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Biomedical subjects

J S Shin

Publications and source records attributed to J S Shin.

At least 91 records · Page 5Linked to original sources
PubMed1995

Mucociliary activity and histopathology of sinus mucosa in experimental maxillary sinusitis: a comparison of systemic administration of antibiotic and antibiotic delivery by polylactic acid polymer.

To evaluate the efficacy of antibiotic delivered by polyactic acid (PLA) polymer in sinusitis, we induced maxillary sinusitis in 32 New Zealand white rabbits by occluding the sinus ostium and inoculating the sinus cavity with Streptococcus pneumoniae. The rabbits were divided into three groups consisting of group 1 (control group, 8 rabbits), which was treated only by reopening the ostium; group 2, which was treated by both reopening the ostium and injecting ampicillin intramuscularly (40 mg/kg/day in three divided doses, 12 rabbits); and group 3 (12 rabbits) in which a piece of PLA-polymer ampicillin (0.326 mg) sheet (1.5 x 1.5 cm) was placed within the sinus after re-establishing ostial patency. The light microscopic findings such as epithelial ulceration, loss of cilia, infiltration of inflammatory cells, and edema were less pronounced in group 2 and minimal in group 3. The electron microscopic findings such as swelling of mitochondria and endoplasmic reticulum and protruded cytoplasm were severest in the control group, followed by groups 2 and 3. The mucociliary transport speed measured at the medial wall of the maxillary sinus was highest in group 3. The results of this study suggest that treatment with PLA-polymer ampicillin may have a better efficacy in maxillary sinusitis than that with systemic administration of ampicillin.

Ampicillin↗
PubMed1995

Histologic structure of antrochoanal polyps.

The antrochonanal polyp (ACP) is defined as a maxillary sinus polyp that originates in the maxillary sinus, passes through the sinus ostia, and extends into the choana. The aim of this study was to compare the histologic findings of 40 cases of ACP with those of allergic and non-allergic nasal polyps, and so possibly to elucidate the pathogenesis of ACP. No allergy could be verified in any of the ACP patients. Inflammatory cell infiltration was significantly more severe in the ACP group than in the allergic polyp group. Eosinophilic infiltration was significantly less severe in the ACP group than in the allergic polyp group. Edema was not significantly different between the ACP, allergic, and non-allergic groups. In the ACP group, the presence of submucous glands was significantly less pronounced than in the ordinary nasal polyp groups. The fibrous type was present significantly more often than the infiltrative or granulating type in the ACP group. The histologic findings and clinical features of the ACP indicate that it has little causal relationship with nasal allergy but is all the more intimately associated with inflammatory processes. The paucity of submucous glands suggests that the ACP results from edematous hypertrophy of the respiratory epithelium rather than from distension of the glandular structures.

Adolescent↗
PubMed1995

Bacteremia in acute pancreatitis of different etiologies.

To evaluate the rationale of using antibiotics in acute pancreatitis and to determine whether the indication for their use depends upon the etiology of the pancreatitis, the records of 202 patients with acute pancreatitis were retrospectively reviewed. The incidence of abnormal body temperature, leukocytosis, bacteremia and the results of biochemistry tests in different etiologies of the disease were investigated. Pancreatitis was found to be alcohol-related (47 patients), gallstone-related (105 patients), idiopathic (26 patients) and miscellaneous (24 patients). On admission, 83 patients had abnormal body temperature and 146 patients showed leukocytosis. Bacteremia occurred in 20 patients. Of these, 15 had gallstone-related pancreatitis, two had pancreatic cancers and one developed bacteremia after endoscopic retrograde cholangio-pancreatography (ERCP). These 18 patients had abnormal biochemistry results (including high serum levels of direct bilirubin, alkaline phosphatase and gamma-glutamyltransferase) and dilated bile ducts on imaging studies, indicating biliary infections. The remaining two patients with bacteremia included one alcoholic patient and one patient with idiopathic pancreatitis. The most commonly involved pathogens were Escherichia coli and Klebsiella pneumoniae. In addition, eight patients (4%) developed secondary pancreatic infections during hospitalization; the blood cultures of seven of these patients were negative on admission. Although fever and leukocytosis are not good predictors of infection in acute pancreatitis our results showed that bacteremia is common in patients whose pancreatitis is related to gallstones, ERCP or pancreatic malignancy with obstructive jaundice. We recommend that antibiotics be used only in this subset of acute pancreatitis patients.

Acute Disease↗
PubMed1995

Spontaneous rupture of hepatocellular carcinoma. A review of 141 Taiwanese cases and comparison with nonrupture cases.

We reviewed the records and statistics of 560 patients hospitalized with hepatocellular carcinoma (HCC) over a 5-year period. One hundred and forty-one patients (26%) had spontaneous rupture of their HCCs. Different characteristics of the rupture (R) and nonrupture (NR) groups were compared; there were statistically significant differences (p < 0.05) in the size of the tumor (R, 9.83 +/- 4.36 cm, and NR, 7.67 +/- 4.01 cm; p < 0.0001), and the minimal thickness of peritumor liver parenchyma (R, 0.03 +/- 0.20 cm, and NR, 0.30 +/- 0.70 cm; p < 0.001), the presence of the ¿hump sign¿ (R, 87.8%, and NR, 45.7%; p < 0.0001), and the minimal thickness of peritumor liver parenchyma (R, 0.03 +/- 0.20 cm, and NR, 0.30 +/- 0.70 cm; p < 0.001). The percentage of left-lobe tumors was significantly higher in the rupture group than in the nonrupture group (p < 0.05). In addition, the Child-Pugh's score and serum transaminase levels were higher, and the prothrombin times more prolonged, in the rupture group. Factors that were not statistically significant included sex, age, etiology of cirrhosis, platelet count, portal vein thrombosis, and the presence of a varix. Multivariate logistic regression analysis indicated that the tumor size, the presence of a hump sign, and the Pugh's score correlated the best with HCC rupture (p < 0.05). Ninety-four patients from the rupture group died during hospitalization. The mortality rate was 66.7%. We conclude that (a) spontaneous rupture of HCC is a likely sequel of progressive expansion of tumor that finally protrudes outside the liver surface and hemorrhages, (b) left-lobe tumor presents a higher risk of rupture, and (c) portal hypertension does not play a major role in the pathogenesis of tumor rupture.

Adolescent↗
PubMed1995

Primary ciliary dyskinesia: ultrastructural defects and clinical features.

Primary ciliary dyskinesia is a genetically determined disorder characterized by immotility or poor motility of the cilia in the airways and elsewhere. Certain specific defects in the ciliary axoneme can be found, which are pathognomonic of the syndrome. The defects include missing dynein arms, abnormally short dynein arms, spokes with no central sheath, missing central microtubules, and displacement of one of the nine peripheral doublets. We have reviewed 19 cases of primary ciliary dyskinesia diagnosed by transmission and scanning electron microscopy. The age distribution ranged from five to 15 years, and there were six males and 13 females. All 19 cases had abnormal cilia which consisted of Ia (three cases), Ib (three cases), isolated Id (three cases), isolated II (one case), isolated III (two cases), and Id + other types (seven cases), according to Sturgess' classification. The most pronounced clinical manifestations are chronic paranasal sinusitis (52%) and chronic bronchiectasis (52%), followed by bronchopneumonia (26%), chronic bronchitis (21%), and nasal polyps (15%).

Adolescent↗
PubMed1994

Influence of paraesophageal venous collaterals on efficacy of endoscopic sclerotherapy for esophageal varices.

To determine the diagnostic accuracy of computer tomography in the detection of venous collaterals surrounding the esophagus in patients with portal hypertension, preoperative computer tomography interpretations of these veins in 15 patients who were candidates for the Sugiura procedure for treatment of esophageal varices were correlated with those of the intraoperative assessment. Laparotomy revealed severe paraesophageal varices in five patients; four of them were found to have paraesophageal varices in computer tomography films. The sensitivity and specificity of computer tomography in diagnosing severe paraesophageal varices were 80% and 100%, respectively. A second assessment was performed in 59 additional patients with esophageal variceal hemorrhage to investigate the influence of paraesophageal varices on the efficacy of endoscopic sclerotherapy in the treatment of varices. The patients were divided into two groups: Group A included 17 patients with and group B 42 patients without paraesophageal varices on presclerotherapy computer tomography. All patients underwent elective sclerotherapy after being deemed hemodynamically stable. Patients in group A required more treatment sessions, more sclerosant and longer periods to obliterate varices completely than did group B patients. Eight patients in group A and six in group B (57% vs. 16%, p < 0.05) had variceal recurrence after obliteration during mean follow-ups of 20.8 and 19.9 mo, respectively. The mean time elapsed before variceal reappearance was shorter for group A than for group B (4.1 +/- 3.3 vs. 11.8 +/- 2.7 mo, p < 0.05). Among patients who developed new varices, five patients in group A and one in group B experienced repeat bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)

Collateral Circulation↗
PubMed1994

Intrafamilial transmission of hepatitis C virus: the important role of inapparent transmission.

To evaluate the intrafamilial transmission of hepatitis C virus (HCV) 104 index patients with type C chronic liver disease and their 307 family contacts were interviewed. After a questionnaire on the risk factors of parenteral exposure, blood samples were obtained and tested for liver biochemistry and anti-HCV antibody by enzyme-linked immunosorbent assay (Abbott II). Overall, 52 family contacts (17%) were positive for anti-HCV, indicating a higher anti-HCV prevalence among family contacts than among the general population in Taiwan. The anti-HCV prevalences in parents, spouses, children, and other contacts of the patients were 54% (14/26), 28% (25/91), 6.9% (10/143), and 6.4% (3/47), respectively. The contacts of index patients had increasingly greater risk of HCV infection when they became older and had lived longer with index patients. All family contacts were divided into two groups categorized by whether the index patients had or did not have a history of parenteral exposure. Among 126 family contacts of the 42 patients without parenteral exposure, blood transfusion and surgery were the factors significantly associated with HCV infection in these family contacts (odds ratio = 7.26, 95% confidence interval = 2.32-32.67; odds ratio = 3.95, 95% CI = 1.29-12.11, respectively). Risk factors were not significantly associated with HCV infection among 181 family contacts of the 62 index patients with parenteral exposure. It is concluded that the index patients without parenteral exposure appeared to have acquired the disease from HCV-infected family members with risk factors. Most of the index patients had a history of parenteral exposure and in turn served as the source of the disease for family members.

Adult↗
PubMed1994

Bleeding peptic ulcer--risk factors for rebleeding and sequential changes in endoscopic findings.

From September 1991 to December 1992, a prospective study was conducted to determine the risk factors and residual risk of rebleeding, and the evolutionary endoscopic changes in peptic ulcers that rebled. Emergency endoscopies were performed on 452 patients with haematemesis or a melaena, or both within 24 hours of admission. If the lesions were actively bleeding, then the patients were treated with injection sclerotherapy. A multivariate analysis of clinical, laboratory, and endoscopic variables of 204 patients with ulcer bleeding showed that hypovolaemic shock, a non-bleeding visible vessel, and an adherent clot on the ulcer base were independently significant in predicting rebleeding (p < 0.05). Considering these three factors according to the estimates of their regression coefficients showed that a non-bleeding visible vessel was the strongest predictor of rebleeding. The study of the residual risk of rebleeding after admission showed that most rebleeding episodes (94.1%), including all associated with hypovolaemic shock, surgical treatment, and death, occurred within 96 hours of admission. After this time, the residual risk of rebleeding was less than 1%. Study of the changes in endoscopic findings before and after rebleeding illustrated that all ulcers with a visible vessel or adherent clot showed at follow up endoscopy were derived from ulcers with initial major stigmata. It is concluded that hypovolaemic shock, a non-bleeding visible vessel, and an adherent clot on an ulcer base are of independent significance in predicting rebleeding. Observation for 96 hours is sufficient to detect most rebleeding episodes after an initial bleed from peptic ulcer.

Blood Vessels↗
PubMed1994

Radiologic assessment of diseased mucosa of the maxillary sinus after functional endoscopic sinus surgery.

We attempted to evaluate postoperative mucosal changes and symptomatic improvement in 99 patients who underwent functional endoscopic sinus surgery from September 1991 through August 1992. The patients were divided into 2-, 4-, 6-, and 12-month postoperative groups. Thickness of the maxillary sinus mucosa measured at the midpoint of the lateral sinus wall on a follow-up ostiomeatal unit computed tomogram (OMU CT) was compared with that of preoperative OMU CT. Postoperative endoscopic findings of the maxillary sinus and changes in presenting symptoms such as rhinorrhea, nasal obstruction, facial pain, headache, anosmia, epiphora, and referred otalgia were analyzed. Improvement in the diseased mucosa of the maxillary sinus, as evaluated on OMU CT, was observed in 69.7% of the patients, and such mucosal changes did not differ significantly among 2-, 4-, 6-, and 12-month follow-up groups. However, apparent mucosal changes exceeding marginal improvement was observed in 32.3% of the patients. The overall symptomatic improvement rate was 57.9% and improvement in endoscopic findings was observed in 46.3% of the patients. Although there was some discrepancy between radiologic and symptomatic improvement rates, symptomatic improvement was significantly related with radiologic improvement. It is suggested that removal of obstructive lesion in the ostiomeatal area might be beneficial in a seemingly early symptomatic improvement, but complete healing of the maxillary sinus mucosa as assessed by OMU CT might take longer than 12 months.

Adolescent↗
PubMed1994

Hepatitis B and hepatitis C virus infection among chronic alcoholic patients with liver disease in Taiwan.

The prevalence of the anti-hepatitis C virus (anti-HCV) antibody and hepatitis B surface antigen (HBsAg) among 123 alcoholic patients with liver disease from our hospital and 44 alcoholic subjects from the local community was evaluated. By radio-immunoassay HBsAg was detected in 30.1% of alcoholic patients with liver disease, compared with 11.4% of alcoholic subjects from the local community (p < 0.05). The prevalence of HBsAg was 40.7% (11/27) in patients with cirrhosis and hepatocellular carcinoma (HCC), 31.5% (17/54) in patients with cirrhosis only, and 29.4% (5/17) in patients with other liver diseases. By enzyme-linked immunosorbent assay, anti-HCV antibody was detected in 30.9% of alcoholic patients with liver disease, compared with 2.3% of alcoholic subjects from the local community (p < 0.0005). The prevalence of anti-HCV antibody was 44.4% in alcoholic patients with cirrhosis and HCC, 29.6% in alcoholic patients with cirrhosis only, and 17.6% in alcoholic patients with other liver diseases. As the degree of liver damage advanced, the prevalence of either HBsAg or anti-HCV antibody, or both, being detected in these alcoholic patients increased significantly (p < 0.05). The serum ALT level was higher among alcoholic patients who had either HBsAg or anti-HCV antibody than those having neither (151 +/- 204 vs 62 +/- 47 IU/L; p < 0.005). All three alcoholic patients with chronic hepatitis had positive HBsAg or anti-HCV antibody. Histologic findings, except cells within sinusoids, were comparable between the alcoholic patients with or without superimposed hepatitis viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Active, bleeding marginal ulcer of Billroth II gastric resection: a clinical experience of 18 patients.

OBJECTIVES: From July 1988 to April 1993, 18 patients with active, marginal ulcer bleeding were investigated for their clinical presentation, endoscopic findings, and successful rate of therapeutic endoscopy. METHODS: Through endoscopic survey, data on the ulcer number, ulcer location, and prevalence rate of each major stigmata of recent hemorrhage were obtained. Therapeutic methods used include heater probe thermocoagulation and local injection with diluted epinephrine (0.01%) or 95% alcohol through the endoscope. RESULTS: All patients were male with a mean age of 65.3 years. Tarry stool passage (15/18; 83.3%) was the most common clinical presentation. Fifteen patients (15/18; 83.3%) had single marginal ulcer. Ulcerations were located in the jejunal site (12/18; 66.6%) and gastro-jejunal anastomosis (5/18; 27.7%). There were two patients with spurting artery, six with nonbleeding visible vessel, two with blood clot adhesion, four with oozing, three with visible vessel-associated oozing and three, with blood clot adhesion accompanying oozing. The rate of therapeutic endoscopy to successfully stop bleeding or prevent rebleeding was 94.4% (17/18). Sixteen cases (16/17) received one session of endoscopic therapy, and one patient (1/17) accepted two sessions. One patient with multiple underlying diseases died of persistent bleeding after three sessions of therapy. No complication was found to be related to the endoscopic procedure. CONCLUSIONS: Marginal ulcer bleeding exhibits the same endoscopic findings as peptic ulcer hemorrhage. Most marginal ulcers are single and located at the saddle area of the jejunal site. Endoscopy can be useful in diagnosing marginal ulcer, and it is safe and effective in managing active marginal ulcer bleeding.

Aged↗
PubMed1994

Endoscopic removal of a large intragastric foreign body with an overtube: a case report.

After amphetamine ingestion, a 39-year-old male attempted suicide by swallowing glass trifles, cigarette lighter and razor blades. All foreign bodies ingested were evacuated spontaneously and smoothly within one week, except for the 10-cm long lighter, which was removed by endoscopy via supplementary overtube with moderate difficulty. The subsequent clinical course was uncomplicated. More than 80% of the ingested foreign bodies which reach the stomach can be eliminated uneventfully through the gastrointestinal tract. The remainder may cause complications such as obstruction, perforation and hemorrhage. Usually the locations of obstruction are over the three anatomic narrowings of the esophagus, the pyloric ring and ileocecal valve. Perforation occurs with ingestion of long, sharp, metallic pointed objects or animal bones, and is more frequent among those who had previous abdominal surgery or intestinal diseases. Endoscopic removal as soon as possible is suggested for high risk groups, with use of the overtube method to prevent complications.

Adult↗
PubMed1994

Gallstone images on plain film and endoscopic retrograde cholangiopancreatography.

Different compositions of gallstone merit different treatments if a non-surgical method is chosen for these patients. In this study, gallstones collected from 125 patients were classified into cholesterol (pure, combination, mixed N = 28), brown (N = 64) and black (N = 41) stones by the Gallstone Classification of the Japanese Study Group (1986). Plain film and endoscopic retrograde cholangiopancreatography (ERCP) were reviewed in an attempt to predict the composition of the stones. We found that shape and location were highly correlated with stone composition. Most of the sandy stones were black stones (15/19, 79%); and 48% (10/21) of the irregular stones were brown stones; 70% (14) of facet stones were brown stones, 30% cholesterol stones. Stones in the gallbladder tended to be of the cholesterol type (47%, 13/28), 64% (51/81) of the bile duct stones were brown stones and 69% (11/16) of the gallbladder and bile duct stones were brown stones. We therefore conclude that imaging studies using plain film and ERCP is a fairly accurate means of predicting the composition of gallstone.

Bile Duct Diseases↗
PubMed1993

Scintigraphic diagnosis of syphilitic lesions in rabbits by radiolabelled monoclonal antibodies specific for Treponema pallidum.

Immunoscintigraphy with radiolabelled monoclonal antibodies has been widely used to detect solid tumours. The purpose of this study was to investigate its potential for the specific localization of syphilitic lesions. F(ab')2 fragments were prepared from murine monoclonal antibodies against Treponema pallidum produced in our laboratory and labelled with 131I. Bilateral testicular infections were created in rabbits by inoculation with T. pallidum or Staphylococcus aureus. Seven to 10 days after inoculation, radiolabelled antibodies were injected intravenously. Serial gamma images were then taken 2 h after the injection and at 24 h intervals thereafter. Beginning as early as 2 h post-injection, the testicles could be visualized with either specific or non-specific antibodies. Gamma images in the monoclonal antibody-treated, T. pallidum-infected group persisted up to 48 h post-injection. Lesions were not discernible from background in the S. aureus-infected group injected with the monoclonal antibody and the S. aureus-infected and T. pallidum-infected groups injected with the polyclonal antibody at 24 h post-injection or later. Therefore, due to its ability to differentiate between specific and non-specific antibody-generated images from 24 h post-injection, immunoscintigraphy using monoclonal antibodies specific for T. pallidum may be employed as one of the methods to diagnose difficult cases of syphilitic internal organ involvement as well as syphilis infection in seronegative HIV-infected patients.

Animals↗
PubMed1993

Possible roles of LFA-1 and Fc gamma receptors on the functional immaturities of cord blood polymorphonuclear leukocytes.

The functional immaturity of PMNs is one of the major causes of overwhelming sepsis in newborns. In this study, we observed functions and surface markers of PMNs to investigate what causes the functional immaturity of PMNs in newborns. As results, the percentage of EA rosette forming PMNs (58.5 +/- 15.5%) and the chemotactic movement (0.14 +/- 0.09 mm) of cord blood PMNs were significantly lower than those of adult peripheral blood PMNs (70.8 +/- 9.9%, 0.60 +/- 0.34 mm). Cord blood PMNs showed decreased glass adherence and ADCC activity. The expression of Fc gamma RII or Fc gamma RIII was a little lower than those of adult peripheral blood PMNs, but the expression of Fc gamma RI (43.1 +/- 26.8%) was significantly higher than that of adult peripheral blood PMNs (3.2 +/- 1.8%). There was a significant difference in LFA-1 expression between EA rosette forming PMNs (92.9 +/- 9.1%) and EA rosette non-forming PMNs (25.6 +/- 22.6%). From these results, it is assumed that neonatal PMNs may consist of heterogeneous populations. And the relatively high percentage of EA rosette non-forming PMNs which express a low level of LFA-1 may be responsible for the functional immaturity of cord blood PMNs.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1993

Effect of polyadenylic.polyuridylic acid on cellular responses of peripheral blood mononuclear cells from patients with chronic active hepatitis B.

We have investigated in vitro proliferative responses of peripheral blood mononuclear cells and productions of interferon-gamma and soluble interleukin-2 receptors by these cells from 6 patients with chronic active hepatitis B immediately before and 24 hours after a single intravenous injection of 100 mg of polyadenylic.polyuridylic acid. Cell proliferations were assessed by the technique of tritiated-thymidine incorporation and productions of interferon-gamma and soluble interleukin-2 receptors were measured by enzyme-linked immunosorbent assay. The administration of polyadenylic.polyuridylic acid to the patients has resulted in significant increases of in vitro proliferations of their peripheral blood mononuclear cells as well as productions of interferon-gamma by these cells. However, in vitro productions of soluble interleukin-2 receptors were not changed significantly. These results suggest that the enhanced cellular responses by polyadenylic.polyuridylic acid might be due to the increased sensitivity rather than the increased expression of cellular interleukin-2 receptor.

Adult↗
PubMed1993

Production of tumor necrosis factor by intravesical administration of bacillus Calmette Guérin in patients with superficial bladder cancer.

Although an immune response to bacillus Calmette Guérin (BCG) has often been associated with antitumor activity, the action mechanism(s) of intravesical BCG therapy for prophylaxis and treatment of superficial bladder cancer is not clearly understood. In an attempt to evaluate the roles of tumor necrosis factor (TNF)-alpha and lymphotoxin (LT) in the antitumor activity, TNF-alpha productivities by peripheral blood monocytes, serum levels of TNF-alpha, and LT productivities by peripheral blood lymphocytes were studied in superficial bladder cancer patients after six intravesical administrations of BCG. TNF-alpha productivities by peritoneal macrophages of guinea pigs were also studied after six intravesical administrations of BCG. The maximum TNF-alpha productivities by peripheral blood monocytes of superficial bladder cancer patients were seen after the fourth week of administration of BCG, and the serum TNF-alpha levels were also slightly increased after intravesical BCG administration in the superficial bladder cancer patients. LT productivities by peripheral blood lymphocytes of superficial bladder cancer patients were significantly enhanced and the maximum LT productivity was also seen after the third or fifth BCG administration. TNF-alpha productivities by peritoneal macrophages of guinea pigs were significantly enhanced and the maximum TNF-alpha productivity was seen after the second or third BCG administration. Our data might suggest that six consecutive intravesical BCG administrations could induce the increased productions of TNF-alpha and LT, which might play an important role in the antitumor activity in superficial bladder cancer.

Administration, Intravesical↗