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Biomedical subjects

H L Lee

Publications and source records attributed to H L Lee.

At least 55 records · Page 3Linked to original sources

The use of genotyping to predict the phenotypes of human platelet antigens 1 through 5 and of neutrophil antigens in Taiwan.

BACKGROUND: The human platelet antigen (HPA) 1 through 5 and the human neutrophil antigen (HNA-1) systems are relevant to immune-related thrombocytopenia and neutropenia. The alloantigen distribution profiles in the population will aid in estimating the risk of alloimmunization. STUDY DESIGN AND METHODS: Genotyping of the genes that control the expression of the HPA-1 through -5 and HNA-1 systems in Taiwanese (n = 326) and Taiwan's indigenous peoples (n = 608) was performed by PCR with the sequence-specific primer (PCR-SSP) method. RESULTS: In the HPA system, HPA-1b and HPA-4b were absent among Taiwan's indigenous tribes and detected among other Taiwanese only with frequencies of <0.2 percent and <0.5 percent, respectively. The GP1BA*2 (HPA-2b) and GP1A*2 (HPA-5b) allele frequencies range from 1 percent to 7 percent and 0.4 percent to 3.5 percent among the two ethnic groups, respectively. GP2B*1 (HPA-3a) and GP2B*2 (HPA-3b) showed similar allele frequencies. In the HNA-1 system, the FCGR3B*1 (HNA-1a) allele frequency was about twice that of FCGR3B*2 (HNA-1b) in Taiwanese and also in most of the indigenous tribes. Three FCGR3B (HNA-1) null persons were found in one indigenous tribe (Ami tribe), for an FCGR3B null frequency of 19.8 percent. However, no FCGR3B*3 (HNA-1c) allele was detected in Taiwan. CONCLUSION: The frequencies of HPA-1b, -2b, and -5b in the Taiwanese population were much lower than those among whites. In Taiwan, all of the HNA-1 null found was due to the deletion of the FCGR3B gene, and this deletion may be widely distributed in the Ami tribe.

Antigens, Human Platelet↗

Factors related to quality of life in breast cancer patients receiving chemotherapy.

This descriptive correlation study investigated the relationship among individual characteristics, disease characteristics, psychological factors (anxiety, depression, self-esteem), social support, and quality of life in patients with breast cancer receiving chemotherapy. One hundred and fifty women from nine Taipei area hospitals were surveyed with a structured questionnaire. The total quality of life index for breast cancer patients was about average (M = 19.88). The family factor scored highest for importance and satisfaction with quality of life. Patients showed the most dissatisfaction with the health factor. Of the individual characteristics affecting patient quality of life, number of children and social status were statistically significant (p < .05). Of the disease characteristics, the stage of the disease, the commencement of chemotherapy, and the number of chemotherapy treatments were statistically significant (p < .05). The psychological factors were significantly related to patients' quality of life (p < .05). Social support of both relatives and health professionals was significantly related to patients' quality of life (p < .01). Of the four independent variables (individual characteristics, disease characteristics, psychological factors and social support), the most influential factor affecting breast cancer patients' total quality of life was the psychological factor of self-esteem (p < .001). The findings can assist nurses to plan and improve the quality of breast cancer care in terms of understanding the factors affecting patients' quality of life.

Adult↗

Histone H1 phosphorylation by Cdk2 selectively modulates mouse mammary tumor virus transcription through chromatin remodeling.

Transcriptional activation of the mouse mammary tumor virus (MMTV) promoter by ligand-bound glucocorticoid receptor (GR) is transient. Previously, we demonstrated that prolonged hormone exposure results in displacement of the transcription factor nuclear factor 1 (NF1) and the basal transcription complex from the promoter, the dephosphorylation of histone H1, and the establishment of a repressive chromatin structure. We have explored the mechanistic link between histone H1 dephosphorylation and silencing of the MMTV promoter by describing the putative kinase responsible for H1 phosphorylation. Both in vitro kinase assays and in vivo protein expression studies suggest that in hormone-treated cells the ability of cdk2 to phosphorylate histone H1 is decreased and the cdk2 inhibitory p21 protein level is increased. To address the role of cdk2 and histone H1 dephosphorylation in the silencing of the MMTV promoter, we used potent cdk2 inhibitors, Roscovitine and CVT-313, to generate an MMTV promoter which is associated predominantly with the dephosphorylated form of histone H1. Both Roscovitine and CVT-313 block phosphorylation of histone H1 and, under these conditions, the GR is unable to remodel chromatin, recruit transcription factors to the promoter, or stimulate MMTV mRNA accumulation. These results suggest a model where cdk2-directed histone H1 phosphorylation is a necessary condition to permit GR-mediated chromatin remodeling and activation of the MMTV promoter in vivo.

Animals↗

Characteristics of repeated ambulance use in an urban emergency medical service system.

BACKGROUND AND PURPOSE: Although many studies have examined the reasons for repeated use of emergency medical service (EMS), little information is available concerning repeated ambulance use in Taiwan. This study evaluated the characteristics of repeated EMS ambulance use in an urban EMS system in Taiwan. METHODS: Data from a local EMS computerized database for the period from January 1996 through December 1998 were collected for analysis. All calls to the dispatch center that resulted in EMS transports were included. Repeat users were identified by matching the user name, sex, age, and home address. Transports were categorized according to how many times the patient was transported by ambulance during the 3-year period: single use, one time; repeated use, two or three times; or frequent use, more than three times. RESULTS: During the 36-month study period, there were 41,792 calls, with 13,076 non-transports (a non-transport rate of 31.3%). Of the 28,716 transports during the study period, 2,101 represented repeated or frequent use (7.3%); the rate of frequent use was 1.4% (406/28,716). The frequency of repeated use reached a daily first peak at 8:00 AM, with the second and third peaks at 1:00 PM and 7:00 PM. The mean age increased with increasing repeated use of transport (37.25 +/- 0.24 vs 41.55 +/- 1.03 vs 46.23 +/- 1.57 years, respectively; p < 0.001). The percentage of non-trauma missions increased with increasing repeated use of transport (26.3% vs 55.6% vs 73.2%; p < 0.001). Response time significantly increased for repeated use (analysis of variance [ANOVA], p < 0.001). The on-scene interval (time from arrival until departure) in the single-use group was shorter than in the repeated and frequent use groups (ANOVA, p < 0.005). CONCLUSIONS: The results of this study indicate that the characteristics of repeat users of EMS transport differ from those of single users. Characteristics of service time, reason for transport, and interval to each subsequent call varied among different groups of users. Studies of repeat use under a wider range of conditions such as in rural EMS systems and after implementation of a priority-dispatch system are needed to determine the implications of repeated ambulance use.

Ambulances↗

Inadvertent hypothermia causes pulseless electrical activity in a patient during cervical spine surgery--a case report.

Recent studies have shown that hypothermia triples the incidence of major cardiac events. We present a happening in which a 71-year-old patient developed pulseless electrical activity (PEA) while he was undergoing cervical laminectomy for spinal stenosis in the sitting position. Thromboembolism or venous air embolism and acute myocardial infarction were respectively excluded by transesophageal echocardiography and cardiac enzymes analysis to be the causes of the cardiac event. The abnormal finding that stood out was low nasopharyngeal temperature (31 degrees C) during the procedure, which was thought to contribute to the development of the PEA episode.

Aged↗

hMLH1 and hMSH2 mutations in families with familial clustering of gastric cancer and hereditary non-polyposis colorectal cancer.

The pattern of hMLHI and hMSH2 mutations was assessed to identify the genetic correlation between hereditary gastric and colorectal cancers. Four disease groups and their healthy family members were assembled according to the presentation of gastric cancer: FG, familial clustering of gastric cancer (n = 32); CG, family with one or more colorectal and gastric cancers in first-degree relatives (n = 22); HS, seven HNPCC families corresponding to the Amsterdam criteria (AMS+) and 12 suspected HNPCC families which did not satisfy one of the criteria (AMS-), but no gastric cancer among first- and second-degree relatives (n = 19); and SG, sporadic gastric cancer (n = 33). In the CG group, three were included in AMS + and six in AMS- criteria. Peripheral blood was obtained from them to detect hMLHI and hMLH2 mutations using PCR-SSCP analysis and direct sequencing. The incidence of mutations was 9.4% in the FG group, 54.5% in the CG group, 31.6% in the HS group, and none in the SG group. The incidence, type, and number of the mutation were not different between the CG and HS groups. Thirty-four different mutations included 19 in hMLH1 and 15 in hMSH2. Gastric cancer was the most common extracolonic malignancy in HNPCC and suspected HNPCC families (9/28, 32.1%). The hMLH1 or hMSH2 mutation occurred in seven of 10 families with AMS+, whereas it occurred in four of 18 with AMS- (70% vs. 22.2%, P = .013). Five mutations in the hMLH1 and six mutations in the hMSH2 were exclusively found in families with gastric cancer. All three mutations in the FG group were in hMLHI and there was no mutation in their healthy family members. This study demonstrates that some familial clustering type of gastric cancer appears to be associated with hMLHI mutations thereby indicating a difference from the hereditary gastric cancer studies previously reported. In addition, hMLHI and hMSH2 mutations may impact the gastric cancer carcinogenesis in HNPCC or suspected HNPCC.

Adaptor Proteins, Signal Transducing↗

Natural history of low-grade squamous intraepithelial lesion.

OBJECTIVE: To determine guidelines for management of CIN1 by evaluating its natural history. METHODS: One hundred fifty-eight patients were diagnosed with CIN1 had colposcopy follow-up with or without cytology every three months. RESULTS: Colposcopically directed biopsy confirmed progression to CIN2 or CIN3 in 17 of 158 (10.7%) patients, persistence of CIN1 in 87 (55%) patients, regression to normal in 54 (34.2%) patients during the 5-year follow-up period. The percentage of abnormal Pap tests were 39%, 64%, and 71% in the regression, persistent, and progression groups, respectively. The percentage of HPV-positive tests were 16%, 29%, 65% in regression, persistent, and progression groups, respectively. CONCLUSIONS: Of the patients who were diagnosed with CIN1 and monitored by colposcopy for 60 months, 34% had disease regression, 55% had persistent disease, and 11% had progressive disease. HPV DNA testing is more informative than the Pap test in the prediction of disease progression.

Journal Article↗

Nitrogen regulatory protein C-controlled genes of Escherichia coli: scavenging as a defense against nitrogen limitation.

Nitrogen regulatory protein C (NtrC) of enteric bacteria activates transcription of genes/operons whose products minimize the slowing of growth under nitrogen-limiting conditions. To reveal the NtrC regulon of Escherichia coli we compared mRNA levels in a mutant strain that overexpresses NtrC-activated genes [glnL(Up)] to those in a strain with an ntrC (glnG) null allele by using DNA microarrays. Both strains could be grown under conditions of nitrogen excess. Thus, we could avoid differences in gene expression caused by slow growth or nitrogen limitation per se. Rearranging the spot images from microarrays in genome order allowed us to detect all of the operons known to be under NtrC control and facilitated detection of a number of new ones. Many of these operons encode transport systems for nitrogen-containing compounds, including compounds recycled during cell-wall synthesis, and hence scavenging appears to be a primary response to nitrogen limitation. In all, approximately 2% of the E. coli genome appears to be under NtrC control, although transcription of some operons depends on the nitrogen assimilation control protein, which serves as an adapter between NtrC and final sigma(70)-dependent promoters.

Artificial Gene Fusion↗

Population genetics of the hypervariable locus D12S391 in Koreans.

The hypervariable short tandem repeat (STR) locus D12S391 was investigated in a Korean population and 34 fragments were sequenced to confirm the structure of alleles. From these sequenced fragments an allelic ladder containing 13 sequenced alleles was constructed. From 595 unrelated Koreans, 14 alleles were detected and one variant allele 19.3 was observed. The observed heterozygosity was 0.795 and no deviation from Hardy-Weinberg equilibrium was observed in the Korean population (p = 0.606). The allele frequency distribution in the Korean population was not similar to other racial or ethnic groups except for Egyptians, Yemenis, Japanese and Caucasoids from the Rhine area. No mutations were observed in the 702 meioses from 144 Korean families. This study demonstrates that the STR locus D12S391 is a useful tool for forensic identification and parentage testing.

Adolescent↗

A Korean population study of the nine STR loci FGA, VWA, D3S1358, D18S51, D21S11, D8S1179, D7S820, D13S317 and D5S818.

DNA typing was performed on 379 randomly selected unrelated Koreans using the nine short tandem repeat loci FGA, VWA, D3S1358, D18S51, D21S11, D8S1179, D7S820, D13S317 and D5S818 present in the AmpF/STR Profiler Plus PCR amplification kit. Allele frequencies, heterozygosity, power of discrimination, mean exclusion chance, and polymorphism information content of each locus were calculated by statistical analysis. All nine loci were in Hardy-Weinberg equilibrium. The combined discrimination index and the combined mean exclusion chance in Koreans was 2.31 x 10(-12) and 0.99983, respectively. By evaluation of 297 children from 128 families, 2 mutations were found at the FGA locus and 1 each at the D18S51 and D13S317 loci. This study demonstrates that this multiplex system is a useful and convenient tool for forensic identification and parentage testing in Korea.

Adolescent↗

Physiology of infants with very low birth weight.

Advances in neonatal management have resulted in dramatic increases in survival in infants with birth weights less than 1,500 g. Extensive basic science and clinical research has led to a more comprehensive understanding of the physiological differences between the VLBW infant and larger neonates. Meticulous attention must be paid to appropriate fluid, electrolyte, nutrition, and temperature maintenance to achieve homeostasis and growth. Additionally, the clinician must be aware of the diagnostic and treatment modalities for the common complications seen in the premature infant to minimize mortality and long-term morbidity.

Body Temperature Regulation↗

Heterogeneity of Taiwan's indigenous population: possible relation to prehistoric Mongoloid dispersals.

Taiwan's 9 indigenous tribes (Tsou, Bunun, Paiwan, Rukai, Atayal, Saisiat, Ami, Puyuma, Yami) are highly homogeneous within each tribe, but diversified among the different tribes due to long-term isolation, most probably since Taiwan became an island about 12,000 years ago. Homogeneity of each tribe is evidenced by many HLA-A,B,C alleles having the world's highest ever reported frequencies, e.g. A24 (86.3%), A26 (18.8%), Cw10 (36.8%), Cw7 (66%), Cw8 (32.1%), B13 (27.9%), B62 (37.4%), B75 (18%), B39 (53.5%), B60 (33.3%), and B48 (24%). Also, all of these tribes have HLA class I haplotype frequencies greater than 10%, with A24-Cw7-B39 in Saisiat (44.5%) being the highest, suggesting Taiwan's indigenous tribes are probably the most homogeneous ( the "purest") population in the world. A24-Cw8-B48, A24-Cw10-B60 and A24-Cw9-B61 found common to many Taiwan indigenous tribes, have also been observed in Maori, Papua New Guinea Highlanders, Orochons, Mongolians, Inuit, Japanese, Man, Buryat, Yakut, Tlingit, Tibetans and Thais. These findings suggest Taiwan's indigenous groups are more or less genetically related to both northern and southern Asians. Principal component analysis and the phylogenetic tree (using the neighbor-joining method) showed close relationship between the indigenous groups and Oceanians. This relationship supports the hypothesis that Taiwan was probably on the route of prehistoric Mongoloid dispersals that most likely took place along the coastal lowland of the Asian continent (which is under the sea today). Cultural anthropology also suggests a relationship between Taiwan's indigenous tribes and southern Asians and to a lesser extent, northern Asians. However, the indigenous groups show little genetic relationship to current southern and northern Han Chinese.

Alleles↗

Effectiveness of ProFile .04 taper rotary instruments in endodontic retreatment.

This study investigated the retreatment effectiveness of .04 Taper nickel-titanium rotary ProFiles. Thirty extracted single-rooted anterior teeth were instrumented and obturated with gutta-percha/Roth's Sealer using lateral condensation. They were distributed into three groups of 10 each. Retreatment for group A was done using Profile alone, group B using Profile and chloroform, and group C using hand files with chloroform. The teeth were then split longitudinally into halves. The remaining gutta-percha/sealer on the root canal wall in the cervical, middle, apical thirds, and the whole canals were visually scored with the aid of light microscopes. The results showed that the mean scores in groups A and B were generally lower (better) than group C. Mean scores of the apical thirds tended to be higher (worse) than the middle and the cervical thirds, except in group A. ProFile with or without chloroform seemed to be a viable alternative retreatment method.

Analysis of Variance↗

Clinical presentations and prognostic factors of a glyphosate-surfactant herbicide intoxication: a review of 131 cases.

OBJECTIVE: Suicide attempts with agricultural chemicals are common in southern Taiwan. Among them, glyphosate-surfactant herbicide (GlySH) intoxication has been encountered with increasing frequency. Although a number of reports have described the clinical course and outcomes following ingestion, predictors of serious complications and mortality have not been elucidated. The purpose of this study was to define predictors of serious complications and probable mortality. METHODS: This was a retrospective study of 131 GlySH-intoxicated patients treated at the National Cheng Kung University Hospital from 1988 to 1995. Medical charts were reviewed and clinical and laboratory variables were abstracted, looking for predictors of mortality. RESULTS: The most common symptoms included sore throat (79.5%), and nausea with or without vomiting (73.8%). The most common laboratory findings were leukocytosis (68.0%), low serum bicarbonate (48.1%), and acidosis (35.8%). Overall, 11 of 131 patients (8.4%) died; the mean +/- SEM time to death was 2.8 +/- 0.8 days after presentation. When comparing the clinical and laboratory characteristics among the survivor and fatality groups, significant differences were identified. Respiratory distress, pulmonary edema, respiratory distress necessitating intubation, shock (systolic blood pressure less than 90 mm Hg), altered consciousness, abnormal chest x-ray, renal failure necessitating hemodialysis, larger amount of ingestion (>200 mL), and hyperkalemia were predictors highly associated with poor outcomes and mortality. Using multiple logistic regression, three predictors were identified, which may predict mortality in severely intoxicated patients. CONCLUSIONS: In managing patients who have larger amount of GlySH ingestion, airway protection, early detection of pulmonary edema, and prevention of further pulmonary damage and renal damage appear to be of critical importance.

Female↗

Squamous cell lung cancer with solitary subungual metastasis.

Subungual metastasis resulting from internal malignancies is an extremely rare event. A few cases of subungual metastasis from lung cancer have been reported. However, subungual metastasis arising from lung cancer without any other form of distant metastases has not been reported. The misdiagnosis of a solitary subungual metastases as a benign inflammatory lesion is an important problem as it may cause the misdiagnosis of a lower stage of lung cancer. We may be reporting the first case of a subungual metastasis from lung cancer without any other distant metastases.

Carcinoma, Squamous Cell↗

Polymorphisms of N-acetyltransferase 2, glutathione S-transferase mu and theta genes as risk factors of bladder cancer in relation to asthma and tuberculosis.

PURPOSE: We investigated whether the polymorphisms of N-acetyltransferase 2 (NAT2), glutathione S-transferase-mu (GSTM1) and glutathione S-transferase-theta (GSTT1) genes were risk factors of bladder cancer among Korean people in relation to other risk factors. MATERIALS AND METHODS: In this case-control investigation of 113 patients with primary bladder cancer and 221 control subjects, we compared the association of bladder cancer with genetic polymorphisms of NAT2, GSTM1 and GSTT1, demographic characteristics, smoking status, and medical histories in a molecular epidemiological way. RESULTS: The risk of bladder cancer was significantly increased in patients with a medical history of tuberculosis (OR 3.61, 95% CI 1.57 to 8.26) and bronchial asthma (OR 4.15, 95% CI 1.61 to 10.75), while smoking history turned out to be insignificant. GSTM1 null genotype was a significant risk factor of bladder cancer (OR 1.81, 95% CI 1.12 to 2.93). On the other hand, slow acetylator and GSTT1 genotypes were insignificant. Also, we could not find any association between GSTM1, GSTT1, slow acetylator genotypes and bladder cancer risk among smokers. The rapid acetylator, GSTM1 null and GSTT1 null genotypes with a medical history of asthma or tuberculosis combinations were significant risk factors in Korean subjects. CONCLUSIONS: Among Korean subjects, GSTM1 null genotype was a significant risk factor for bladder cancer. The reason why bronchial asthma and tuberculosis are risk factors in Korean subjects is yet unknown, but a variety of factors, including enzyme activities for detoxification, medication for these diseases and immunological background might be involved.

Arylamine N-Acetyltransferase↗