Biomedical subjects
Publications and source records attributed to H C Liu.
An 81-year-old man with cervical spondylotic myelopathy developed an acute frontal lobe like syndrome with prominent preservation and an abnormal electroencephalogram after being given seven doses (70 mg) of baclofen for spasticity. The clinical symptoms cleared up in 72 hours after the medication was discontinued.
Taiwan is geographically, culturally, and socially close to southern Japan, which is an endemic area of human T-lymphotropic virus type 1-associated myelopathy (HAM). Taiwan, however, is not an endemic area of HAM. We report the first case of HAM in a native Taiwanese, a 61-year-old woman, without known HTLV-1 risk factors.
We prospectively investigated 131 consecutive cases (both in- and outpatients) of suspected dementia to evaluate the relative frequency of different types of dementia in Chinese patients. Dementia was confirmed in 110 cases (84.0%). In contrast to the Western series, vascular dementia (39.1%) was slightly more frequent than the Alzheimer's disease (36.4%). Twelve cases (10.9%) of potentially treatable dementia were found. Careful clinical observation was the most useful part of the evaluation. CT scan of brain was the most useful laboratory test.
We report a case of bilateral cerebral ischemia with frequent painful tonic spasms involving face, both upper and sometimes both lower extremities. The spasms subsided after treatment with diazepam.
We have established HPLC assay conditions that could measure the levels of 14 monoamines and their metabolites simultaneously. Monoamine levels in cerebrospinal fluids of 12 Chinese patients with Alzheimer's disease were compared with those in samples from patients with benign prostate hyperplasia. Of the 14 monoamines and metabolites, only three were found to be present in all samples. Although the levels of 5-hydroxy-3-indoleacetic acid (HIAA) and homovanillic acid (HVA) in cerebrospinal fluid of patients with Alzheimer's disease were lower, and the levels of 3-methoxy-4-hydroxyphenylglycol (MHPG) higher, as compared to control patients, no significant differences were found between these two groups.
A standardized questionnaire was sent to family members or care-givers of 105 patients with dementia; 68 were returned. Eighty-eight percent of the patients were cared for at home by their spouses or adult children. The adverse impacts of dementia on patient family's economy, relations among family members, and social life are recognized. The majority of the subjects had only limited understanding of dementia. Having medical insurance helps the family in caring for the demented patients, emotionally and socially, but not financially. A better social welfare system, as well as health insurance, is recommended.
Prorenin (PR) is present in high concentrations in the follicular fluid (FF) of the preovulatory follicle. It is the predominant form of renin detected in FF. Its biosynthesis and secretion from the ovary are regulated by gonadotropins. In the present study we measured PR and steroid levels in FF from 136 follicles. Follicular fluids were obtained, 36 h after hCG injection, from 41 ovarian-stimulated patients who underwent follicle puncture and oocyte retrieval for in vitro fertilization. We related FF PR to steroid levels and to the stage of oocyte-cumulus complex maturation. PR levels in 62 FF containing mature healthy fertilized oocytes averaged 2620 +/- 157 (+/- SE) ng/mL.h (728 +/- 44 ng/L.s; range, 1020-6880 ng/mL.h, 283-1911 ng/L.s). A subgroup of 16 of these follicles containing mature oocytes were from 7 women who conceived, in which PR levels spanned only the lower range from 1030-2720 ng/mL.h (286-756 ng/L.s). No patient conceived with FF PR above 2800 ng/mL.h (778 ng/L.s), yet one third of all mature follicles were above this range. Lower levels of PR were detected in FF containing immature oocytes (germinal vesicle stage) associated with either compact (1665 +/- 480 ng/mL.h; 463 +/- 133 ng/L.s; n = 22; P less than 0.02) or expanded (1785 +/- 193 ng/mL.h; 496 +/- 54 ng/L.s; n = 24; P less than 0.005) cumulus mass; a subgroup (n = 5) of follicles with immature oocytes and compact cumulus had very high levels of FF PR, ranging from 3830-7520 ng/mL.h (1064-2089 ng/L.s), while the remainder had levels less than 1300 ng/mL.h (361 ng/L.s). Progesterone and estradiol (E2) were lower in FF surrounding immature oocytes associated with compact (P less than 0.005) or expanded (P less than 0.02) cumulus, than in those containing mature oocytes. Testosterone (T) and androstenedione were measured in only a fraction of the samples; there were no apparent differences between follicles containing mature and immature oocytes. However, T and androstenedione levels were high in the subgroup of follicles containing immature oocytes and very high levels of PR. Of the hormones measured, T revealed the most striking relationship with PR (r = 0.62; n = 49; P less than 0.001).(ABSTRACT TRUNCATED AT 400 WORDS)
This is an autopsy report of a female neonate with acrocallosal syndrome, which shows developmental retardation, callosal dysgenesis and preaxial hemimelia of the upper limbs. Either dysgenesis or corpus callosum or congenital absence of radius is rare; their combination are even rarer and only eleven cases of acrocallosal syndrome have been reported in the English literature. Our case appears to be the first report in Taiwan. The family history and pregnant course were unremarkable except that her mother had taken Chinese herb medicine for common cold in the 4th pregnant month. Prenatal obstetric sonography showed "ventriculomegaly" at the 31st week. We reviewed the literature and discussed the incidence, embryology, pathogenesis, symptoms as well as etiology concerning this rare syndrome.
Three osseous tumors multicentrically arising in the radius, ulna, and metacarpal bones of a 10-year-old girl and another in the femur of a 75-year-old man are reported. These lesions were designated as aggressive fibrous histiocytoma because of the benign cytological appearance with aggressive roentgenographic findings. These tumors were composed mainly of spindle cells tightly packed in a storiform pattern. Clear histiocytes and multinuclear giant tumor cells were occasionally seen. Variable amounts of collagen fiber were found. Both patients have been followed for 32 and 21 months respectively without evidence of local recurrence or distant metastasis.
Rage reaction was induced in mice by sc 4-aminopyridine (4-AP) 6 mg . kg-1. Mice appeared hyperreactive after 8-12 min and then squeaked and fought each other. These manifestations were most distinct in 10-30 min and subsided after 40-60 min. The occurrence of rage reaction on this dose level was around 90%. At higher doses 4-AP caused convulsions and death after evocation of rage reaction. The ED50 of 4-AP for eliciting rage reaction was 4.7 +/- 0.7 mg . kg-1 sc. No significant difference in induction of rage reaction was seen between male and female mice of different body weights. Both neuroleptic drugs (chlorpromazine, haloperidol, tarden and clozapine) and anxiolytic drugs (diazepam, chlordiazepoxide, and meprobamate) inhibited 4-AP-induced rage reaction in mice. Barbiturates, Chloral hydrate, methaqualone, morphine hydrochloride, aspirin, phenytoin sodium, diphenhydramine hydrochloride, atropine sulfate, and procaine hydrochloride did not affect rage reaction. The 4-AP-induced aggressive behavior, similar to that induced by electric footshock or isolation, has the merits of convenience to deal with and time saving. Hence we recommended it as a screening method for drugs with neuroleptic and anxiolytic activities.
Twenty-one consecutive cases of gastrointestinal spindle cell stromal tumors (SCSTs) were studied histologically and immunohistochemically. They consisted of 18 smooth muscle tumors, 2 neurilemmomas (schwannomas), and 1 unclassified malignant tumor designated as stromal sarcoma. Slender, spindle and wavy nuclei with palisading associated with peripheral tumor aggregation of lymphocytes are the pathological hallmarks of neurilemmoma. With peroxidase-antiperoxidase method, antibodies to Glial Fibrillary Acidic Protein (GFAP), Leu-7, S-100, desmin and HHF35 were applied. Antibodies to Leu-7 and GFAP could only be demonstrated in neurilemmomas (2 cases). Antibody to S-100 was observed strongly in 2 neurilemmomas and 1 stromal sarcoma, and focally in a leiomyoma, while the other SCSTs were negative. One neurilemmoma disclosed focal positivity of desmin. Six of 10 leiomyomas revealed varied degrees of positive staining of desmin and HHF35. One epithelioid leiomyoma, two leiomyosarcomas and five smooth muscle tumors of undetermined malignant potential (STUMP) disclosed no immunoreactivity. The study suggests that panel of immunostaining should be applied. Coexpression of GFAP, Leu-7 and S-100 as well as negative staining of HHF35 is characteristic of neurilemmoma. On the contrary, coexpression of desmin and HHF35 while negative for GFAP, S-100 and Leu-7 are suggestive of smooth muscle tumor. In poorly differentiated SCST, histological features and immunostains are always disappointing. Diagnosis of those tumors as stromal tumor is more appropriate or electron microscopic observation should be included for accurate classification.
The histologic procedure technique was used to evaluate the bone fracture healing rate of manually fractured fibulae after they were submitted to several different types of capacitively-coupled electric field stimulation, classified depending on the parameters of peak-to-peak voltage, frequency and duration. Using a completely randomized design, 30 New Zealand male rabbits were divided into six different groups: a control group, a 60 kHz and 220 mVp-p sine wave group as proposed by Brighton in 1985, and four special parameters of pulse wave groups. After comparing these different types of electrical stimulation, the group with the parameters of a pulse train repetition frequency of 15 Hz, a pulse frequency of 10 kHz and 5 V peak-to-peak intensity experienced the same enhancement of bone fracture healing as the group with the parameters suggested by Brighton in 1985.
Malignant haemangiopericytoma was grown in vitro to assess the histogenesis of the tumour. Disaggregated tumour cells maintained in serum-supplemented Waymouth's MB 752/1 medium showed monolayers of homogeneous spindle cells. Post-confluent cultures exhibited hillocks or plaques of multilayer growth within which considerable amount of basal lamina-like material and fibrillar matrix were present between cells. Delicate basal laminae were also expressed on cell surfaces facing matrix material. Other consistent features were attenuated cytoplasmic processes, desmosome-like junctions, abnormal mitochondria and a paucity of intracellular filaments. The three-dimensional organization of tumour cells with concomitant expression of differentiated phenotype in vitro has significant implications on the cell of origin and differentiation process of haemangiopericytoma.
A cerebral primitive neuroectodermal tumor with astrocytic differentiation and extracranial metastases in a 28-day-old infant is reported. The infant presented with a progressively enlarged head, cutaneous lesions in the neck, and enlarged cervical lymph nodes. A computed tomography brain scan demonstrated a giant thalamic tumor with subarachnoid dissemination and hydrocephalus. Biopsy material from the cervical lesions showed a picture of glioma with anaplastic astrocytes. The patient received a ventriculoperitoneal shunt operation and palliative chemotherapy, but died at 3 months of age. Autopsy was performed. Histological studies, which included immunohistochemical stains of the thalamic tumor, showed small, round, primitive, neoplastic cells with focal astrocytic differentiation.
The invasive properties of human renal cell carcinoma were tested on a gel-like reconstituted basement membrane matrix extracted from Engelbreth-Holm-Swarm transplantable mouse tumor (Matrigel). Both high-grade (Fuhrmans's nuclear grade III) and low-grade (Fuhrman's nuclear grade I) renal carcinoma cells as well as normal human renal tubular cells were seeded onto a thin-layered, full-strength gel (1-2 mm). The normal tubular cells migrated to form small irregular colonies interconnected by polygonal networks of cell cords and grew along the surface contour of the gel. No evidence of distortion, dissolution, or invasion of underlying gel was observed but a thin layer of electron dense lamina was found to form underneath the cells. The noninvasive morphology was observed to have lasted for more than 3 weeks. On the contrary, both low-grade and high-grade carcinoma cells formed individual colonies and invaded the underlying matrix by developing invasion buds and subsequently cords or tubule-like structures of variable length. No basement-membrane-like electron dense deposit was observed at the cell-matrix interface. The observation that the mean invasion depth was higher in high nuclear grade carcinoma has significant implications on the association between invasiveness and nuclear grade. The findings that cancer cells closely contacted the surrounding matrix and reorganized the matrix in the immediate vicinity provided additional evidence of cell-matrix interaction.
Ninety-three supracondylar fractures of the femur treated with 95 degrees angulated condylar plates were retrospectively evaluated. Seventy-one patients were males and 22 were females; ages ranged from 15 to 80 years (mean, 46.9 years). Seventy-two patients were involved in traffic accidents; 44 of them were victims of motorcycle accidents. Twenty patients sustained open fractures. Fifty patients had associated injuries, 41 of them had multiple fractures. There were 13 patients referred for management of complications. The followup periods ranged from 1 to 10 years (4.6 years). Seventy-nine patients had excellent/good results. Eighty-one patients achieved sound union. Stiffness of knee, nonunion, delayed union, and infection were the major complications. Careful selection of the patients, adherence to the principles of anatomic reduction and rigid fixation, and early mobilization are essential for satisfactory outcomes.
Sixty children who had recovered from purulent meningitis one to six years earlier were investigated for long-term impairment of brain and auditory function, using brainstem auditory evoked potentials(BAEP) and developmental screening tests. Neurological and/or audiological BAEP abnormalities were found in 23 per cent of the children: 15 per cent had mild brainstem impairment and 12 per cent had hearing dysfunction. Developmental screening tests were administered to 46 children, of whom 61 per cent had normal, 22 per cent questionable and 17 per cent abnormal results. The results of the BAEP significantly correlated with those of the developmental screening tests, suggesting that the neuropsychological development of children with BAEP abnormalities was significantly delayed compared with that of children without BAEP abnormalities. The characteristic finding in a neurologically abnormal BAEP was slightly depressed amplitude of wave V, and the authors suggest that this is the most sensitive BAEP measure for the assessment of brainstem function in children recovered from meningitis.
Two shrimp trypsins have been purified from the midguts of Penaeid shrimps by various chromatographies and HPLC. The molecular masses of them are 27 and 29 kDa, respectively. They show the typical specificity of trypsin for substrates and inhibitors, and their N-terminal amino-acid sequences are homologous to those of other trypsins. The shrimp enzymes are very acidic (pI less than or equal to 2.4), and show distinctively low Km for the synthetic amide substrates. They also hydrolyse various native proteins more efficiently than bovine trypsin in vitro. However, the anionic shrimp trypsins do not have special preference for basic protein substrates over the acidic one. Collagenolytic activity of the midgut extract was mainly due to serine proteases. The collagenolytic activity of the purified shrimp trypsin was confirmed by assays with either soluble or insoluble native type I collagens. In comparison with the other trypsins from the Crustacean decapods, the shrimp enzymes have four pairs of disulfide bonds, intermediary between the crayfish trypsin (three pairs) and the crab trypsin (five pairs), and are immunochemically different from them.