Hookworm infestation diagnosed by capsule endoscopy (with video).
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Aged, 80 and over↗
Biomedical subjects
Chun-Che Lin
Publications and source records attributed to Chun-Che Lin.
Protective effect of s-allyl cysteine and s-propyl cysteine on acetaminophen-induced hepatotoxicity in mice.
In vivo protective effects of s-allyl cysteine (SAC) and s-propyl cysteine (SPC) against acetaminophen-induced hepatotoxicity in Balb/cA mice were studied. SAC and SPC at 1g/L were added into drinking water for four weeks and followed by acetaminophen treatment. Acetaminophen treatment significantly depleted glutathione content, increased oxidation stress and elevated alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities (P < 0.05); however, the intake of SAC or SPC significantly alleviated glutathione depletion and the elevation of ALT and AST, enhanced glutathione peroxidase activity, and lowered malondialdehyde formation (P < 0.05). Plasma levels of C-reactive protein (CRP), von Willebrand factor (vWF), IL-6, IL-10 and TNF-alpha were significantly increased by acetaminophen treatment (P < 0.05); and SAC or SPC intake significantly suppressed acetaminophen-induced elevation of CRP, vWF and the three cytokines (P < 0.05). Acetaminophen treatment also significantly increased plasminogen activator inhibitor-1 (PAI-1) activity and plasma fibrinogen level, and decreased antithrombin III (AT-III) and protein C activities (P < 0.05). SAC or SPC intake alleviated AT-III and protein C reduction (P < 0.05); but did not affect PAI-1 activity and plasma fibrinogen level (P > 0.05). These data suggest that SAC and SPC are potential multiple-protective agents against acetaminophen-induced hepatotoxicity.
Acetaminophen↗
Bedside colonoscopy for critically ill patients with acute lower gastrointestinal bleeding.
OBJECTIVE: To determine the clinical impact of bedside colonoscopy for critically ill patients with acute lower gastrointestinal (GI) bleeding. DESIGN AND SETTING: A 3-year retrospective analysis (chart review). Medical intensive care unit (ICU) of a 1,312-bed tertiary-care center in Taiwan. PATIENTS AND PARTICIPANTS: Fifty-five people undergoing bedside colonoscopy for lower GI bleeding that developed while in the ICU. INTERVENTIONS: Bedside colonoscopy. MEASUREMENTS AND RESULTS: Colonoscopy was successful in diagnosing the source of bleeding in 37 patients. Among them, colitis (15 patients, including ischemic, pseudomembranous, or radiation-induced) and acute hemorrhagic rectal ulcer (nine patients) were the most frequent confirmed causes. In seven patients, fresh blood was noticed above the colonoscopically accessible area and considered to originate from the small bowel. No adverse event was associated with colonoscopy. Spontaneous cessation of bleeding was noted in 29 (29/55, 53%) patients, whereas 16 (16/55, 29%) achieved endoscopic hemostasis. Ten (10/55, 18%) patients failed primary hemostasis or localization. Overall in-hospital mortality was 53% (29/55); however, hemorrhage-related death occurred in only two patients. CONCLUSIONS: ICU patients with acute lower GI bleeding have distinctive causes. Bedside colonoscopy is effective for diagnosis in two-thirds of patients, but only a minority of them needs endoscopic hemostasis.
Acute Disease↗
Microchip electrophoresis with hydrodynamic injection and waste-removing function for quantitative analysis.
Quantitative analysis is problematic for microchip electrophoresis for several reasons including chip-to-chip variation, discontinuous sample re-loading, channel reconditioning, and electrokinetic injection bias. In this study, the capability for quantitative analysis on a flow-through based microchip electrophoresis, which provides continuous sample re-loading, channel washing, reconditioning and hydrodynamic injection as well as waste removing is demonstrated to be more quantifiable and more reproducible compared to manual electrokinetic injection method. Using the flow-through microchip with waste-removing function, FITC-labeled estrogen or Rhodamine B could be continuously analyzed without significant changes (R.S.D. < 6.6%) in signal intensity for over 3 h, which is sufficient for a complete set of quantitative analysis. With the use of a phosphorylated kinase substrate as the model, a calibration curve for quantitative analysis of phosphopeptides were constructed and results indicate that both R2 value of the linearity and R.S.D. values of the peak intensity were around 0.9961 and 3.16%, respectively, without the use of an internal standard. These values were slightly improved to be around 0.9986 and 2.27%, respectively, with the use of a non-phosphopeptide counterpart as the internal standard. The potential of this flow-through device for the development of a kinase phosphorylation assay based on the quantitative method was also briefly discussed.
Amino Acid Sequence↗
Recent progress in pharmacokinetic applications of capillary electrophoresis.
This review is a continuation of the previous reviews (Electrophoresis 1999, 20, 3259-3268; Electrophoresis 2001, 22, 4244-4248) to update the recent publications from 2001 to 2003 on pharmacokinetic studies using capillary electrophoresis (CE). During this period of time, CE remains as a unique analytical method for some studies, which would otherwise be limited by many factors, such as the sample volume, detection sensitivity, or separation power. It is particularly noticeable that the separation of chiral drugs in biological sample and the use of solid-phase extraction (SPE) as a simple and convenient means of sample preparation appear to become popular for CE-based assays. The use of CE for assessing complete pharmacokinetic information, however, did not show a significant growth during this period of time. In order to provide a broad range of view on how biological samples are analyzed by CE, this review will cover publications during the past two years on the use of CE for the analysis of drugs in biological fluids for general pharmacokinetic applications including drug monitoring and bioavailability studies.
Animals↗
Flow-through sampling for electrophoresis-based microchips and their applications for protein analysis.
This work presents a model behind the operation of a flow-through sampling chip and its application for immunoseparation, as well as its integration with a wash/elution bed for protein purification, concentration, and detection. This device used hydrodynamic pressure to drive the sample flow, and a gating voltage was applied to the electrophoretic channel on the microchip to control the sample loading for the separation and to inhibit sample leakage. The deduced model indicates that the critical gating voltage (VC) that is defined as the minimum gating voltage applied to the microchip for sampling is a function of the pump flow rate, the configuration of the microchannel on the chip, and the electroosmosis of the buffer solution. It was found that the theoretical V(C) values calculated from the measured electroosmotic mobilities and flow split ratios were comparable to those experimentally obtained from two microchips with different sampling channel sizes. This had an error percentage ranging from 1 to 20%. Because the hydrodynamic flow is insensitive to electrophoretic mobility, this electrophoresis-based microchip device was free of injection bias due to different ionic strength and electrophoretic mobility in the sample. Additionally, the usefulness of this device was demonstrated for the study of affinity interactions. Mixtures of Cy5-labeled bovine serum albumin (Cy5-BSA) and anti-BSA in various proportions were introduced into the microchip via a syringe pump, and the immunocomplex was electrophoretically separated from the free Cy5-BSA on the microchip. Based on the relative intensity of the free and complex BSA, the binding constant of BSA and anti-BSA was estimated as 3.3 x 10(7) M(-1). Furthermore, a C18 microcartridge (20 microL) was connected to the hydrodynamic inlet of the microchip. Using this device, the wash/elution step can be integrated on-line with the electrophoretic separation and detection on the microchip. Results show that the calibration curve of Cy5-BSA obtained from this integrated device has an R2 value greater than 0.99 and a minimum of quantitation at approximately 10 ng. This direct sampling method is another means of subfractionation, resulting in a relatively greater concentration factor than the average concentration of the whole fraction. Moreover, the electrical field-free bed ensures that the protein interaction will not be affected by the electric field during the wash/elution step.
Algorithms↗
Automation for continuous analysis on microchip electrophoresis using flow-through sampling.
Automation of electrophoretic microchips for sequential analysis of different samples is demonstrated. This system used an autosampler, which was on-line connected to the microchip and the whole process including sample loading and injection, analysis and data acquisition as well as washing were all automated. Rhodamin B at different concentrations was first loaded into a hydrodynamic flow stream by an autosampler, delivered to the microchip, and then sequentially injected into the electrophoretic microchannel for analysis and detection. Automation was achieved by running two independent programs, one for sample loading by an autosampler and the other one for electrophoretic injection by voltage switching, on the same computer. Using this sampling chip, each loaded volume (0.2-1 microL) can be injected for dozens of electrophoretic analyses (1-10 nL for each injection). The variances caused by the external connections, which did not affect the electrophoretic analysis but would cause band broadening of the loaded sample in the hydrodynamic flow stream, were theoretically deduced. Results indicate that the dead volume (approximately 300 nL) due to the connection fitting on the chip could lead to dilution of the loaded sample by a factor of one when 0.2 microL of sample was loaded. Such a design allows sequential analysis of a series of samples while the running buffer is continuously pumped into the connection capillary as well as microchannels for washing between two loaded samples to minimize cross contamination without human intervention. Using this sampling chip, the required sample amount and handling time can be greatly reduced compared to the manual method.
Automation↗
Endoscopic hemostasis of a bleeding marginal ulcer: hemoclipping or dual therapy with epinephrine injection and heater probe thermocoagulation.
BACKGROUND AND AIMS: Endoscopic hemoclipping and dual therapy with epinephrine injection and heater probe thermocoagulation have been proven effective in the hemostasis of bleeding peptic ulcers. However, the hemostatic efficacy has not been investigated in bleeding marginal ulcers. The aim of this study is to investigate the hemostatic efficacy of endoscopic hemoclipping and dual therapy with epinephrine injection and heater probe thermocoagulation in bleeding marginal ulcers. METHODS: From November 1997 to July 2000, 50 patients with active marginal ulcer bleeding underwent either hemoclipping (20 patients) or dual therapy (30 patients) for hemostasis. The demographic data, clinicopathological characteristics, endoscopic findings, initial hemostatic rates, rebleeding rates, amount of blood transfusion, the need of surgery, and mortality rates were collected and analyzed. RESULTS: Marginal ulcers were located at the anastomotic site (64%), saddle portion (22%), efferent loop (10%), or at the afferent loop (4%). The bleeding stigmata were classified into spurting artery (32%), oozing vessel (38%), visible vessel (20%), and blood clot adhesion (10%). The overall therapeutic results in 50 patients were initial hemostasis (100%), rebleeding rate (22%), need for surgery (4%), and hospital mortality rate (4%). There was no significant difference in demographic data and clinicopathological characteristics between the two modes of treatments, whereas recurrent bleeding developed in 5% in the hemoclipping group and 33% in the dual therapy group. No complication related to the procedure occurred in either mode of therapy. The hospital mortality rates were 0 and 6.7%, respectively. CONCLUSION: Endoscopy is effective in achieving initial hemostasis from bleeding marginal ulcers. However, the rebleeding rate remains high and repeated endoscopy may be needed to arrest the hemorrhage.
Adrenergic Agonists↗
Endoscopic hemoclip placement and epinephrine injection for Mallory-Weiss syndrome with active bleeding.
BACKGROUND: Mallory-Weiss syndrome with active bleeding requires effective hemostasis. This is an investigation of the respective efficacy and safety of endoscopic hemoclip placement and endoscopic epinephrine injection in Mallory-Weiss syndrome. METHODS: Thirty-five patients with Mallory-Weiss syndrome with spurting vessels or oozing in a university hospital were enrolled prospectively and randomly assigned to endoscopic hemoclip placement (18 patients) or endoscopic epinephrine injection (17 patients) performed by 4 endoscopists with similar clinical experiences. Demographic characteristics, endoscopic variables, and outcome parameters as well as rates of hemostasis and recurrent bleeding were analyzed. RESULTS: The mean (SD) number of hemoclips applied was 2.5 (1.2) and the mean volume of injection was 7.9 (4.3) mL. Primary hemostasis was achieved in all 35 patients. In each group there was 1 case of recurrent bleeding. Secondary hemostasis was achieved by repeating the same procedures as at randomization in both cases. There were no significant differences in age, gender, prior ingestion of alcohol, presenting symptoms, hemoglobin level, shock, comorbid diseases, bleeding stigmata, tear location, blood transfusion, or hospitalization between the groups. There were no procedure-related complications in either group; surgery was not required in any patient. For both groups, there were no second episodes of recurrent bleeding, procedure-related complication, or need of operation. CONCLUSION: Endoscopic hemoclip placement and endoscopic epinephrine injection are equally effective and safe for the management of active bleeding in Mallory-Weiss syndrome, even in patients with shock or comorbid diseases.
Adult↗
Etiology of acute pancreatitis--a multi-center study in Taiwan.
BACKGROUND/AIMS: Little is known about the etiology of acute pancreatitis in Taiwan. The aim of this study was to evaluate the current etiology of acute pancreatitis in Taiwan by a multi-center cooperative study. METHODOLOGY: Patients with acute pancreatitis were collected from 8 major leading hospitals located at northern, southern, middle and eastern Taiwan from July 1, 1998 to June 30, 2000. The diagnosis of acute pancreatitis was based on characteristic clinical signs and symptoms and three-fold elevation of serum amylase/lipase level or positive evidence in imaging studies. The etiology was attributed to alcohol, gallstones, hypertriglyceridemia, miscellaneous causes, and idiopathic causes. RESULTS: In total 1,193 patients with acute pancreatitis were identified. There were 852 (71.4%) men and 341 (28.6%) women with a mean age of 52.5 years, ranging from 9 to 100 years. Etiology was identified as alcohol in 423 (33.6%), gallstones in 407 (34.1%), hypertriglyceridemia in 147 (12.3%), miscellaneous causes in 109 (9.1%), and idiopathic causes in 107 (9.0%). Patients with alcohol-related acute pancreatitis were the youngest (mean age: 41.5 years), while those with gallstone pancreatitis were the eldest (mean age: 64.1 years) (p < 0.001). The predominant cause of acute pancreatitis in women is gallstones, while alcohol is the leading cause of acute pancreatitis in Taiwanese males. In northern Taiwan, gallstone is the major cause of acute pancreatitis, while alcohol is the predominant etiology in middle, southern, and eastern Taiwan. CONCLUSIONS: Alcohol has become the predominant cause of acute pancreatitis in Taiwan recently. Ecological and gender differences play important roles in the etiology of acute pancreatitis in Taiwan.
Acute Disease↗
The etiology and clinical characteristics of acute lower gastrointestinal bleeding in patients hospitalized for comorbid illnesses.
BACKGROUND/AIMS: To determine whether there are different causes of acute lower gastrointestinal bleeding and different clinical courses in patients (a) with comorbid illnesses vs. (b) patients with only severe hematochezia. METHODOLOGY: From January 2001 to December 2003, 107 hospitalized patients with acute lower gastrointestinal bleeding were evaluated by urgent colonoscopy. Our analyses compared the etiology and clinical characteristics of bleeding in patients with (group A) and without (group B) one or more comorbid illnesses. RESULTS: Group A patients tended to have longer hospital stays, more severe anemic conditions, and more transfusion requirements. The overall mortality rate was 29.5% in group A and 4.3% in group B (p < 0.05). Bleeding-related mortality was not significantly different between groups. Colitis, rectal ulcer, and angiodysplasia were the leading causes of lower gastrointestinal bleeding in group A. Rectal ulcer was a more common cause of bleeding in group A (16.4%) than in group B (2.1%) (p < 0.05), and it resulted in longer hospital stays and more severe anemia and leukocytosis compared to patients with other causes of lower gastrointestinal bleeding. CONCLUSIONS: Patients with acute lower gastrointestinal bleeding that starts after hospitalization for other comorbid illnesses have distinctive etiologies and clinical characteristics compared with ordinary patients admitted to the hospital with only bleeding. Rectal ulcer is an important but obscure cause of acute lower gastrointestinal bleeding in elderly patients with significant comorbid diseases.
Acute Disease↗