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Biomedical subjects

E S Yu

Publications and source records attributed to E S Yu.

At least 19 recordsLinked to original sources
PubMed2001

Results on preemptive or prophylactic treatment of lamivudine in HBsAg (+) renal allograft recipients: comparison with salvage treatment after hepatic dysfunction with HBV recurrence.

BACKGROUND: Lamivudine has been reported to be able to stabilize liver enzyme and hepatitis B virus (HBV) replication with recurrent hepatitis that has been regarded as a frequent and major risk factor for hepatic dysfunction and chronic liver disease in renal transplant recipients. Because large number of hepatitis antigenemia patients among renal transplant patients experience recurrent hepatic dysfunction with HBV recurrence and permanent histological deterioration, preemptive or primary prophylactic use of lamivudine before transplantation may be more beneficial than a trial for the treatment of advanced hepatic dysfunction. METHODS: We conducted a double arm study to compare the efficacy of lamivudine between the preemptive (HBV DNA positive) or prophylactic (HBV DNA negative) trial for the maintenance of stable liver function (n=10) and the trial for the salvage of advanced hepatic dysfunction developed after renal transplantation (n=6) in hepatitis B viremia carrier renal transplant recipients. RESULTS: Hepatic dysfunction with recurrent HBV antigenemia developed in 11 of 36 (30.6%) hepatitis antigenemia patients with a mean duration of 8.4 months (range 5-19.4 months). In six patients treated with lamivudine after hepatic dysfunction from recurrent hepatitis B viremia, serum AST and ALT level normalized within 1 month and HBV-DNA disappeared in all cases. HBV-DNA, however, reappeared in three (50%) without any discontinuation of lamivudine. Liver biopsy revealed recurrent chronic active hepatitis with severe activity of fibrosis in four cases, cholestatic fibrosing hepatitis in one, and permanent cirrhotic change in one. In seven patients who had preemptive lamivudine treatment at 9, 6, 2, 2, 1, 0, 0 month before the transplantation, HBV-DNA had converted to negative with a mean follow up of 1.2 months (range 1-2 month) in all case. Three patients who had prophylactic trials with lamivudine have all remained HBV-DNA negative. The recurrence rate of HBV viremia in the preemptive or prophylactic lamivudine treated group is 10.0% (1/10), which is significantly lower than that (42.3%, 11/25) in the nonlamivudine-treated group. The re-recurrence rate of HBV viremia was significantly higher (3/6, 50.0%) in the reactive lamivudine treated group than in prophylactic or preemptive group (1/10, 10%). CONCLUSION: Although lamivudine treatment after hepatic dysfunction can be a sound conventional treatment modality, this preliminary study may suggest that preemptive or prophylactic trial of lamivudine before hepatic dysfunction might be a more effective strategy for prevention of permanent histological deterioration and recurrence of hepatitis B viremia.

DNA, Viral↗
PubMed1999

Cervical cancer screening knowledge and practices among Korean-American women.

Cervical cancer is one of the most common cancers of American women. The Papanicolaou (Pap) smear test for cervical screening is a widely used and effective means to reduce the morbidity and mortality rate from cervical cancer through early detection. Despite these benefits, many women have never been screened or are not screened at regular intervals. The purpose of this study was to examine cervical cancer screening knowledge and practices of Korean-American women. The sample consisted of 159 Korean-American women, 40 to 69 years of age. The 1987 Cancer Control Supplement questionnaire was translated into Korean and used to collect data. Twenty-six percent of the respondents never heard of the Pap smear test. Only 34% of respondents reported having had a Pap smear test for screening. The most frequently cited reason for not having had a Pap smear test was absence of disease symptoms. Results indicate that education and usual sources of health care were significant factors related to having heard of or having had a Pap smear test. The findings from this study have important implications for health practitioners and policy makers who serve this ethnic population.

Adult↗
PubMed1999

Individual or combined effects of enalapril and verapamil on chronic cyclosporine nephrotoxicity in rats.

Previous studies have demonstrated that enalapril and verapamil seem to attenuate the cyclosporine nephrotoxicity. However, the mechanisms have not been completely understood, especially on molecular events. The aim of this study was to examine the effect of individual or combined treatment on osteopontin, TGF-beta, endothelin-1 and procollagen alpha 1(I) mRNA expressions. Enalapril (50 mg/L in drinking water) and verapamil (0.5 mg/kg/day, subcutaneously), alone or in combination, were administered to rats with chronic cyclosporine nephrotoxicity (cyclosporine, 25 mg/kg/day, subcutaneously) (n = 5 each). Five rats treated with olive oil vehicle were used as control. After 4 weeks, biochemical parameters were measured, and renal cortical mRNA levels were evaluated by Northern blot analysis. Cyclosporine reduced renal creatinine clearance significantly and induced renal cortical osteopontin, TGF-beta, endothelin-1 and procollagen alpha 1(I) gene expressions around 13.5 +/- 1.3, 2.4 +/- 0.2, 1.5 +/- 0.1, 1.9 +/- 0.1 folds, respectively. Individual treatment with enalapril or verapamil significantly suppressed the osteopontin and TGF-beta mRNA expression, but not endothelin-1 and procollagen alpha 1(I). Combined treatment also inhibited the osteopontin and TGF-beta mRNA expression but there was no difference between combined and individual treatment. In conclusion, enalapril or verapamil significantly blunted the cyclosporine-induced osteopontin and TGF-beta gene expressions. However, combined treatment did not show any additive effect.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1998

Self-perceived health and 5-year mortality risks among the elderly in Shanghai, China.

Studies of the elderly worldwide over the last 3 decades have reported that a self-rating of "poor" compared with "excellent/good" health increases the relative risk of dying. The authors tested the strength of this association by performing age-stratified Cox regression analyses on a 5-year longitudinal study of a representative sample of noninstitutionalized elderly aged 65 years and older (n=3,094) in a district of Shanghai, China. More than 20 potential confounders that were only partially controlled in other studies and threats to response validity due to cognitive impairment or diagnosed dementia that were not considered in previous studies were taken into account in this analysis. The results showed that among those aged 65-74 years, "poor" perceived health increases the adjusted relative risk of death by 1.93 (95% confidence interval 1.20-3.11) compared with "excellent/good" health. The adjusted relative risk of a "fair" rating of health is 2.16 (95% confidence interval 1.44-3.25). In the older age group, mortality risks for the ratings of fair as well as poor compared with excellent/good health were not statistically significant. The authors posit that several mechanisms related to host vulnerability markers and greater-than-expected utilization of health services may explain the association between self-assessed health and mortality risks. Future research should strive to develop more precise measures of these and related variables.

Aged↗
PubMed1998

Time course of cell cycle-related protein expression in diethylnitrosamine-initiated rat liver.

BACKGROUND/AIMS: Cell cycle control and the relationship that exists between cellular proliferation, the expression of cell cycle control proteins and cancer have been reported. This study was designed to decipher the timing of cell cycle control protein expression during the initiation of diethylnitrosamine-induced rat hepatocarcinogenesis. METHODS: Three-week-old female Sprague-Dawley rats were intraperitoneally injected twice in 1 week with diethylnitrosamine; after the second injection, all animals were sacrificed at 1, 2 and 24 h, and 3 and 7 days. The expression of cell cycle-related proteins such as CDK2 and 4, cyclin proteins (D1, E and cdc2), proliferating cell nuclear antigen, tumor suppressor proteins (p53 and Rb), CDK inhibitory proteins (p21waf1 and p27Kip1), and apoptosis-inhibiting protein (bcl-2) following diethylnitrosamine treatment was examined. RESULTS: The peak induction time of each cell cycle-related protein during DEN-induced cellular proliferation was diverse, and expressions of CDK2, CDK4, cdc2, p53, bcl-2, p21Waf1 and p27Kip1 appear to be of the greatest interest. CONCLUSIONS: Data generated from this study may provide information about cell cycle-related protein expression in the initiation stage of hepatocarcinogenic signaling pathways stimulated by a genotoxic agent such as diethylnitrosamine.

Animals↗
PubMed1998

Cancer risk among Scandinavian immigrants in the US and Scandinavian residents compared with US whites, 1973-89.

Studies of migrants can generate hypotheses on the aetiology of cancer. Such studies are most informative when cancer incidence data are available both in the source and host country. We compared the incidence rate ratio of cancers (stomach, lung, female breast, colorectal and prostate) in Scandinavian immigrants to the US to US-born whites, using data from the SEER registry, 1973-89. Odds ratios (OR) for cancer sites in relation to birthplace were estimated using logistic regression. We also compared rate ratios (RR) for Scandinavian and US residents, using Poisson regression. Compared with US whites, most Scandinavian migrant groups had elevated OR for stomach cancer (1.58 to 3.92), and lower OR for lung cancer (0.38 to 0.88). Similarly, compared with US whites, residents of most Scandinavian countries had elevated RR for stomach cancer (1.47 to 3.33) and lower RR for lung cancer (0.27 to 0.97). Therefore, risk factors for lung and stomach cancers, such as smoking habits and Helicobacter pylori infection, respectively, may have been retained upon migration. Risks for breast, colorectal and prostate cancer among immigrants approached risks in the US (contrasting Scandinavian risks) suggesting assimilation of environmental and/or lifestyle factors.

Adolescent↗
PubMed1997

A cross-cultural validation of coping strategies and their associations with caregiving distress.

Coping strategies were compared among family caregivers of Alzheimer's disease patients in Shanghai, China (n = 110) and San Diego, California (n = 139). Four coping factors were reliably consistent in both samples, supporting their widespread relevance to life adversity; behavioral confronting, behavioral distancing/social support, cognitive confronting, and cognitive distancing. Shanghai and San Diego caregivers endorsed similar rates of coping, but Shanghai caregivers reported fewer symptoms of depression and anxiety. Although coping strategies were similar, cultural ideals promoting family interdependence, veneration of elderly family members, and acceptance of traditional family roles may have reduced the psychological impacts of caregiving in the Shanghai sample.

Adaptation, Psychological↗
PubMed1997

Xanthogranulomatous cholecystitis: CT features with emphasis on differentiation from gallbladder carcinoma.

PURPOSE: To evaluate the computed tomographic (CT) features of xanthogranulomatous cholecystitis (XGC) and to distinguish it from gallbladder carcinoma. MATERIALS AND METHODS: Retrospective analysis was performed in 11 patients with XGC and 17 patients with gallbladder carcinoma in which the wall was thickened. The following CT features were analyzed: maximum wall thickness, intramural hypoattenuated nodules, mucosal line, patterns of wall thickening and enhancement, and the presence of stones. The changes outside the gallbladder were also compared. RESULTS: The mean thickness of the gallbladder wall was 1.8 cm in patients with XGC and 2.1 cm in patients with gallbladder carcinoma. Intramural hypoattenuated nodules were seen in all patients with XGC but in only seven patients with gallbladder carcinoma (P = .008). The mucosal line was observed in nine patients with XGC and in six with gallbladder carcinoma (P = .02). The gallbladder wall was more diffusely thickened in patients with XGC (10 of 11 patients) than in patients with gallbladder carcinoma (seven of 17 patients) (P = .01). The occurrence of changes outside the gallbladder did not differ statistically significantly. CONCLUSION: Because of a statistically significant overlap of CT features, only when intramural hypoattenuated nodules occupy a large area of the thickened gallbladder wall can the diagnosis of XGC be highly suggestive. The diagnosis of XGC at CT may indicate a less aggressive surgical approach.

Adult↗
PubMed1997

Effects of apolipoprotein E on dementia and aging in the Shanghai Survey of Dementia.

We investigated the status of the apolipoprotein E allele in 538 participants in the incidence phase of the ongoing Shanghai Survey of Dementia, including 103 demented subjects, 72 with mild cognitive impairment and 363 cognitively normal. The apo E epsilon 4 allele was present in 10.2% of control subjects and the allelic frequency did not change between ages 60 to 96 years. The apo E epsilon 4 allelic frequency was increased both in those wiht Alzheimer's disease (AD) (25.4%) and those with vascular dementia (VaD) (22.2%), but not in those with other dementing illnesses or the cognitively impaired. All of the subjects homozygous for apo E epsilon 4 were demented, three were diagnosed as having AD, and three met NINDS/AIREN criteria for VaD. The increased apo E epsilon 4 allelic frequency in clinically diagnosed VaD patients suggests that some of the infarcts are secondary to congophilic angiopathy. The adjusted odds ratio of developing AD in this community-derived study for persons with at least one apo E epsilon 4 allele was 4.1 (95% CI: 2.2, 7.7). Thus, the apo E epsilon 4 risk of developing AD in this Chinese cohort is similar to that in western community studies.

Age Factors↗
PubMed1996

HIV infection and AIDS in China, 1985 through 1994.

OBJECTIVES: This paper analyzes data on the distribution of and risk factors for the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection in China. METHODS: Ten years of data on persons tested for HIV infection and AIDS and the proportion who tested positive were analyzed against the background of China's population count. The Chinese- and English-language literature on HIV and AIDS from 1985 through 1995 was also reviewed. RESULTS: Overall, more males than females had HIV infection. Intravenous drug use was the primary source of transmission, followed by heterosexual contacts. Only a small number of the persons tested were homosexual, but their proportion of HIV seropositivity ranked third to that of drug users; that of general hospital patients ranked fourth. CONCLUSIONS: HIV infection and AIDS in China began as a highly regionalized and largely rural problem in Yunnan Province. However, HIV infection and AIDS have become an emerging urban problem. HIV seropositivity is low among several groups thought to have an elevated risk.

Acquired Immunodeficiency Syndrome↗
PubMed1995

ADL dependence and medical conditions in Chinese older persons: a population-based survey in Shanghai, China.

OBJECTIVE: To describe the prevalence of activities of daily living (ADL) dependence and medical conditions and the relationship between illnesses and ADL performance in the older population of Shanghai, China. DESIGN: Probability sample survey of community residents. SETTING: The Jing An district of Shanghai, China. The interviews were carried out at the homes of the older persons. PARTICIPANTS: There were 3763 noninstitutionalized elders screened, 3745 of whom completed the interview. MEASUREMENTS: The dependent variables were the five basic ADL items: eating, dressing, transferring, toileting, and bathing. The independent variables were dementia and 19 self-reported medical conditions, along with age, gender and education level. MAIN RESULTS: Of those in Shanghai aged 65 and older, 8.28% (6.52% of males, 9.17% of females) were functionally dependent in one or more ADLs. The most prevalent self-reported illness was cardiovascular disease, including hypertension (29.12%) and heart disease (26.65%). ADL performance was associated with dementia and a number of medical conditions in univariate analysis. The best predictors of functional dependence in both age groups (65-74 years; 75 years and older), based on the multiple logistic regression analysis and after controlling for age, gender, and education, were stroke, dementia, Parkinson's disease, diabetes, and emphysema. CONCLUSIONS: The authors have successfully applied five ADL items selected and culturally adapted from Older Americans Resources and Services to the study of older Chinese. A consistent and reliable estimate of functional dependence among older persons is obtained. The prevalence of dementia and many self-reported illness, as well as the ADL status by medical condition, are reported. The findings reveal certain patterns of relationship between illness conditions and ADL performance.

Activities of Daily Living↗
PubMed1994

The malignancy of dementia. Predictors of mortality in clinically diagnosed dementia in a population survey of Shanghai, China.

OBJECTIVE: To evaluate the effect of dementing illnesses on the risk of dying, taking into account other conditions that would shorten survival. DESIGN: Five-year follow-up of community survey of dementia. SETTING: Five-year data were obtained for the 3531 subjects, aged 65 years and older, who participated in the 1987 population survey of dementia in Shanghai, China. MAIN OUTCOME MEASURE: Time to death. Relative risks of dying were calculated for demographic variables, dementia diagnoses based on findings of clinical evaluations, and 15 reported prevalent medical conditions using the proportional hazards model. RESULTS: In those subjects aged 65 to 74 years, the mortality risk ratio was 5.4 (95% confidence interval, 2.0 to 14.6) for Alzheimer's disease and 7.2 (95% confidence interval, 3.6 to 14.4) for vascular dementia. The risk ratio for Alzheimer's disease was similar to the mortality risk ratio for cancer (5.6 [range, 2.9 to 10.9]). In this age group, dementing illnesses were uncommon, and few deaths were therefore attributable to the dementing illnesses. In those subjects aged 75 years and older, the mortality risk ratios were 2.8 (95% confidence interval, 2.1 to 3.6) for Alzheimer's disease, 3.5 (95% confidence interval, 2.4 to 5.1) for vascular dementia, and 3.6 (95% confidence interval, 2.0 to 6.7) for "other dementias." Because these dementing disorders were common in those subjects aged 75 years and older, 23.7% of the risk of death could be attributed to these disorders. CONCLUSIONS: Both Alzheimer's disease and vascular dementias are truly malignant and constitute major risk factors for death in persons older than 75 years.

Aged↗
PubMed1993

Nutritional status of Chinese-, Korean-, and Japanese-American elderly.

OBJECTIVE: To examine the nutritional status of three major subgroups of Asian-American elderly. SUBJECTS: The sample consisted of 169 Chinese, 90 Korean, and 50 Japanese elderly who lived in five apartment buildings for senior citizens in Chicago, Ill. MAIN OUTCOME MEASURES: Twenty-four-hour dietary recalls were used to evaluate dietary intake. Anthropometric measures of height, weight, and triceps skinfold thickness were also obtained. RESULTS: Many Asian-American elderly consume an inadequate amount of dietary calcium. A large percentage of Korean elderly also consume inadequate amounts of protein and vitamins A and C. Underweight was more common than obesity among these ethnic elderly groups. APPLICATIONS: The information in this article provides valuable data to the Asian-American community for program planning as well as to health providers who work with individual Asian-American elderly to meet their nutrition needs.

Aged↗
PubMed1993

Functional status, education, and the diagnosis of dementia in the Shanghai survey.

We examined the relationship of culturally adapted Chinese versions of the Mini-Mental State Examination (CMMS) and several functional measures to the effect of education on the clinical diagnosis of dementia in 554 subjects (55 to 95 years; median, 74) who had undergone intensive evaluation during the Shanghai survey of dementia. Low education was associated with increased prevalence of clinically diagnosed dementia. The standardized history and one functional scale (Pfeffer Outpatient Disability Scale [POD]) clustered closely with clinical diagnosis on factor analysis, whereas the CMMS, Instrumental Activities of Daily Living scale (IADL), and Activities of Daily Living scale (ADL) loaded additionally onto an education-weighted component. A logistic equation based on the CMMS, history, POD, and IADL was the best predictor of the clinical diagnosis of dementia, but history, POD, and IADL without a mental status score also predicted the diagnosis with a sensitivity of 88.6%, a specificity of 89.3%, a positive predictive value of 66.0%, and a negative predictive value of 97.1%. When dementia was diagnosed using an algorithm based on the three functional scales alone, low education continued to be associated with increased age-specific risk of dementia.

Activities of Daily Living↗
PubMed1993

Early allograft function in canine single lung transplant.

An assessment of early graft function in canine single lung transplant recipients was made by analysing early postoperative radiographic progression, lung perfusion, bronchial patency and bronchial anastomotic wound healing and histopathology of the allografted lung. Eighteen mongrel dogs weighing 15kg on average were used. Donor lung bloc with a generous atrial cuff, the pulmonary artery and left bronchus were taken and flushed with Euro-Collins solution which implanted in the pneumonectomized recipient dog. Anastomosis was done with the atrium, pulmonary artery and bronchus in that order. To assess an early graft function, a protocol for a grading system was designed into the chest roentgenogram, lung perfusion scan, bronchial patency and histopathologic progression of the bronchial anastomosis and allografted lung (Table 1). The results were obtained as follows: Radiographically, clear to infiltrate was seen in 67% (8/12), 33% (5/15), 30% (3/10) and 33% (2/6) on postoperative day 0, 1, 2 and 3 respectively. Lobar to total opacification was 33% (4/12), 67% (10/15), 70% (7/10) and 67% (4/6) on days 0 to 3 (Table 2). Perfusion scan showed normal to mild defect in 43% (3/7) and moderate to severe defect in 57% (4/7) on day 0 and 100% (5/5) on day 2 (Table 3). The bronchial anastomotic site showed patent to mild stenosis in 100% (8/8) on day 0 and mild stenosis in 2/2 on day 9 bronchofiberscopically, and showed normal wound healing in 38% (3/8), cellular infiltration in 38% (3/8) and infarction in 25% (2/8) up to day 9 postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗