After amphetamine ingestion, a 39-year-old male attempted suicide by swallowing glass trifles, cigarette lighter and razor blades. All foreign bodies ingested were evacuated spontaneously and smoothly within one week, except for the 10-cm long lighter, which was removed by endoscopy via supplementary overtube with moderate difficulty. The subsequent clinical course was uncomplicated. More than 80% of the ingested foreign bodies which reach the stomach can be eliminated uneventfully through the gastrointestinal tract. The remainder may cause complications such as obstruction, perforation and hemorrhage. Usually the locations of obstruction are over the three anatomic narrowings of the esophagus, the pyloric ring and ileocecal valve. Perforation occurs with ingestion of long, sharp, metallic pointed objects or animal bones, and is more frequent among those who had previous abdominal surgery or intestinal diseases. Endoscopic removal as soon as possible is suggested for high risk groups, with use of the overtube method to prevent complications.

Adult↗