Biomedical subjects

H C Lin

Publications and source records attributed to H C Lin.

At least 289 records · Page 16Linked to original sources

PubMed1995

Autoimmune aspects of primary pulmonary hypertension.

Although primary pulmonary hypertension (PPH) is considered to be an idiopathic condition, it has been postulated that autoimmunity may play a role in the pathogenesis of the disease. This argument has been based on frequent coexisting clinical and serological rheumatic findings. Moreover, approximately in a third of the patients with PPH, and antinuclear factor can be detected. Pulmonary hypertension may appear as a secondary complication to various autoimmune conditions. In light of these findings we examined sera derived from 40 patients diagnosed as having PPH for the presence of 18 different autoantibodies by the ELISA and immunofluorescent techniques. Of the 40 patients, 62.4% had circulating autoantibodies and 47.5% presented with multiantibody responses. Autoantibodies most commonly observed were antinuclear (42.5%), anti-ssDNA (25%) and antithyroglobulin (30%) antibodies. These results may imply that in a subgroup of patients with PPH the disease may be ascribed to an immune dysregulation or alternatively that autoantibodies accompany the disease progression as an epiphenomenon.

Antibodies, Antinuclear↗

PubMed1995

Autoantibody profile of primary sclerosing cholangitis.

Primary sclerosing cholangitis (PSC) is a chronic progressive liver disease of unknown etiology. It has been suggested that genetic and immunological factors are important in its pathogenesis. The present study examined the prevalence of 23 different autoantibodies in 25 PSC sera, by ELISA, in order to better define the autoimmune profile of PSC. The results indicate that 88% of PSC patients produced at least 1 autoantibody, and 36% had reactivity to multiple autoantibodies. Moreover, 35% of the PSC patients produced anti-endothelial-cell antibodies (AECA) and 75% of the sera contained perinuclear antineutrophil cytoplasmic antibodies (pANCA), detected by indirect immunofluorescence. The prominent ANCA autoantibody was anti-cathepsin-G, demonstrated in 35% of the patients. The multiplicity of the autoantibody profile, revealed in the present study, points to the autoimmune characteristics of PSC. In addition, the association of ANCA and of AECA in PSC may suggest a pathogenic role for these antibodies in PSC.

Antibodies, Antineutrophil Cytoplasmic↗

PubMed1995

Attenuated cardiovascular response to adenosine in the brain stem nuclei of spontaneously hypertensive rats.

We previously reported that adenosine has significant depressor effects in the nucleus tractus solitarii and area postrema of the rat. The purpose of this study was to determine whether the spontaneously hypertensive rat (SHR) has abnormalities in medullary sensitivity to adenosine. Male SHR and Wistar-Kyoto (WKY) rats (aged 12 to 15 weeks) were anesthetized with urethane, and blood pressure was monitored intraarterially. Stereotaxic microinjection (60 nL) of adenosine was made into the nucleus tractus solitarii and the area postrema and was confirmed histologically. Dose-related decreases in mean blood pressure and heart rate occurred in both strains tested, and this effect was completely abolished by 1,3-dipropyl- 8-p-sulfophenylxanthine (0.92 nmol), a potent adenosine receptor antagonist. However, there were significant differences between SHR and WKY rats in the magnitude of blood pressure and heart rate depression. A similar pattern of response was found in the area postrema. Thus, adenosine is a potent depressor agent in the nucleus tractus solitarii and area postrema of rats, and adenosine has significantly fewer depressor effects in SHR. These data suggest that alterations in purinergic mechanisms of central cardiovascular control exist in the SHR model.

Adenosine↗

PubMed1995

Anti-neuronal antibodies in antiphospholipid syndrome with central nervous system involvement: the difference from systemic lupus erythematosus.

The presence of antineuronal antibodies was compared in 43 patients with primary aPLS and 57 patients with neuropsychiatric SLE. Fifty-eight patients with Guillain-Barré syndrome and 72 normal healthy donors served as control groups. Seventeen patients in the study group had aPLS associated with CNS involvement. Antineuronal antibodies were studied in the sera employing a novel flow cytometric assay. The frequency of antineuronal antibodies in patients with aPLS and CNS involvement was not significantly different from that of patients with aPLS without CNS disease or from that found in the control groups (12%, 19% and 7%, respectively). However, it was significantly different from that found in SLE patients with CNS involvement (60%) (P < 0.001). Our results provide further evidence that unlike CNS-SLE, the major mechanism of CNS involvement in patients with primary aPLS might not be autoantibody (antineuronal) mediated, but rather 'thrombotic' in origin, or due to yet unknown factors.

Antiphospholipid Syndrome↗

PubMed1995

Different roles of class I and class II Clostridium histolyticum collagenase in rat pancreatic islet isolation.

Crude Clostridium histolyticum collagenase was purified by gel filtration and fractionated by anion exchange chromatography into class I with high collagen digestion activity (CDA) and low FALGPA (2-furanacryloyl-L-leucylglycyl-L-prolyl-L-alanine) hydrolysis activity (FHA), class II with low CDA and high FHA, and a fraction called class I/II with intermediate activities. The roles of these collagenase classes in rat pancreatic islet isolation were investigated. Dissociations were carried out with 360 mg of pancreatic tissue in 10 ml of buffer containing 10% (wt/vol) albumin to suppress endogenous proteolytic activity, 100 U of C. histolyticum neutral protease, and one or two purified collagenase(s). For purified nonfractionated (PNF) collagenase, 2.6 mg of enzyme containing 2.4 U CDA and 38.0 U FHA was used, and for the separate classes, comparable amounts of activity were added. PNF collagenase dissociated the tissue completely in 32 min and yielded 5.0 +/- 0.4 microliters islet tissue/g pancreas. Class I collagenase alone dissociated pancreatic tissue extremely slowly and incompletely; only a few islets were released (0.7 +/- 0.2 microliters/g pancreas). Class II collagenase alone dissociated the tissue adequately in 50 min, and a high islet yield of 5.7 +/- 0.6 microliters/g was obtained. With class I/II, a similar dissociation time (47 min) and islet yield (5.5 +/- 0.3 microliters/g) were obtained. Combining class I and class II collagenase resulted in a more rapid dissociation (32 min) and a higher islet yield (7.1 +/- 0.8 microliters/g) than that obtained with PNF collagenase (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗

PubMed1995

The effects of chronic administration of indomethacin and misoprostol on renal function in cirrhotic patients with and without ascites.

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) often cause renal dysfunction in cirrhotic patients with ascites through inhibition of prostaglandin synthesis. However, their renal effects in cirrhotic patients without ascites are controversial. In addition, the role of prostaglandins in cirrhotic patients with ascites and in non-ascitic cirrhotic patients receiving NSAIDs also remains elusive. Thus we evaluated the chronic renal effects of indomethacin and misoprostol in 9 cirrhotic patients with ascites (protocol 1) and 21 cirrhotic patients without ascites (protocol 2). METHODS: The patients of protocol 1 received 200 micrograms of misoprostol every 6 h for 7 consecutive days. In protocol 2, 11 patients received 25 mg indomethacin three times a day for 7 consecutive days. The other 10 patients received 25 mg indomethacin three times a day plus 200 micrograms misoprostol every 6 h for 7 consecutive days. Renal function tests, plasma renin activity, and plasma aldosterone concentration were measured before and after treatment. RESULTS: In protocol 1, misoprostol tended to reduce the urinary sodium excretion (p = 0.08). In protocol 2, indomethacin alone greatly impaired renal plasma flow (p < 0.05), creatinine clearance (p < 0.05), blood urea nitrogen (p < 0.05), and serum creatinine (p = 0.06) in 11 patients. Similar magnitudes of renal dysfunction were observed in the other 10 patients despite the concomitant misoprostol treatment. CONCLUSION: Chronic administration of misoprostol may have caused a negative natriuretic effect in cirrhotic patients with ascites. In cirrhotic patients without ascites chronic administration of indomethacin may induce a renal dysfunction that cannot be reversed by misoprostol.

Aged↗

PubMed1995

Comparison of endoscopic variceal injection sclerotherapy and ligation for the treatment of esophageal variceal hemorrhage: a prospective randomized trial.

To determine the efficacy of endoscopic variceal sclerotherapy (EVS) and ligation (EVL) in the management of esophageal variceal bleeding, 134 cirrhotic patients were randomized to receive either treatment. The clinical and endoscopic characteristics were similar in both groups. Active bleeding was controlled with ligation (20 of 20) as efficiently as with sclerotherapy (14 of 16). Elective sclerotherapy consumed less time than ligation (7.9 +/- 1.8 minutes vs. 11.5 +/- 2.7 minutes, P < .001), but there was no difference between emergent sclerotherapy (14.5 +/- 5.8 minutes) and ligation (14.9 +/- 4.1 minutes). Ligation reduced one grade of variceal size more quickly than sclerotherapy (1.1 +/- 0.4 vs. 2.0 +/- 1.7 session, P < .001). The rebleeding rate was lower with ligation (13 of 67 vs. 28 of 67, P < .01). Esophageal ulcer was the most common source of rebleeding. Recurrence of varices appears more probable with ligation (P = .079). The complication rate was higher with sclerotherapy (15 of 67 vs. 3 of 67, P < .01), with esophageal stricture being the most common cause. Survival rate was the same in both groups even after stratifying patients into good and poor hepatic reserve groups. Hepatic failure was the major cause of death, followed by exsanguination. In summary, EVL was superior to EVS regarding rebleeding and complications but not in other aspects such as time consumption in elective treatment and recurrence of varices. Substantial results for long-term follow-up are required before conclusion of the treatment of choice.

Esophageal and Gastric Varices↗

PubMed1995

Descriptive study of prognostic factors influencing survival of patients with primary tracheal tumors.

From 1977 to 1992, 23 patients with primary tumors of the trachea were reviewed. Nineteen of these patients had squamous cell carcinomas, 2 had adenoid cystic carcinomas, 1 had a small cell carcinoma, 1 had a poorly differentiated carcinoma, and 1 had a pleomorphic adenoma. The prognosis of squamous cell, small cell and poorly differentiated carcinomas appeared to be grave, especially in association with vocal cord palsy (26%). Short-term survival occurred in 7 to 9 patients with tumors in the upper-middle third of trachea and 4 of them had concurrent acute respiratory distress. Cough (65.2%), dyspnea (91.3%), and hemoptysis (47.8%) were the most common symptoms. For patients with hoarseness, dysphagia, and cervical lymphadenopathy, the prognosis was poor (p < 0.0010). Two patients (8.7%) had multiple malignancies and all died within 1 year. Smoking was not only a risk factor as reported in previous studies, but also a significant prognostic factor (p = 0.0020) in our series. Emergent irradiation ( < 40 Gy in our cases) was useful in alleviating acute respiratory distress, but worthwhile survival was only obtained by the combination of surgery and radiation therapy (p = 0.0200, compared with surgery or irradiation, respectively). There was a significant correlation between prognosis and histologic type, tumor location, clinical presentation, smoking history and management, but not roentography or tumor size. These factors can be used to assess the survival of patients with primary tracheal tumors.

Carcinoma, Squamous Cell↗

PubMed1995

Prevalence of duodenal ulcer in cirrhotic patients and its relation to Helicobacter pylori and portal hypertension.

BACKGROUND: The prevalence of duodenal ulcer increases in cirrhotic patients. However, the pathogenesis remains unclear. METHODS: The prevalence of duodenal ulcer and their relationship to cirrhosis and portal hypertension were evaluated in 325 cirrhotic patients, and compared with 325 age- and sex-matched healthy subjects. Portal and systemic hemodynamic studies were performed in all cirrhotic patients. Histological examination of gastric antral mucosa for Helicobacter pylori (H. pylori) was performed in 16 cirrhotic patients with duodenal ulcer and in 34 cirrhotic patients without duodenal lesions. RESULTS: The prevalence of duodenal ulcer in cirrhotic patients was 9.5% (31 out of 325), significantly higher than 4.0% (13 out of 325) in the healthy controls (p = 0.007), but was not related to the severity of liver cirrhosis. The positive rate of H. pylori was not different between cirrhotic patients with duodenal ulcer and those without duodenal lesions (9/16 vs. 18/34, p > 0.05). The hepatic venous pressure gradient was also not different between these groups (17.2 +/- 5.1 vs. 16.1 +/- 4.9 mmHg, p > 0.05). Other variables including sex, smoking, and etiology of cirrhosis did not show significant differences. CONCLUSIONS: The prevalence of duodenal ulcer is significantly higher in cirrhotic patients than in the age- and sex-matched healthy subjects. The severity of cirrhosis, the presence of H. pylori or portal hypertension per se does not play an important role in the increased prevalence of duodenal ulcer in cirrhotic patients.

Duodenal Ulcer↗

PubMed1995

Integrating a health IC card system into a hospital information system.

As an experiment, a health IC card has been linked into the hospital information system of the National Cheng Kung University (NCKU) Hospital. The NCKU Hospital Information System (NCKU-HIS) services all the procedures for patient registration, billing, prescriptions, and the processing and storing of test results. The health IC card system provides good quality information to the doctors, the hospital, the patients, and the insurance organizations. For a fully comprehensive system, it is essential to integrate the health IC card system into the operational NCKU-HIS, the communication protocols, and the national insurance procedures. The experiment was designed to see if the development of such a system was feasible, and the results have been impressive. It has proved possible to operate the health IC card system, linking into different machines under different computing environments. A single computer system to store all the data of all the patients and to process all the nation's healthcare information would require almost unlimited mainframe processing power and unlimited storage. It would be very difficult to construct such a large computerized information system. All the hospitals would be required to use the same data format to process their information, and a large national healthcare network would have to be built, making the collection and storage of personal medical information very difficult and probably inefficient and unsatisfactory. Even if it was possible, it would be a very costly and time-consuming task. An IC card is cheap and easy to use, and offers an alternative solution to the problem of handling the nation's healthcare information. The original healthcare IC card experiment (started in 1990) was limited to the NCKU Hospital and the Taiwan Government Employees' Clinic. The experimental system was designed to be fully integrated into the NCKU-HIS and has been widely accepted by the users, especially the IC card-holding patients. It is also well-suited to the management of healthcare insurance. An expanded healthcare IC card system was implemented from the end of 1993 and covers six clinics and six hospitals in Penghu County. The operation of the registration and billing subsystems are supported by PC workstations in a client/server network as these subsystems are used very frequently. Some of the other computerized functions in the NCKU-HIS are supported by the mainframe TANDEM computer system. The interfaces with the communication protocols and application software provide for the effective two-way transfer of data and programs. For future use, consideration is being given to the employment of the Health Level Seven (HL/7) protocol for electronic data interchange. National standards such as Chinese information processing, the use of standard codes, the authorization of the content of the IC card, and communication protocols are already incorporated in the system.

Hospital Information Systems↗

PubMed1994

Milk production in cows with endotoxin-induced mastitis treated with isotonic or hypertonic sodium chloride solution.

Milk production was monitored in 16 cows for 6 milkings after intramammary infusion of 1 mg of endotoxin in a single forequarter. The cows were randomly assigned to 1 of 2 treatment groups; 8 cows were treated with isotonic saline solution and 8 cows were treated with hypertonic saline solution. Saline solutions were administered IV (5 ml/kg of body weight) 4 hours after infusion of endotoxin. Mean cumulative change in milk yield and interval change in milk yield were greater in cows treated with isotonic saline solution than in cows treated with hypertonic saline solution. Significant differences between treatment groups were not detected.

Animals↗

PubMed1994

Antibodies to histone (H2A-H2B)-DNA complexes in the absence of antibodies to double-stranded DNA or to (H2A-H2B) complexes are more sensitive and specific for scleroderma-related disorders than for lupus.

OBJECTIVE: To assess the role of antibodies to histones H2A, H2B, and anti-double-stranded DNA which form (H2A-H2B)-DNA complexes in patients with scleroderma-related disorders. METHODS: Antihistone antibodies were measured, by enzyme immunoassay, in 26 patients with scleroderma-related disorders, 100 patients with systemic lupus erythematosus (SLE), and 24 patients with rheumatoid arthritis. RESULTS: Antibodies to histone (H2A-H2B)-DNA complex were more commonly seen in patients with scleroderma-related disorders than in those with SLE (P < 0.0001). CONCLUSION: Scleroderma-related disorders should be included among conditions in which various types of antihistone antibodies are produced. A hypothesis to account for this finding is discussed.

Antibodies↗

PubMed1994

On the molecular nature of the Duarte variant of galactose-1-phosphate uridyl transferase (GALT).

Galactosemia is an inborn error of galactose metabolism secondary to deficiency of galactose-1-phosphate uridyl transferase (GALT). GALT is a polymorphic enzyme and Duarte (D) is the most common enzyme variant. This variant is characterized by faster electrophoretic mobility and reduced activity. Duarte/galactosemia compound heterozygotes (D/G) are commonly identified in galactosemia newborn screening programs. However, these patients do not generally require treatment. By using a "candidate mutation" approach to define the molecular basis of the Duarte variant of GALT, a close association between the previously reported N314D polymorphism and the Duarte variant of GALT was found. We suggest that N314D encodes the D variant of GALT and that molecular testing for N314D might be useful to confirm a biochemical diagnosis of Duarte variant of GALT.

Alleles↗

PubMed1994

Molecular subtypes of env sequences around V3 region of human immunodeficiency virus type 1 in Taiwan.

Samples of peripheral blood mononuclear cells (PBMC) were collected during 1990-91 from seropositive healthy, male HIV-1 carriers visiting Taipei Venereal Disease Control Center, and a male AIDS patient admitted to a general hospital. The V3 and its flanking nucleotide (nt) sequences in their DNA were amplified by polymerase chain reaction (PCR) and compared with those of known HIV-1 prototypes. The nt sequences obtained from 21 individuals (e.g., TW92) clustered as Group A, which were highly homologous (95.6-99.5%) to that of HXB2 virus while those from 6 individuals (TW90, TW91, TW97, TW99, TW102 and TW104) were classified as Group B showing low similarities (73.2-84.2%) to those of HXB2 and moderate similarities (80.7-90.0%) to those of SC and Bangkok (BK) viruses. By comparison of their deduced amino acid sequences with those of consensus sequences for subtypes A-F as defined by Myers et al. (1993), both Groups A and B viruses (except TW102) together with those of HXB2, SC and BK viruses could be identified as members or variants of subtype B, and the TW102 virus as a member of subtype E viruses. Individuals with the Group A viruses included 4 homosexual and 17 heterosexual Taiwanese males, 2 of the latter having a history of i.v. drug abuse. Among individuals with Group B viruses, those with TW97, TW99, TW104 and TW91, who was an AIDS patient, were heterosexual Taiwanese males, whereas both TW90 and TW102 viruses were from individuals who were overseas heterosexual Chinese from Thailand, the former with a history of i.v. drug abuse and the latter without.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Erythromycin accelerates solid emptying at the expense of gastric sieving.

Erythromycin accelerates gastric emptying by inducing antral contractions similar to phase III of interdigestive MMC. These powerful contractions are capable of forcing coin-sized indigestibles out of the stomach. In contrast, fed motility is associated with submaximal contractions that fragment (trituration) and propel solids while retaining large (> 0.5 mm) pieces for further size reduction (gastric sieving). In this study, using dogs with duodenal fistulas, we tested the hypothesis that erythromycin-induced acceleration of gastric emptying resulted in the passage of inadequately triturated (> 0.05 mm) chunks of solids into the duodenum. We found that gastric emptying was accelerated by erythromycin (vs 0.15 M NaCl control, P < 0.05). However, the percentage of chyme collected in the > 0.5-mm fraction was much greater (P < 0.01) in the erythromycin-treated experiments (63 +/- 9%) than the controls (7 +/- 1%). Correspondingly, while a fine gruel was passed during controls, under erythromycin infusion, most of the solids were emptied as large chunks virtually unchanged from the swallowed pieces. We conclude that erythromycin accelerates gastric emptying at the expense of gastric sieving.

Animals↗

PubMed1994

Abnormal intestinal feedback in disorders of gastric emptying.

Many patients who complain of postprandial bloating discomfort and episodic nausea and vomiting exhibit abnormally slow gastric emptying of a standard meal during scintigraphic study. Nevertheless, on clinical grounds, the group of slow emptiers would appear to be comprised of two types of patients: (1) those with primary motor dysfunction (pump failure) and (2) those who have normal muscle performance but abnormally intense inhibition of gastric emptying by nutrients in small intestine (too much feedback). Our studies suggest that these two groups may be distinguished by varying the nutrient content in the test meal during multiple studies of gastric emptying.

Animals↗

PubMed1994

Effects of octreotide on postprandial systemic and hepatic hemodynamics in patients with postnecrotic cirrhosis.

The effects of octreotide on postprandial hemodynamic responses were evaluated in 20 patients with postnecrotic cirrhosis. They were randomly assigned to receive either a 100-micrograms bolus with a 100-micrograms/h infusion of octreotide or a placebo. Placebo administration did not affect any of the hemodynamic values. However, after a liquid meal of 500 kcal, postprandial increases in the hepatic venous pressure gradient and hepatic blood flow were observed in patients receiving placebo, while the systemic hemodynamic values remained unchanged. In contrast, in patients receiving octreotide, the hepatic blood flow was significantly decreased 30 min after administration, while the hepatic venous pressure gradient and the systemic hemodynamic values were not affected. After ingestion of a meal, the mean values of the hepatic blood flows were not significantly different from basal values. Moreover, the wedged hepatic venous pressure, the hepatic venous pressure gradient and the systemic hemodynamic values were not affected by meal ingestion. However, during octreotide infusion, hepatic blood flow 30 min after the meal had a tendency to increase compared to before the meal. In conclusion, octreotide inhibited the postprandial increase in portal pressure in patients with postnecrotic cirrhosis. In addition, octreotide decreased hepatic blood flow in the fasting state. When given before a meal, the increase in blood flow induced by the meal restored the hepatic blood flow to basal levels.

Adult↗

PubMed1994

Malignancy-related ascites: a diagnostic pitfall of spontaneous bacterial peritonitis by ascitic fluid polymorphonuclear cell count.

To define patients with an ascitic fluid polymorphonuclear cell count > or = 250 cells/mm3 or > or = 500 cells/mm3 but without spontaneous bacterial peritonitis, 166 patients with sterile cirrhotic ascites, 46 patients with spontaneous bacterial peritonitis, 123 patients with hepatocellular carcinoma, 67 patients with peritoneal carcinomatosis or massive liver metastasis and 12 patients with other miscellaneous diseases were studied. The sensitivity, specificity and accuracy of the diagnosis of spontaneous bacterial peritonitis were 100, 86 and 88% with the cut-off value of an ascitic fluid polymorphonuclear cell count > or = 250 cells/mm3; and were 93, 91 and 92% with that value > or = 500 cells/mm3, respectively. With the cut-off value > or = 250 cells/mm3 or > or = 500 cells/mm3, the prevalence was 18% or 14% in hepatocellular carcinoma; and 30% or 19% in peritoneal carcinomatosis or massive liver metastasis. The ascitic fluid lactate concentration was insensitive and nonspecific. Among the patients with an ascitic fluid polymorphonuclear cell count greater than the cut-off values, an ascitic fluid erythrocyte count > or = 10,000 cells/mm3, a ratio of ascitic fluid erythrocyte to total leukocyte count > or = 100, and the ratio of ascitic fluid polymorphonuclear cell to total leukocyte count < or = 75% indicated hepatocellular carcinoma, while serum to ascites albumin gradient < or = 1.1 g/dl and a ratio of ascitic fluid polymorphonuclear cell to total leukocyte count < or = 75% indicated peritoneal carcinomatosis or massive liver metastasis.

Ascites↗