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Biomedical subjects

C Y Liu

Publications and source records attributed to C Y Liu.

At least 127 records · Page 7Linked to original sources
PubMed1998

Unusual pulmonary manifestations of disseminated Penicillium marneffei infection in three AIDS patients.

Penicillium marneffei is a rare fungal pathogen which can cause human infections in people predominantly living in South-east Asia and the southern portion of China. We report three cases of systemic P. marneffei infection in patients infected with HIV who lived in or had travelled to endemic areas. The clinical manifestation includes high fever, chills, weight loss, general malaise, chronic cough, haemoptysis, multiple skin lesions, abnormal liver function, etc. Chest X-ray showed single or multiple cavitary lesions with smooth or irregular thin wall. P. marneffei is cultured from blood, sputum, skin biopsy, sono-guide aspiration and bronchoscopic biopsy. After antifungal therapy with intravenous amphotericin B or oral fluconazole, skin lesions resolved completely within 2 weeks and cavitary lesions in the lungs changed to chronic fibrotic and interstitial processes after several months to a few years later. Our two cases had been treated as either pulmonary tuberculosis or suspected malignancy. A definite diagnosis and early treatment are important because this fungal infection is a marker of AIDS in South-east Asia.

AIDS-Related Opportunistic Infections↗
PubMed1998

Acinetobacter calcoaceticus-baumannii complex bacteremia: analysis of 82 cases.

Eighty-two cases of Acinetobacter calcoaceticus-baumannii complex bacteremia were identified during a 33-month period, from November 1993 to July 1996, at the Veterans General Hospital, Taipei. All cases were due to hospital-acquired infections, with 28 cases of polymicrobial bacteremia. Most patients had severe debilitating conditions: 26 had malignancies, 40 required stay in Intensive Care Unit and 17 had undergone major operations. The main predisposing factors included central venous catheterization, endotracheal intubation or tracheostomy, prior antibiotic therapy and prolonged hospitalization. Amikacin, tobramycin, and ceftazidime were the most effective agents in vitro against A. calcoaceticus-baumannii complex. 32 patients (39 %) died during hospitalization, 19 of the cases (23 %) directly attributed to septicemia. Factors that adversely influenced mortality included polymicrobial bacteremia, inappropriate antimicrobial therapy and prior antibiotic treatment. Of particular interest is the fact that none of the patients who did not receive appropriate antimicrobial therapy survived. Early diagnosis and appropriate antibiotic therapy are critical for improving the prognosis of A. calcoaceticus-baumannii complex bacteremia.

Acinetobacter Infections↗
PubMed1998

Schizophreniform-like psychotic disorder induced by phentermine: a case report.

Phentermine is a central nervous system stimulant that can increase brain dopamine levels and has a structure similar to amphetamine. We report a case of schizophreniform-like psychotic disorder induced by phentermine in a young woman without a personal or family history of psychiatric disorders. The patient had taken phentermine 30 mg daily for more than three years. Psychotic symptoms developed acutely after she increased the phentermine dosage to 150-180 mg/day for one month due to an increase in work load. After discontinuation of phentermine and administration of neuroleptics, the psychotic symptoms subsided in two weeks. This is the first documented case of phentermine psychosis in Taiwan. This report will review the literature and discuss the prognosis of central nervous system stimulant-related psychotic disorders.

Adult↗
PubMed1998

Bacteremia in patients with hematologic malignancies.

The decision regarding the appropriate empirical antibiotic therapy for bacteremia in patients with hematologic malignancies must be individualized in each institution, by taking into account variations in the patterns of microbial isolates and their resistance profiles. Microbial isolates and antibiotic resistance patterns must be taken into account at each hospital. A shift from bacteremia due to infections caused by predominantly gram-negative organisms to predominantly gram-positive organisms in patients with hematologic malignancies has been noted in reports from other countries. We investigated bacterial isolates and their antibiotic sensitivities in patients with hematologic malignancies in the Veterans General Hospital-Taipei. A total of 185 episodes of bacteremia in 140 patients with hematologic malignancies were recorded during the period from 1995 to 1996. Unlike foreign reports, our investigation shows that gram-negative organisms still predominate, accounting for 72.7% of isolates, followed by gram-positive organisms, accounting for 26.3% of isolates, and anaerobes, accounting for 1% of isolates. Escherichia coli was the most commonly isolated organism, accounting for 23.9% of isolates, followed by Klebsiella pneumoniae (18.5%), Pseudomonas aeruginosa (12.2%), Enterobacter cloacae (7.3%), and methicillin-resistant Staphylococcus aureus (7.3%). A high mortality rate was observed in gram-negative bacteremia: 31% for E. coli, 26% for K. pneumoniae, 24% for P. aeruginosa, and 33% for E. cloacae. If methicillin-resistant S. aureus bacteremia occurred, mortality was high (47%). The antibiotic sensitivity profiles of the four most common gram-negative isolates (E. coli, K. pneumoniae, P. aeruginosa, and E. cloacae) indicated that, in our hospital, amikacin with either cefoperazone, ceftazidime, ciprofloxacin, or imipenem, would be an ideal combination for empirical therapy for bacteremia in patients with hematologic malignancies.

Adolescent↗
PubMed1998

Activity of cefepime compared with other antibiotics against gram-positive bacteria and cefuroxime-resistant gram-negative bacteria.

BACKGROUND: Cefepime is a new, parenteral, fourth-generation antibiotic that is stable in the presence of Bush group 1 beta-lactamases. In vitro activity of cefepime, cefuroxime, ceftazidime, ciprofloxacin and imipenem against Gram-positive cocci and cefuroxime-resistant Gram-negative bacilli was studied. METHODS: The agar dilution method described by the US National Committee for Clinical Laboratory Standards was used to determine the minimum inhibitory concentrations of antibiotics tested. These included cefepime, cefuroxime, ceftazidime, ciprofloxacin and imipenem. The tested clinical isolates included Gram-positive cocci (methicillin-sensitive coagulase-negative staphylococci, methicillin-resistant coagulase-negative staphylococci, methicillin-sensitive Staphylococcus aureus, methicillin-resistant S aureus, Streptococcus pyogenes, viridans streptococci, Streptococcus pneumoniae, group D enterococci) and cefuroxime-resistant Gram-negative bacilli (Escherichia coli, Klebsiella pneumoniae, Acinetobacter spp, Pseudomonas aeruginosa, Enterobacter cloacae, Serratia marcescens, Burkholderia cepacia and Xanthomonas maltophilia). RESULTS: The activity of cefepime against most Gram-negative bacilli other than B cepacia and X maltophilia is better than that of ceftazidime. However, cefepime is less active against these Gram-negative bacilli than ciprofloxacin and imipenem. The activity of cefepime against B cepacia and X maltophilia is less than that of ceftazidime or ciprofloxacin. Among Gram-positive cocci, cefepime was active against most isolates of methicillin-sensitive staphylococci, S pyogenes, viridans streptococci and S pneumoniae. However, cefepime has poor activity against methicillin-resistant S aureus and enterococci. CONCLUSIONS: Due to its extended spectrum of activity, cefepime has potential use as suitable empiric monotherapy for the treatment of a variety of community- and hospital-acquired infections.

Cefepime↗
PubMed1998

beta-Lactam resistance and beta-lactamase isoforms of Moraxella catarrhalis isolates in Taiwan.

Moraxella catarrhalis is an important pathogen in both upper and lower respiratory tract infections. More than 90% of isolates worldwide produce beta-lactamase. The beta-lactamases produced by M. catarrhalis can be differentiated by isoelectric focusing (IEF) into BRO-1 and BRO-2 patterns. In this study, we investigated the prevalence of various beta-lactamase isoforms in clinical isolates of M. catarrhalis in Taiwan, as well as the relationships of these isoforms with antibiotic resistance. A total of 271 clinical isolates of M. catarrhalis were collected from 12 large medical laboratories in Taiwan from 1 August 1993 to 31 July 1995. The overall prevalence of beta-lactamase production was 98.2% (266 of 271 isolates). Analytical IEF revealed BRO-1 was the most common beta-lactamase pattern among the isolates (238 isolates, 88%); BRO-2 was the only other pattern found, with 32 (12%) isolates. The geometric mean minimum inhibitory concentration of ampicillin for BRO-1 producers was 63-fold higher than that for beta-lactamase-negative isolates, and 6.5-fold higher than that for BRO-2 producers. beta-Lactam antibiotics, such as amoxicillin + clavulanate and the cephalosporins, tested were very active against this species, regardless of whether the isolate produced beta-lactamase or not. In conclusion, beta-lactamase is common among clinical isolates of M. catarrhalis in Taiwan, with BRO-1 being the most common isoform. However, because most isolates tested were still sensitive to amoxicillin + clavulanate and cephalosporins, these agents appear to be reliable alternatives to first-line therapy when M. catarrhalis is contributing to a clinical infection.

Anti-Bacterial Agents↗
PubMed1998

Prevalence of nosocomial respiratory tract infections in the surgical intensive care units of a medical center.

BACKGROUND: The intensive care unit (ICU) is one of the most common locations in the hospital for the development of nosocomial respiratory tract infections (RTIs). The purpose of this study was to better understand and compare the rate of nosocomial RTIs, their distribution and the frequency of infective organisms in three different adult surgical ICUs at a medical center in Taiwan. METHODS: This retrospective study covered the period from 1991 to 1996, and targeted patients who had acquired nosocomial RTIs more than 72 hours after admission to the surgical, cardiovascular surgical, or neurosurgical ICU. Infection control nurses made routine weekly rounds to the units and conducted comprehensive patient-based surveys. Data collected were subjected to descriptive and deductive statistical analyses. RESULTS: A total of 277 episodes of nosocomial RTIs were encountered (3.8 episodes per 1,000 patient-days of hospitalization). Neurosurgical ICU patients had the highest infection rate (4.8%) (p < 0.01). The median length of hospital stay of patients acquiring nosocomial RTIs was 61 days; the infection occurred 19 days (median) after admission to the ICU and the length of postinfection stay was 38 days (median). Pneumonia accounted for 91.3% of these infections. The overall mortality rate was 42.6%, with the surgical ICU having the highest mortality rate (61.5%), which was significantly higher compared with the other two ICUs studied. The majority of patients with nosocomial RTIs had medical catheters or devices in place. A total of 297 isolates were cultured from 277 infected patients. Pseudomonas aeruginosa was the predominant organism isolated (29.6%), followed by Staphylococcus aureus (26.6%), of which 88.2% were methicillin-resistant S aureus (MRSA). CONCLUSIONS: The rate of nosocomial RTIs was significantly higher in neurosurgical ICU patients; the majority of infected patients had medical catheters or devices in place. S aureus played an increasingly important role as a nosocomial pathogen; hence, control of MRSA should be the focus of infection control policies.

Adult↗
PubMed1998

Identification of the cornea-specific keratin 12 promoter by in vivo particle-mediated gene transfer.

PURPOSE: Keratin 12 (K12) is a cornea epithelial cell-specific intermediate filament component. To provide a better understanding of its expression, it is necessary to identify and characterize the promoter of Krt1.12 gene. METHODS: The 2.5-kb DNA 5' to Krt1.12 gene was sequenced. Krt1.12 promoter-beta-gal DNA constructs were prepared and used in vivo to transfect rabbit corneas, conjunctivas, and skin by particle-mediated gene transfer (Gene Gun). In vitro, the DNA constructs were transfected into cultured T-antigen-transformed rabbit corneal epithelial (RCE-T) cells and human fibrosarcoma HT-1080 fibroblasts with lipofectamine. The promoter activity was assessed by measuring beta-gal (beta-galactosidase) activity using histochemical staining with 5-Bromo-4-chloro-3-indolyl-beta-D-galactoside and enzyme assay with o-nitrophenyl beta-D-galactopyranoside. RESULTS: There are four Pax-6 pair box binding elements found between -910 and -2000 bp 5'-flanking the transcription initiation site of the Krt1.12 gene. None of promoter constricts can be expressed by HT-1080 cells. Cotransfection of Pax-6 cDNA with K12 promoter-beta-gal constructs containing Pax-6 elements results in a fourfold increase of beta-gal activities in RCE-T cells but not HT-1080 fibroblasts. The data of in vivo transfection in the rabbit by Gene Gun indicate that reporter gene constructs containing 0.6-kb and longer DNA fragments 5'-flanking Krt1.12 gene are effectively expressed in corneal, but not conjunctival or epidermal epithelial cells. CONCLUSIONS: The particle-mediated gene transfer is a suitable technique for in vivo delivery of transgenes to corneal epithelial cells. The 2.5-kb DNA fragment 5'-flanking Krt1.12 contains corneal epithelial cell-specific regulatory cis-DNA elements. Pax-6 is a positive transcription factor essential for keratin 12 expression.

Animals↗
PubMed1997

Construction and characterization of the soybean leaf metalloproteinase cDNA.

The cloning and analysis of a cDNA clone encoding the soybean metalloproteinase obtained by polymerase chain reaction (PCR) and the rapid amplification of cDNA ends (RACE) reaction are described. The cDNA was constructed from poly(A)+ RNA isolated from 15-17 day old leaves. The deduced amino acid sequence of the cDNA reveals that the plant metalloproteinase is synthesized as a preproenzyme and the proenzyme form shares a structural motif, responsible for maintenance of inactive zymogen, with the matrix metalloproteinase (e.g. collagenase) family of enzymes from vertebrate origin. Northern and Western blot analysis demonstrated that the metalloproteinase transcript and protein are under a strict developmental program in that both are expressed only in leaf tissue and in a temporal fashion. The physiological function of the metalloproteinase still remains unclear although the data suggest that the enzyme is extracellular and a portion of the mature form of the enzyme is tightly bound to the cell wall.

Amino Acid Sequence↗
PubMed1997

The correlation of depression with functional activity in Parkinson's disease.

We evaluated 109 Chinese patients with Parkinson's disease (PD) in three ways: using a standardized psychiatric interview for depression and anxiety, using standardized neurological evaluation for motor disability, and using cognitive assessment for cognitive impairment. Six of the 109 patients who had dementia and another two afflicted with organic delusional disorder were excluded from further analysis. The remaining 101 PD patients were divided into the following three groups according to the DSM-III-R criteria: major depressive disorder (n = 18), other depressive disorders (n = 25) including dysthymic disorder and depressive disorder not otherwise specified, and no depression (n = 58). The frequency of major depressive disorder of the 109 PD patients was 16.5%, and the frequency of major and other depressive disorders, taken together, was 42.2%. Using the percentage points measured on the Schwab & England Activities of Daily Living Scale as the dependent variable to fit a multivariate regression model, we found the lower score significantly correlated with the diagnosis of depressive disorder and higher score of the Hamilton Depression Rating Scale, in addition to motor disability and disease severity of PD. Given the high frequency of depression and the significant correlation between depression and performance in daily functional activites, we believe that an evaluation of PD patients for coexisting depression is necessary for a better therapeutic outcome.

Aged↗
PubMed1997

Depressive disorders among older residents in a Chinese rural community.

BACKGROUND: Two recent surveys of depression among Chinese elderly people sampled different populations, used different case ascertainment methods and resulted in a seven-fold difference in prevalence rates. The present study was conducted to compare prevalence rates obtained with two commonly used methods in the same population, and to examine the risk factors for depression. METHODS: The target population included all residents aged 65 years and over in a rural Chinese community. Participants were interviewed for demographic and medical information, examined by a neurologist and administered Chinese versions of the Geriatric Depression Scale-Short Form (GDS-S), the Cognitive Abilities Screening Instrument (CASI) and an Activities of Daily Living (ADL) form. Individuals who screened positive on the GDS-S were also interviewed by a psychiatrist for diagnosis according to the DSM-III-R criteria. RESULTS: Among the 1313 participants, 26% screened positive on the GDS-S and 13% were diagnosed as having a depressive disorder, including 6.1% with major depression. Individuals with depressive disorders were more likely to have poor ADL scores, lower CASI scores, and chronic physical illnesses. They were also more likely to be female, older, illiterate and without a spouse, but adding these variables did not increase the overall association with the GDS-S score. CONCLUSIONS: Depression was quite common in this Chinese rural geriatric population. The prevalence rate was twice as high when judged by depression symptomatology rather than clinical diagnosis. The critical risk factors were functional impairments, poor cognitive abilities and the presence of chronic physical illnesses.

Activities of Daily Living↗
PubMed1997

Occurrence of fumonisin B1 and B2 in corn-based foodstuffs in Taiwan market.

Corn-based human foodstuffs purchased in Taiwan were analyzed for fumonisin B1 (FB1) and fumonisin B2 (FB2) using high-performance liquid chromatography. Fifty-two (33.9%) and 32 (20.9%) of 153 samples were found to contain FB1 (73-2395 ng/g) and FB2 (120-715 ng/g), respectively. The highest frequency of detection and also the highest FB1 concentrations were found in sweetcorn (50%, 1089 ng/g) and cornflour (50%, 608 ng/g), followed by corn snacks (33.3%, 2395 ng/g), miscellaneous corn products (33.3%, 73 ng/g), popcorn (31.8%, 1003 ng/g) and cornflakes (23.5%, 1281 ng/g). 16 corn snacks (= approximately 20.5% of the samples) had an average FB1 and FB2 content of 456 and 145 ng/g, respectively, while six sweetcorn (= 25%) samples were contaminated with an average of 400 ng/g of FB1 and 65 ng/g of FB2. Of the 22 pop-corn samples examined, 7 had an average of 347 ng/g and 116 ng/g of FB1 and FB2, respectively. During an analysis of the distribution pattern for the combined fumonisin levels of FB1 and FB2, it became apparent that more than 69% of tested samples had fumonisin concentrations below 100 ng/g, while 11.1% (or 17 samples) contained in excess of 600 ng toxins per g. These results clearly illustrated that commercially available corn-based foodstuffs for human consumption in Taiwan are frequently contaminated with FB1 and FB2.

Carboxylic Acids↗
PubMed1997

Alteration of endogenous antioxidant enzymes in naturally occurring hypertrophic cardiomyopathy.

We have recently developed a porcine model with naturally occurring hypertrophic cardiomyopathy (HCM). Similar to humans, occluded intramural coronary artery and damaged mitochondria are frequently observed in these animals in which the disease is thought to be associated with the local ischemia of myocardium. In view of antioxidant functions involved in the ischemic injury, we measured the expression of endogenous antioxidant enzymes in the tissues with and without HCM. The results showed a significant increase of Cu,Zn-superoxide dismutase (SOD), but not Mn-SOD, and decrease of catalase (CAT) activities in the various areas of HCM hearts. It was demonstrated that SOD/CAT ratios in the HCM hearts were significantly higher than those in normals and were found to be dramatically correlated with the severity of cardiac hypertrophy. The altered SOD/CAT ratio was also consistent with increase in lipid damage. We hypothesize that the elevated SOD combined with an inadequate amount of H2O2 scavenging enzyme may lead HCM heart at oxidative stress risk. However, the pathogenic role of imbalanced antioxidant enzyme needs to be further explored.

Animals↗
PubMed1997

Mutations of N-terminal regions render the retinoblastoma protein insufficient for functions in development and tumor suppression.

To assess biological roles of the retinoblastoma protein (RB), four independent transgenic mouse lines expressing human RB with different deletions in the N-terminal region (RBdeltaN) were generated and compared with mice expressing identically regulated, full-length RB. Expression of both RB and RBdeltaN caused developmental growth retardation, but the wild-type protein was more potent. In contrast to wild-type RB, the RBdeltaN proteins were unable to rescue Rb-/- mice completely from embryonic lethality. Embryos survived until gestational day 18.5 but displayed defects in the terminal differentiation of erythrocytes, neurons, and skeletal muscle. In Rb+/- mice, expression of the RBdeltaN transgenes failed to prevent pituitary melanotroph tumors but delayed tumor formation or progression. These results strongly suggest that N-terminal regions are crucial for embryonic and postnatal development, tumor suppression, and the functional integrity of the entire RB protein. Furthermore, these transgenic mice provide models that may begin to explain human families with low-penetrance retinoblastoma and mutations in N-terminal regions of RB.

Amino Acid Sequence↗
PubMed1997

The Kinmen Neurological Disorders Survey (KINDS): a study of a Chinese population.

We conducted an epidemiological study of several neurological disorders among the Chinese aged 50 years or older on the islet of Kinmen. All participants were interviewed and examined by neurologists. From the targeted population of 5,061 individuals, 3,915 (77.4%) of them completed the evaluations. Among the 4,087 individuals with whom face-to-face contact was made, the refusal rate was 4.2%. The disorders of interest were dementia, Parkinson's disease, essential tremor, stroke, transient ischemic attacks, and migraine. Among the 3,915 participants, 366 cases were found with 1 or more of the surveyed neurological disorders on the prevalence day, August 1, 1993, yielding a prevalence of 93.5/1,000. The purpose of this study, the general methodology, and some overall findings are presented in this communication in order to provide a common background for detailed findings on each disorder to be reported separately.

Age Factors↗
PubMed1997

Risk factors for Alzheimer's disease: a case-control study.

The extent of current knowledge of risk factors for Alzheimer's disease (AD) is still limited. We conducted a case-control study of 98 AD patients and 98 age- and sex-matched controls. Light smoking had a decreased risk for AD (AD: 2.0%, controls: 21.4%, odds ratio = 0.10, p = 0.003), whereas daily smoking showed a trend to increase the risk for AD (AD: 45.9%, controls: 26.5%, odds ratio = 1.73, p = 0.08). After multivariable analyses factors associated with AD included the presence of apolipoprotein epsilon4 allele, and the duration of well water consumption.

Aged↗
PubMed1997

Poststroke depression among the Chinese elderly in a rural community.

BACKGROUND AND PURPOSE: A door-to-door survey was conducted in two townships in the Kinmen islets to investigate the prevalence and other characteristics related to depressive disorders of stroke survivors in an elderly Chinese population. METHODS: Our target population comprised the registered residents > or = 65 years old (n = 2056) of a total population of 26 105 on August 1, 1993. All participants answered a questionnaire, filled in a Geriatric Depression Scale-short form (GDS-S), and received a neurological examination. Depression was defined as a GDS-S score > or = 5. RESULTS: Twenty-eight of 45 stroke survivors (62.2%) and 491 of 1471 nonstroke subjects (33.4%) were classified as depressed. The frequency of stroke survivors' depressive disorders was significantly higher that of nonstroke subjects (P < .001). Multiple regression analysis indicated that GDS-S scores were most related with the activities of daily living (R2 = .19, P = .004) in the stroke survivors. CONCLUSIONS: Depressed mood was common after stroke, and activities of daily living were an important factor for depression in stroke survivors in the community.

Activities of Daily Living↗