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Biomedical subjects

H C Wang

Publications and source records attributed to H C Wang.

At least 91 records · Page 5Linked to original sources

Newly identified stress-responsive protein kinases, Krs-1 and Krs-2.

The activation of protein kinases is a frequent response of cells to treatment with growth factors, chemicals, heat shock, or apoptosis-inducing agents. However, when several agents result in the activation of the same enzymes, it is unclear how specific biological responses are generated. We describe here two protein kinases that are activated by a subset of stress conditions or apoptotic agents but are not activated by commonly used mitogenic stimuli. Purification and cloning demonstrate that these protein kinases are members of a subfamily of kinases related to Ste20p, a serine/threonine kinase that functions early in a pheromone responsive signal transduction cascade in yeast. The specificity of Krs-1 and Krs-2 activation and their similarity to Ste20p suggest that they may function at an early step in phosphorylation events that are specific responses to some forms of chemical stress or extreme heat shock.

3T3 Cells↗

A door-to-door survey of Parkinson's disease in a Chinese population in Kinmen.

BACKGROUND: Most published studies have shown lower prevalence rates of Parkinson's disease (PD) in Asian and black African than in Western countries, leading to the hypothesis that Asians and blacks might be protected from PD. OBJECTIVE: To investigate the prevalence of PD in a Chinese population. DESIGN: Community-based survey. SETTING: Registered residents 50 years of age or older (N = 5061) on the islet of Kinmen located off the southeastern coast of China [corrected]. METHOD: Single-phase door-to-door survey by neurologists. All participants were administered a questionnaire and received motor examinations of the Unified Parkinson's Disease Rating Scale. RESULTS: The participation rate was 96% (N = 3915) among 4158 contacted individuals. Twenty-three cases of PD were identified, including three cases with dementia. The crude prevalence rate of PD was 587 (95% confidence interval (CI), 373 to 884) per 100,000 persons 50 years of age or older. Assuming no case of PD among individuals under 50 years of age, the prevalence rate was 119 (95% CI, 80 to 169) per 100,000 for the total population. CONCLUSIONS: The prevalence rates of PD in Kinmen were much higher than those reported from mainland China, but slightly lower than those reported from more developed countries. The present findings suggest that, instead of genetic factors, differences in case-ascertainment, life expectancy, and the length of survival with PD may be more important contributors to the variations in observed PD prevalence rates.

Aged↗

Induction of down-regulation of the kinase activities of Mek, p42Erk, p90RSK, and p63SAMK in chicken embryo fibroblast at the late stage of src-induced cellular transformation.

Two distinct stages in regulation of protein kinases are detectable upon cellular transformation of CEF induced by pp60v-src. Upon cellular transformation induced by ts v-src mutants, the kinase activities of Mek and p42Erk are rapidly induced at the early stage and significantly decreased at the late stage of cellular transformation. In contrast, a novel p63SAMK is partially activated at the early stage and is fully activated at the late stage of cellular transformation. However, p90RSK is activated through the entire course of cellular transformation. In this study, I detect a transient down-regulation of p90RSK activity that is inducible in cultures at the late stage of the src-induced cellular transformation by an increase of extracellular pH value from 7 to 8 and unidentified components in DMEM, but not in cultures which are at the early stage. Concomitant with down-regulation of p90RSK activity, the kinase activities of Mek, p42Erk, and p63SAMK are also down-regulated. Blockage of down-regulation of p90RSK activity by pretreatment of cells with different phosphatase inhibitors correlates with blockage of the down-regulation of either p42Erk or p63SAMK activity. Multiple pathways appear to involve in regulation of p90RSK activity. The discrepancy in regulation of protein kinase activity between the early and late stages of cellular transformation induced by pp60src may indicate a change in signaling cascades during the progress of cellular transformation. The induction of the down-regulation event in this study may provide a new approach to investigate the regulation not only of protein kinases but also phosphatases in transformed cells.

Actin Cytoskeleton↗

Diagnostic value of transbronchial lung biopsy under fluoroscopic guidance in solitary pulmonary nodule in an endemic area of tuberculosis.

In the endemic area of tuberculosis, there are many cases that present tuberculosis as a solitary pulmonary nodule (SPN) on chest radiographs. The objective of this study is to evaluate the diagnostic yield of transbronchial lung biopsy (TBLB) under fluoroscopic guidance in SPNs such as lung cancer or pulmonary tuberculoma in areas with high prevalence of tuberculosis. One hundred and seventy patients with SPNs on chest radiographs were included in the study; all had negative sputum smears for tubercle bacilli and no malignancy by sputum cytology before bronchoscopy. Transbronchial lung biopsy and brushing were performed, routinely, under fluoroscopic guidance. Of 170 patients, 120 (70.6%) had lung cancer (including three with metastatic cancer), 40 (23.5%) patients had pulmonary tuberculosis (Tb), and the remaining 10 (5.9%) patients had other benign pulmonary lesions. The overall diagnostic rate in SPNs was 62.4% (106 of 170). Transbronchial lung biopsy and brushing revealed a diagnostic sensitivity of 70.0% in lung cancer (84 of 120) and a sensitivity of 55% in Tb (22 of 40). In addition, TBLB and brushing also provided rapid microscopic identification of Tb in 18 of 40 patients (45%, including 15 by TBLB, one by brushing smear, and two by postbronchoscopic sputum). The percentage of positive diagnosis correlated with diameter of the SPN. Solitary pulmonary nodules with diameter less than 2 cm were diagnosed in only 35.3% of cases (6 of 17; cancer 40% vs. Tb 29%). In contrast, the diagnostic rates in SPNs with diameters 2-4 cm and greater than 4 cm were 64.5% (78 of 121; cancer 72.0% vs. Tb 62.5%) and 68.8% of cases (22 of 32), respectively. Diagnostic bronchoscopy under fluoroscopic guidance is a useful tool in evaluation of patients with a peripheral pulmonary nodule since it may provide additional information to minimize unnecessary thoracotomy and give way for proper medication as early as possible.

Adult↗

Bronchoscopic and angiographic findings in tracheobronchial endometriosis.

The case is described of a 31 year old woman who presented with complaints of recurrent haemoptysis coinciding with menstruation. Bronchoscopic examination revealed multiple purplish-red submucosal lesions on the right side of the trachea and bilateral bronchial trees which appeared during her menses and regressed in the intermenstrual periods. Brush cytology revealed cell clusters consistent with endometrial origin. Bronchial angiography demonstrated prominent vasculature at the right paratracheal area and bilateral bronchial trees corresponding to the lesions seen on bronchoscopic examination. Her haemoptysis was satisfactorily controlled by danazol therapy and follow up bronchoscopy showed disappearance of the tracheobronchial lesions. To our knowledge this is the first case of thoracic endometriosis with tracheal involvement.

Adult↗

Digital ischemia associated with lung cancer: a case report.

Digital ischemia or necrosis has unusually been associated with neoplasm. The occurrence of cryoglobulinemia and lung cancer with digital ischemia has been extremely rare in the past. This report concerns a case with adenocarcinoma of the lung associated with cryoglobulinemia, with rapidly developing digital ischemia of the tips of fingers and toes. Following concurrent chemoradiotherapy, there was improvement in digital ischemia and disappearance of serum cryoglobulin. The mechanisms of neoplasm-associated digital ischemia are complex; however, the cryoglobulinemia and probable arteritis may have played important roles in producing the ischemic symptoms in this case.

Adenocarcinoma↗

[The influential factors of formation and development of personality in children with congenital heart disease].

106 children with congenital heart disease (CHD) were tested by the Eysenck personality Questionaire (EPQ) and the Psychological Monitor Card in this study. The result showed that the personality of the CHD children is more introversive and moody than that of normal children. The influential factors including disease, family, and society were analysed. It suggested that it is important to provide psychological support to the CHD children and psychological knowledge to the parents.

Child↗

The surgical treatment and prognostic factors of well-differentiated thyroid cancers in Chinese patients: a 20-year experience.

BACKGROUND: Well-differentiated thyroid cancers (WDTC) are usually slow-growing neoplasm with an indolent clinical course. Assessment of treatment modalities for them requires a long-term follow-up in a large population, and is still of much debate. A systematic analysis of the history, prognosis and therapy for this disease in Taiwan is lacking. METHODS: A retrospective analysis of clinical and pathological records was conducted on 488 patients (149 male and 339 female, male: females = 1:2.28) treated for WDTC in the Veterans General Hospital-Taipei from 1971 to 1991 with subsequently follow-up until December 1994 (Mean follow-up: 8.5 years). Factors influencing recurrence, survival and different treatment were analyzed. RESULTS: Papillary thyroid cancer increased obviously as compared to our experience from 1959-1976. Changing tumor behaviors, including increasing female/male ratio, higher percentage of papillary cancer, decreasing primary tumor size and lower distant metastatic rate at the time of initial diagnosis, were noted. Factors influencing survival, as determined by univariate analysis, included age, gender, distant metastasis, extrathyroidal invasion, tumor size, nodal involvement, histological type, extent of surgical therapy and use of postoperative radioactive iodine. Those patients aged more than 45 at initial diagnosis, with primary tumors larger than 4 cm, with extrathyroidal invasion, and with distant metastasis at initial diagnosis were classified as being at high risk. The others were at low risk. Total or near total thyroidectomy (TTx), depending on the judgement of each surgeon, had much higher complication rate than lobectomy with/without isthmusectomy, but offered no benefit effect on disease-free survival or overall survival rates. Postoperative radioactive iodine ablation treatment and thyroxine replacement in suppressive dose after TTX improved survival among high risk patients. Lobectomy with/without isthmusectomy in low risk patients, followed by thyroxine suppression therapy, was adequate to improve the postoperative outcome and with low complication rate. Lymph node resection in patients with clinically palpable nodes improved longterm prognosis. CONCLUSIONS: Changing tumor behavior of WDTC leading to favorable prognosis has been noticed since 1971. Total or near total thyroidectomy is worthwhile in high risk patients with WDTC but does not appear necessary in low-risk patients. Lymph node dissection for metastatic lymph node could improve the survival rate.

Adult↗

Transthoracic needle biopsy of thoracic tumours by a colour Doppler ultrasound puncture guiding device.

BACKGROUND: Ultrasound guided transthoracic needle aspiration biopsy has recently been used to obtain specimens for histological diagnosis of pulmonary and mediastinal tumours. Conventional real time, grey scale puncture guiding devices cannot differentiate vascular structures, and clear visualisation of the needle shaft or tip within a desired target is not always possible. This study describes a new built-in colour Doppler ultrasound puncture guiding device and assesses the relative safety of transthoracic needle aspiration biopsy of thoracic tumours by grey scale or colour Doppler ultrasound guidance. METHODS: Thirty patients with radiographic evidence of pulmonary (22 patients) or mediastinal tumours (eight patients) underwent ultrasonographic evaluation and transthoracic needle aspiration biopsy by using the colour Doppler ultrasound puncture guiding device (Aloka UST 5045P-3.5). These tumours were initially examined by grey scale ultrasound, and colour Doppler imaging was then used to evaluate the number of blood vessels surrounding and within the target tumour and the possibility of visualisation of the needle shaft or needle tip during the aspiration biopsy procedure. RESULTS: The colour Doppler ultrasound guiding device was far superior to the grey scale device for identification of the number of vessels surrounding or within the target tumour (83% v 20%) and for visualisation of the needle shaft or needle tip (80% v 17%). CONCLUSIONS: By using the colour Doppler ultrasound puncture device, vascular structures surrounding or within the target tumour can be verified. Visualisation of the needle shaft or tip is also better. Biopsy routes can be selected to avoid puncturing vessels. This approach should be particularly helpful for guiding biopsies of mediastinal tumours, where puncturing the heart or great vessels is a potential complication.

Adult↗

A pseudoepidemic of Mycobacterium chelonae infection caused by contamination of a fibreoptic bronchoscope suction channel.

An unusual increase in the frequency of isolation of Mycobacterium chelonae subspecies chelonae from specimens of bronchial washings was found between September and December 1992 in National Taiwan University Hospital. During this period, a total of 123 patients underwent fibreoptic bronchoscopy with an Olympus P20. Seventy six patients had bronchial washing for bacteriological study and cytological examination. Acid-fast bacilli were found in 21 patients, in 18 of whom Mycobacterium chelonae were isolated from bronchial washing cultures. Eight patients were treated as mycobacterial infected, because of the presence of unexplained pulmonary lesion, positive acid-fast stain and culture for Mycobacterium chelonae. Diagnosis of lung cancer was delayed in one patient because of the initial negative cytological study and positive bacterial culture. The fibreoptic bronchoscope was disinfected by automated washing machine (EW-20, Olympus) using 2.3% glutaraldehyde according to a standard protocol. From a survey to search for possible sources of contamination, they were identified at the suction channel of four different bronchoscopes. This episode proved to be a pseudoepidemic. The contamination was controlled by extensive suction and rinsing of the channel with 70% alcohol immediately after disinfection by the automated bronchoscope disinfection machine. This study shows that, despite using the disinfection machine, the suction channel could still be contaminated with Mycobacterium chelonae. This may cause diagnostic confusion and unnecessary antimycobacterial treatment.

Aged↗

[Drug release kinetics of ibuprofen coated granules and their in vitro-in vivo correlation].

A sustained release of ibuprofen granules coated with ethyl cellulose has been studied both in vitro and in vivo with a selected formulation. The drug release process follows Higuchi equation when coating extent is low, and zero-order kinetics when coating extent is high. The primary factors that influence drug release include granule size, coating extent, pH of dissolution medium and pressure. The release rate decreases when either granule size or coating extent increases or pH value decreases. The release rate increases greatly when the coated granules are compressed directly into tablets in that the coating film is destroyed. The results from oral administration of coated granules by seven healthy volunteers show that the in vitro and in vivo correlation of drug release from coated granules is highly significant.

Adult↗

Elevated serum CK-MB and CK-BB isoenzymes in a patient with small cell lung cancer: a case report.

An increase in serum creatine kinase-MB (CK-MB) isoenzyme is regarded as a specific indication of acute myocardial infarction. Recently, increased concentrations of various types of creatine kinase isoenzymes (mostly CK-BB and macro CK type 2 isoenzymes) have been found in the blood of some patients with malignancies. However, highly elevated serum CK-MB isoenzyme associated with malignancy has rarely been reported previously. Herein a case of extensive small cell lung cancer is presented in which the elevated serum levels of CK were detected throughout the three weeks of hospitalization. Fractionation of its isoenzymes by gel electrophoresis displayed elevated CK-MB and CK-BB isoenzymes. The proportion of serum CK-MB and CK-BB isoenzyme activities was persistently above normal (CK-MB 50-53%, normal < 5%). Clinical examination showed no evidence of myocardial infarction or injury, or tumor involvement of the heart. The tumor was the probable source of most circulating CK-MB isoenzyme. In clinical practice, markedly elevated levels of CK-MB, or increased levels of CK-MB in combination with CK-BB may point away from a myocardial origin and toward the existence of a malignancy.

Aged↗

Pseudomyxoma peritonei: does a true mucolytic agent exist? In vitro and in vivo studies.

Reproducibility of the so-called "mucolytic effect" of the 2%-10% dextrose-water solution is questioned. To test the mucolytic effect of 5% and 10% dextrose-water solutions and to determine what could be a true mucolytic agent, in vitro and in vivo studies were undertaken in two proven pseudomyxoma peritonei cases. In vitro study: Immediately after the mucin jelly was taken out of the peritoneal cavity, the jelly was immersed in various 40 cc solutions including: 1) 5% dextrose-water; 2) 10% dextrose-water; 3) normal saline; 4) lactated Ringer; 5) distilled water. The mucolytic effects of these solutions were observed once every hour after vigorous mixing. In vivo study: After completion of the operation, the peritoneal cavity was repeatedly irrigated with massive warm 5% dextrose-water and normal saline solutions in an attempt to dissolve the residual mucin cake and jelly. Neither 5% and 10% dextrose-water solution nor control solutions of normal saline, lactated Ringer, and distilled water could dissolve the mucin jelly in test tubes at 0, 1, 2, and 3 hours. The "claimed" mucolytic agent, 5% dextrose-water solution could not facilitate the removal of both mucin jelly and cake in the peritoneal cavity. The 5% dextrose-water solution was not superior to the normal saline solution in terms of mucolytic effect. In the present study, a true mucolytic agent does not exist. Currently, multiple laparotomy for aggressive cytoreduction remains the treatment of choice for pseudomyxoma peritonei.

Aged↗

Is pancreatoduodenectomy justified for periampullary cancers with regional lymph node involvement?

Justification of pancreatoduodenectomy for highly malignant periampullary cancers with regional lymph node involvement is questioned. Attempting to clarify the therapeutic dilemma, we compared the prognoses of resectable periampullary cancers with and without lymph node involvement, as well as unresectable cancers with lymph node involvement. The medical records of surgical patients with periampullary adenocarcinoma were reviewed. We compared the survival times of resectable cancers with (resectable TanyN1M0) and without (resectable TanyN0M0) regional lymph node involvement, and the survival times of resectable cancers with lymph node involvement (resectable TanyN1M0) and unresectable cancers with lymph node involvement (unresectable TanyN1M0). There were 138 resectable and 115 unresectable periampullary cancers including 117 cancers of the pancreatic head, 117 cancers of ampulla of Vater, 7 cancers of duodenum, and 12 cancers of distal common bile duct. The prognosis was very poor in cancer of the pancreatic head. Neither resectability nor status of lymph node involvement could influence the survival time of the cancer of pancreatic head. In resectable non-pancreatic periampullary cancers, the prognosis was significantly better in the group without lymph node involvement. However, once the lymph node was involved, the outcomes were the same in the resectable and unresectable groups. Although pancreatoduodenectomy does not seem to be justified for periampullary cancers with regional lymph node involvement, this procedure should be considered for periampullary cancers without nodal involvement.

Adenocarcinoma↗

The effect of acupuncture on spinal motor neuron excitability in stroke patients.

BACKGROUND: Spasticity is a common symptom in stroke patients, and its management constitutes a major problem in their rehabilitation. Acupuncture has been applied with moderate effect; their has been clinical experience but little objective evidence to support its use. H-reflex recovery time and H recovery curve were quantitative methods applied to measure spinal motor neuron excitability. Acupuncture for stroke patients as treatment to spastic hemiparesis was studied to see the acupuncture effect on increased spinal motor neuron excitability in spasticity. METHODS: Sixteen stroke patients with spastic hemiparesis were collected to evaluate the therapeutic effect of acupuncture on their spinal motor neuron excitability. H-reflex recovery time and H recovery curve were applied as quantitative evaluations of spinal motor neuron excitability. Eleven age-matched normal volunteers were used as a control group. RESULTS: The mean H-reflex recovery time of normal controls was 73.3 +/- 18.3 mesc; that of the sound-side limbs of stroke patients was 67.1 +/- 21.5msec. The difference was not significant statistically (p = 0.2). However, the mean H-reflex recovery time of the paretic limbs of stroke patients was 52.3 +/- 16.8 msec, significantly shorter than for the normal controls (p = 0.003). The mean H-reflex recovery time of the paretic limbs of stroke patients became 57.6 +/- 19.9 msec after acupuncture, significantly prolonged as compared with that before acupuncture (p = 0.03). The H recovery curve of the paretic limbs after acupuncture also approximated that of the normal controls. CONCLUSIONS: This result provides positive evidence of increased spinal motor neuron excitability in paretic limbs of stroke patients and also of the acupuncture effect which decreased that excitability. The study also presents a simple and practical technique for measuring the effects of various types of treatments, including acupuncture, on other types of central nervous system disorders.

Acupuncture Therapy↗

Isolation and identification of influenza viruses from clinical materials in 1977-1993 at Veterans General Hospital-Taipei.

From 1977 to 1993, 15,189 throat swab samples were received for isolation and identification of influenza virus in the Clinical Virology Laboratory, Veterans General Hospital-Taipei. Most of the samples came from the Pediatric Department. There were 634 identified strains of the influenza virus; the successful isolation rate was 4.17% in average/year. Among these isolates, 56.3% (357/634) were influenza B; 12.1% (77/634) were influenza A/H1N1 and 28.1% (178/634) were influenza A/H3N2. About 3.5% (22/634) were classified as flu-like agents because of no reaction with available monoclonal antibodies. In recent years, reverse transcriptase polymerase chain reaction (RT-PCR) was established here to re-evaluate these virus stocks. This method can provide rapid diagnosis method to identify influenza A/H1N1, A/H3N2 and B. Further, the RT-PCR method and sequencing of amplified DNA could be used to see the variation of virus isolates which were recirculated or which reappeared in the Taipei area.

Amino Acid Sequence↗