Biomedical subjects

J H Chang

Publications and source records attributed to J H Chang.

At least 73 records · Page 4Linked to original sources

PubMed2000

Microvascular decompression in trigeminal neuralgia: a correlation of three-dimensional time-of-flight magnetic resonance angiography and surgical findings.

We analyzed 104 patients with trigeminal neuralgia who underwent microvascular decompression and who were followed up for more than 12 months during the period from January 1992 to June 1998. In this recent series, we utilized three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) for all patients with trigeminal neuralgia. A 3D-TOF MRA was beneficial in treatment planning and in predicting surgical outcome by demonstrating cranial nerve compression as well excluding other etiologies such as tumor or vascular lesions. The patients were followed up for 1-7 years (mean 5.7 +/- 1.2 years). Initial pain relief was complete in 89 patients (85.6%) and partial in 12 patients (11.5%). There were three primary failures (2.9%). The acceptable pain relief rate (complete relief: 79.8%, partial relief: 11.5%) was determined in the long-term follow-up of surgical results. Pain recurred in 6 patients (5.8%). The mean time to recurrence was 48 months (36-93 months). There were no serious or annoying complications such as anesthesia dolorosa.

Adult↗

PubMed2000

Accelerated hyperfractionation in patients with non-small cell bronchogenic cancers as a cost-effective and user- and patient-friendly schedule.

We developed an accelerated hyperfractionation schedule with acceptable effect and toxicity in non-small cell bronchogenic carcinomas. An evolutionary institutional pilot was initiated in March 1995 as a modification of Radiation Therapy Oncology Group (RTOG) 9205, thrice-daily fractionation schedule. Twenty-nine patients with bronchogenic and 7 with head and neck cancers had treatment initiated and completed. A dose of 1.2 Gy was delivered to a mediastinal plus tumor field concomitantly with synchronous boost of 0.6 Gy to a limited volume of gross tumor (twice daily for 21 treatments days in 4 weeks) with a total dose being 75.60 Gy to the primary gross tumor and 50.4 Gy to the elective volume. The bronchogenic cancers were stages IB (medically unresectable, n = 3), IIB (n = 4), IIIA (n = 4), or IIIB (n = 18). Eleven patients had squamous cell cancers, 13 adenocarcinomas, 1 large cell, and 2 carcinomas not specified. With 12 months median follow-up, tolerance has been excellent without any patient complaining of at least Oncology Nursing Society (ONS) grade 3 esophagitis; treatment interruptions occurred in only one patient after 8 days. Weight loss occurred in 12 patients, averaging 4.8% for these patients and 2% overall. Seven patients had a complete response and 20 a partial response. Median survival was 12 months, 1-year survival 58%, 2-year 21%, and 3-year 18%. Seven patients with bronchogenic cancer are still alive. Seven head and neck cancer patients were treated, in which five had base of tongue tumors stage T2 to 4, N0 to N1. Pharyngitis and mucositis were problematic in at least four patients. The outcomes are comparable with other RTOG experience. Hyperfractionated synchronous concomitant boost of total tumor dose to 75.6 Gy in 4 weeks for bronchogenic patients was well tolerated and acceptable to physicians and patients.

Aged↗

PubMed2000

Gamma knife radiosurgery as a primary treatment for prolactinomas.

OBJECT: The purpose of this study was to estimate the efficacy of gamma knife radiosurgery (GKS) in controlling tumor growth and endocrinopathy associated with prolactinomas. METHODS: Between 1993 and 1997, 164 of 469 patients with pituitary adenomas treated by GKS harbored prolactinomas. The dose to the tumor margin ranged from 9 to 35 Gy (mean 31.2 Gy), and the visual pathways were exposed to a dose of less than 10 Gy. The mean tumor diameter was 13.4 mm. The mean follow-up time for 128 cases was 33.2 months (range 6-72 months). Tumor control was observed in all but two patients who underwent surgery 18 and 36 months, respectively, after GKS. Clinical cure was achieved in 67 cases. Clinical improvement was noted with a decrease in the hyperprolactinemia after GKS. Nonetheless, in 31 (29%) of 108 patients who were followed for more than 2 years no improvement in serum prolactin levels was demonstrated, although this could be normalized by bromocriptine administration after treatment. Nine infertile women became pregnant 2 to 13 months after GKS and all gave birth to normal children. There was no visual deterioration related to GKS. Five women experienced premature menopause. In these patients there was subtotal disappearance of the tumor and an empty sella developed. CONCLUSIONS: Gamma knife radiosurgery as a primary treatment for prolactinomas can be safe and effective both for controlling tumor growth and for normalization of prolactin hypersecretion. A higher margin dose (> or = 30 Gy) seemed to be associated with a better clinical outcome. Gamma knife radiosurgery may make prolactinomas more sensitive to the bromocriptine.

Humans↗

PubMed2000

Factors related to complete occlusion of arteriovenous malformations after gamma knife radiosurgery.

OBJECT: The authors sought to evaluate the effects of gamma knife radiosurgery (GKS) on cerebral arteriovenous malformations (AVMs) and the factors associated with complete occlusion. METHODS: A total of 301 radiosurgical procedures for 277 cerebral AVMs were performed between December 1988 and December 1999. Two hundred seventy-eight lesions in 254 patients who were treated with GKS from May 1992 to December 1999 were analyzed. Several clinical and radiological parameters were evaluated. CONCLUSIONS: The total obliteration rate for the cases with an adequate radiological follow up of more than 2 years was 78.9%. In multivariate analysis, maximum diameter, angiographically delineated shape of the AVM nidus, and the number of draining veins significantly influenced the result of radiosurgery. In addition, margin radiation dose, Spetzler-Martin grade, and the flow pattern of the AVM nidus also had some influence on the outcome. In addition to the size, topography, and radiosurgical parameters of AVMs, it would seem to be necessary to consider the angioarchitectural and hemodynamic aspects to select proper candidates for radiosurgery.

Adolescent↗

PubMed2000

A clinical analysis of 11 patients with chronic actinic dermatitis in Korea.

Chronic actinic dermatitis is a rare disease worldwide and also in Korea. However there has been no clinicohistologic and photobiological analysis of chronic actinic dermatitis in Korea. We examined 11 patients who were diagnosed as chronic actinic dermatitis and the results of this study were compared with previous reports. Most patients were elderly men who had erythematous papules or lichenified plaques on sun-exposed areas such as the face, neck, and dorsum of the hands with severe itching sensation. All patients had severe sensitivity to UVB and biopsied specimens showed findings of chronic eczema. Five patients had positive photopatch test materials. The patients were treated with systemic and topical steroid, cyclosporine and antihistamine.

Adult↗

PubMed2000

The classification of segmental vitiligo on the face.

Segmental vitiligo usually has an onset early in life and spreads rapidly within the affected area. Among 1,300 patients with vitiligo, 191 patients with segmental vitiligo involving the face were evaluated. In this study, the distribution of segmental vitiligo on the face could be classified into 5 patterns which have distinctive features. This classification of facial segmental vitiligo can provide some indication of the future distribution of early lesions if they have begun to spread.

Female↗

PubMed2000

[Study on the packings of affinity chromatography for the separation of urokinase].

Two kinds of affinity chromatographic packings for the separation of urokinase were synthesized by coupling of p-amino benzamidine (p-ABZ) to commercially available sepharose and polyepoxypropyl methacrylate (PEPMA). Then they were applied for separating crude urokinase. It was found that the average recovery of bioactivity on sepharose was higher than that on PEPMA, resulting in 108.3% and 43.4% respectively. The high rigidity of PEPMA permits fast flow of protein solutions and operation by higher-pressure affinity chromatography. The average purification times were 36.9 folds for PEPMA column and nine-folds for Sepharose column. The purification of crude urokinase described in this paper demonstrates that PEPMA column is effective for purifying biological products in a large scale.

Chromatography, Affinity↗

PubMed1999

SLAP, a dimeric adapter protein, plays a functional role in T cell receptor signaling.

Engagement of the T cell antigen receptor (TCR) leads to rapid activation of protein tyrosine kinases, which in turn phosphorylate downstream enzymes and adapter proteins. Some adapter proteins, such as SLP-76, Vav, and LAT, positively regulate TCR-mediated signal transduction, whereas others, such as Cbl, play an inhibitory role. SLAP (Src-like adapter protein), an adapter protein containing a Src homology 3 and a Src homology 2 domain, was isolated from a yeast interacting screen by using N-terminal Cbl as bait. N-terminal Cbl interacts with SLAP in vivo and in vitro in a tyrosine phosphorylation-independent manner. We observed that SLAP is expressed in T cells, and upon TCR activation, SLAP interacts with ZAP-70, Syk, LAT, and TCRzeta chain in Jurkat T cells. In transiently transfected COS-7 cells, SLAP forms separate complexes with ZAP-70, Syk, and LAT through its Src homology 2 domain. Overexpression of a C-terminal-truncated SLAP mutant down-regulates nuclear factor of activated T cells-AP1 activity. We have evidence that SLAP forms homodimers through its C-terminal region. Serial truncations and mutations in the C terminus of SLAP demonstrate that there is a correlation between the loss of dimerization and the inhibition of nuclear factor of activated T cells-AP1 activity. The in vivo association of SLAP with key signaling molecules and its inhibition of T cell activation suggests that SLAP plays an important role in TCR-mediated signal transduction.

Adaptor Proteins, Signal Transducing↗

PubMed1999

Retinoic acid promotes ubiquitination and proteolysis of cyclin D1 during induced tumor cell differentiation.

Mechanisms by which differentiation programs engage the cell cycle are poorly understood. This study demonstrates that retinoids promote ubiquitination and degradation of cyclin D1 during retinoid-induced differentiation of human embryonal carcinoma cells. In response to all-trans-retinoic acid (RA) treatment, the human embryonal carcinoma cell line NT2/D1 exhibits a progressive decline in cyclin D1 expression beginning when the cells are committed to differentiate, but before onset of terminal neuronal differentiation. The decrease in cyclin D1 protein is tightly associated with the accumulation of hypophosphorylated forms of the retinoblastoma protein and G(1) arrest. In contrast, retinoic acid receptor gamma-deficient NT2/D1-R1 cells do not growth-arrest or accumulate in G(1) and have persistent cyclin D1 overexpression despite RA treatment. Notably, stable transfection of retinoic acid receptor gamma restores RA-mediated growth suppression and differentiation to NT2/D1-R1 cells and restores the decline of cyclin D1. The proteasome inhibitor LLnL blocks this RA-mediated decline in cyclin D1. RA treatment markedly accelerates ubiquitination of wild-type cyclin D1, but not a cyclin D1 (T286A) mutant. Transient expression of cyclin D1 (T286A) in NT2/D1 cells blocks RA-mediated transcriptional decline of a differentiation-sensitive reporter plasmid and represses induction of immunophenotypic neuronal markers. Taken together, these findings strongly implicate RA-mediated degradation of cyclin D1 as a means of coupling induced differentiation and cell cycle control of human embryonal carcinoma cells.

Carcinoma, Embryonal↗

PubMed1999

Development of two novel nontoxic mutants of Escherichia coli heat-labile enterotoxin.

Escherichia coli heat-labile enterotoxin (LT) is composed of catalytic A and non-catalytic homo-pentameric B subunits and causes diarrheal disease in human and animals. In order to produce a nontoxic LT for vaccine and adjuvant development, two novel derivatives of LT were constructed by a site-directed mutagenesis of A subunit; Ser63 to Tyr63 in LTS63Y and Glu110, Glu112 were deleted in LT delta 110/112. The purified mutant LTs (mLTs) showed a similar molecular structural complex as AB5 to that of wild LT. In contrast to wild-type LT, mLTs failed to induce either elongation activity, ADP-ribosyltransferase activity, cAMP synthesis in CHO cells or fluid accumulation in mouse small intestine in vivo. Mice immunized with mLTs either intragastrically or intranasally elicited high titers of LT-specific serum and mucosal antibodies comparable to those induced by wild-type LT. These results indicate that substitution of Ser63 to Tyr63 or deletion of Glu110 and Glu112 eliminate the toxicity of LT without a change of AB5 conformation, and both mutants are immunogenic to LT itself. Therefore, both mLTs may be used to develop novel anti-diarrheal vaccines against enterotoxigenic E. coli.

Amino Acid Substitution↗

PubMed1999

Constitutively active Pto induces a Prf-dependent hypersensitive response in the absence of avrPto.

Resistance in tomato to Pseudomonas syringae pv tomato (avrPto) is conferred by the gene Pto in a gene-for-gene relationship. A hypersensitive disease resistance response (HR) is elicited when Pto and avrPto are expressed experimentally within the same plant cell. The kinase capability of Pto was required for AvrPto-dependent HR induction. Systematic mutagenesis of the activation segment of Pto kinase confirmed the homologous P+1 loop as an AvrPto-binding determinant. Specific amino acid substitutions in this region led to constitutive induction of HR upon expression in the plant cell in the absence of AvrPto. Constitutively active Pto mutants required kinase capability for activity, and were unable to interact with proteins previously shown to bind to wild-type Pto. The constitutive gain-of-function phenotype was dependent on a functional Prf gene, demonstrating activation of the cognate disease resistance pathway and precluding a role for Prf upstream of Pto.

Amino Acid Sequence↗

PubMed1999

The extracellular signal-regulated kinase pathway is required for activation-induced cell death of T cells.

T cells can undergo activation-induced cell death (AICD) upon stimulation of the T cell receptor-CD3 complex. We found that the extracellular signal-regulated kinase (ERK) pathway is activated during AICD. Transient transfection of a dominant interfering mutant of mitogen-activated/extracellular signal-regulated receptor protein kinase kinase (MEK1) demonstrated that down-regulation of the ERK pathway inhibited FasL expression during AICD, whereas activation of the ERK pathway with a constitutively active MEK1 resulted in increased expression of FasL. We also found that pretreatment with the specific MEK1 inhibitor PD98059 prevented the induction of FasL expression during AICD and inhibited AICD. However, PD98059 had no effect on other apoptotic stimuli. We found only very weak ERK activity during Fas-mediated apoptosis (induced by Fas cross-linking). Furthermore, preincubation with the MEK1 inhibitor did not inhibit Fas-mediated apoptosis. Finally, we also demonstrated that pretreatment with the MEK1 inhibitor could delay and decrease the expression of the orphan nuclear steroid receptor Nur77, which has been shown to be essential for AICD. In conclusion, this study demonstrates that the ERK pathway is required for AICD of T cells and appears to regulate the induction of Nur77 and FasL expression during AICD.

Animals↗

PubMed1999

Expression and release of chemokines associated with apoptotic cell death in human promonocytic U937 cells and peripheral blood mononuclear cells.

To characterize mechanisms which may determine the fate of apoptotic cells, we investigated chemokine expression in apoptotic promonocytic U937 cells or peripheral blood mononuclear cells (PBMC). Exposure of U937 cells to etoposide (VP-16) or the nitric oxide (NO) donor DETA-NO, both inducers of apoptosis in these cells, was associated with increased expression of the chemokines IL-8 and macrophage inflammatory protein-1 alpha. Up-regulation of IL-8 mRNA expression by VP-16 or DETA-NO was observed as early as 4 h or 6 h, respectively, after onset of treatment and was still detectable after 19 h of exposure. A serine protease inhibitor prevented both VP-16-induced apoptosis and release of IL-8, whereas inhibition of p38 MAP kinases reduced IL-8 secretion only. Moreover, we observed that incubation with 2-chlorodeoxyadenosine (CdA) up-regulated release of IL-8 from adherent PBMC in parallel to induction of apoptosis. In these cells a modest but significant induction of TNF-alpha release by CdA was also detected. In addition, CdA augmented release of IL-8 from whole blood cultures. By facilitating adequate recruitment of phagocytes to sites of cell death, stress-induced up-regulation of chemokines associated with apoptosis may contribute to mechanisms aiming at efficient removal of apoptotic cells.

Apoptosis↗

PubMed1999

Decrease in nucleophosmin/B23 mRNA and telomerase activity during indomethacin-induced apoptosis of gastric KATO-III cancer cells.

The mRNA expression of nucleophosmin/B23 in gastric cancers (T) and the matched adjacent "normal" gastric mucosa (N) obtained from patients without any preoperative treatment were determined. Telomerase activity was detected in tumor tissues from six of seven patients. Analysis of the adjacent "normal" gastric mucosa in the same patients revealed all seven were negative for telomerase activity. In comparing clinical data for all seven patients, the stages of cancer seemed to be associated with T/N nucleophosmin/B23 mRNA expression. Cancers of later stages seemed to have higher T/N nucleophosmin/B23 mRNA ratio. After 3-4 days of 1 mM indomethacin treatment about 60-85% of gastric cultured KATO III cancer cells exhibited the features with highly condensed nuclei and decrease in cell size. Concomitant with the increase in the percentage of KATO III cells exhibiting the morphological features of apoptosis, there was a decrease in the viability of cells as determined by exclusion of trypan blue. A decline in telomerase activity in indomethacin-treated versus untreated cells was observed over times (2-4 days). The steady-state level of nucleophosmin/B23 mRNA, as determined by the levels of radioactivity of the hybridizing bands also decreased during the indomethacin treatment. At some times after the removal of indomethacin, cell growth and telomerase activity resumed in little extent (approx. 60%). When nucleophosmin/B23 antisense oligonucleotide was included in the cell culture upon removal of indomethacin, virtually no recovery of cell growth and telomerase activity were observed.

Apoptosis↗

PubMed1999

Primary laparoscopic placement of gastrostomy buttons for feeding tubes. A safer and simpler technique.

BACKGROUND: During a 4-year period, 240 gastrostomy buttons were placed in children, as the initial surgical feeding tube, using laparoscopic techniques. MATERIALS AND METHODS: The technique requires the use of a minilaparoscope (1.6-mm) and a single 5-mm trocar placed at the exit site for the gastrostomy button. It can also be performed in addition to a laparoscopic fundoplication using the same trocar sites. The technique requires no special instrumentation or kits. When performed alone, operative times average 15 min. When performed with fundoplication, it adds approximately 5-10 min to the time for the procedure. RESULTS: There were no intraoperative complications and five (2.1%) postoperative complications. CONCLUSIONS: This technique has proven to be simple and effective. It allows primary placement of a gastrostomy button that is cosmetically and functionally superior to a gastrostomy tube.

Adolescent↗

PubMed1999

Plants expressing the Pto disease resistance gene confer resistance to recombinant PVX containing the avirulence gene AvrPto.

Elicitation of hypersensitive cell death and induction of plant disease resistance by Pseudomonas syringae pv. tomato (Pst) is dependent on activity of the Pst Hrp secretion system and the gene-for-gene interaction between the tomato resistance gene Pto and the bacterial avirulence gene avrPto. AvrPto was expressed transiently in resistant or susceptible plant lines via a potato virus X (PVX) vector. We found that while PVX is normally virulent on tomato, a PVX derivative expressing avrPto was only capable of infecting plants lacking a functional Pto resistance pathway. Mutations in either the Pto or Prf genes allowed systemic spread of the recombinant virus. These results indicate that recognition of AvrPto by Pto in resistant plant lines triggers a plant defense response that can confer resistance to a viral as well as a bacterial pathogen.

Cloning, Molecular↗

PubMed1999

Diagnostic issues in tuberculosis of the ribs with a review of 12 surgically proven cases.

The ribs and surrounding chest wall are uncommon sites of tuberculosis (TB). Tuberculosis of the rib bone is often delayed in diagnosis or is recurrent with medical treatment. Rib TB is often negative or shows nodular shadows which is mimicking a metastatic tumour. We reviewed 12 cases of rib TB, which were confirmed by surgical rib resection. The most common reason given for attending the hospital was palpation of the chest wall mass, the onset of chest pain or draining sinus on the chest wall. The correct diagnosis was often delayed due to misdiagnosis of the other conditions. The misdiagnosis was produced from vague symptoms and various radiological features of rib TB. Occasionally, previous TB history could provide an indication of rib TB. Occasionally, their pre-operative diagnostic processes were inadequate and were not consistent depending on the physician. From these reviews, we attempted to reconstruct the best diagnostic and therapeutic modalities. Our recommendation for detecting rib TB is an accurate medical history and physical examination, and early differential diagnosis with bone scintigram, computed tomogram, and percutaneous needle biopsy. Surgery can be a final diagnostic option for differential diagnosis or in a therapeutic role for recalcitrant or complicated cases.

Adolescent↗

PubMed1999

The application of in vivo confocal microscopy and tear LDH measurement in assessing corneal response to contact lens and contact lens solutions.

PURPOSE: To evaluate differences in corneal response to daily wear (DW) of soft contact lens (CL) wear with different CL solutions and to assess the ability of in vivo confocal microscopy (CM) and tear lactate dehydrogenase (LDH) measurement to detect such differences in NZW rabbits. METHODS: Daily treatment of lenses consisted of a rub and rinse cleaning, then overnight soak in one of five solutions: Sauflon All in One (ALL), Compound A (CoA), OPTI-FREE((R) )Rinsing, Disinfecting, and Storage Solution (OPT), ReNu((R)) <?Pub Caret>Multipurpose Solution (REN), and UNISOL( (R)) Saline Solution (UNI). Rabbits (4/test group) wore 71% H( 2)O/type4 soft lenses approximately 7 hours daily. On days 0, 1, 3 and 7, slit lamp examination, tear LDH measurement, and in vivo CM were performed after removal of lenses. Using in vivo CM, epithelial thickness, epithelial cell area, and stromal thickness were measured, both centrally and peripherally. RESULTS: Epithelial thickness in ALL, CoA, and UNI-treated eyes showed a significant decrease of 15.6%, 13. 3%, and 10.6% (p < 0.05 in all groups), centrally, while CoA, OPT, and UNI showed a significant decrease of 9.3%, 7.1%, and 4.4% (p < 0. 05 in all groups), peripherally. ALL showed a significant 9.5% (p < 0.05) decrease of central cell area, while CoA showed a significant 21.5% (p < 0.01) decrease peripherally. UNI demonstrated a significant 3.2% (p < 0.05) decrease in central stromal thickness. ALL, CoA, and UNI showed a significant increase in LDH level of 152. 1%, 192.1%, and 308.2% (p < 0.05 in all groups) at day 3, respectively, but values declined at day 7. Significant changes in basal epithelial morphology were also observed with CoA on day 7 on in vivo CM. CONCLUSIONS: Overall, lens care solutions in combination with CL wear may interact to cause increased epithelial desquamation leading to decreased surface cell area and epithelial thickness. The clinical significance of these changes will require further investigation. In vivo CM combined with tear LDH assay is a quantitative, objective, non-invasive method of assessing CL wear and CL disinfecting solution effects on the cornea, and is able to detect differences in corneal response to different CL solutions.

Animals↗