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Biomedical subjects

J T Lin

Publications and source records attributed to J T Lin.

At least 217 records · Page 12Linked to original sources
PubMed1989

A modified formula of GIK (glucose-insulin-potassium) therapy for treatment of extensive burn injury in dogs.

The effectiveness of a modified glucose-insulin-potassium (GIK) formula, which was derived from the results of a previous study (the maximal glucose disposal rate of 400 mg/M2/min required an insulin infusion rate at 1,200 mU/M2/min and KCl supplement rate at 0.08 mEq/M2/min), was evaluated in the treatment of extensive acute burn injury (EABI) in dogs. Under anesthesia initially with intravenous sodium pentobarbital 35 mg/kg followed by a maintenance dose of 5 mg/kg/hr, a third-degree burn of about 50% of the total body surface was created by acetylene torch over the ventral wall of the chest and abdomen. Cardiovascular parameters including heart rate, mean arterial blood pressure, pulmonary wedge pressure, cardiac index, and cardiac contractility (dP/dt of left ventricular pressure), as well as blood chemical data of pH value and K+ concentration were monitored. The present GIK therapy in EABI dogs effectively prevented a decrease in cardiac function, markedly enhanced cardiac function, steadily prolonged cardiac enhancement, and safely avoided hypoglycemic attack.

Acute Disease↗
PubMed1989

Effect of Ca on Na-D-glucose cotransport across isolated renal brush-border membranes.

Brush-border membrane vesicles were prepared from rat kidney cortex by Mg precipitation. Using quin2 (free acid), intravesicular [Ca2+] was found to be 44 microM and less than 300 nM when vesicles were incubated in 0.2 mM CaCl2 or Ca-free buffer, respectively. In Ca-loaded vesicles, the initial D-glucose uptake, measured in the presence of 150 mM Na+ and 0.1 mM D-glucose inward gradients, was reduced to 30% of the control uptake. This reduction persisted when the extra-vesicular Ca2+ was chelated by ethylene glycol-bis(beta-amino-ethyl ether)-N,N,N',N'-tetraacetic acid but was abolished in the presence of saturating concentrations of D-glucose. Whereas KG0.5 (g) for D-glucose at constant [Na] in the Ca-loaded membranes increased by approximately 50% of the control value (0.5 +/- 0.1 mM), no significant change in Jmax was observed. In contrast, both Jmax and KG0.5 (Na) for glucose, measured as a function of [Na] in the extravesicular fluid, were found to be significantly reduced. Na uptake, determined in the presence of 0.5 mM amiloride, was found to increase by approximately 30% of the value for control membrane. This increase was abolished when vesicles were preincubated with 0.5 mM neomycin or 0.5 mM phlorizin. The results suggest that the effect of Ca2+ on Na entry may be mediated in part by activation of phospholipase C and are consistent with a model of cotransport in which Ca2+ increases the mobility of the binary Na-sugar-translocator complex, thus leading to uncoupling of Na transport from glucose uptake ("slipping") and in part with Ca-induced Na entry by nonmediated leakage.

Animals↗
PubMed1989

Multiple-hormone-producing islet cell carcinoma: report of a case.

Although part of pancreatic endocrine tumors may be multihormonal by immunohistochemical study, the clinical manifestations are often related to hypersecretion of only one type of peptide hormone. Only a few cases have shown two or more syndromes simultaneously or transition of one type of syndrome to another with the passage of time. The case reported here is an islet cell carcinoma with liver metastases. The clinical manifestations changed from Zollinger-Ellison syndrome to hypoglycemic syndrome with the secretion of gastrin, insulin and serotonin. The immunohistochemical study confirmed multihormonal production. The elevation of growth hormone with acromegaly was also noted in this case. It remains to be seen if the excessive production of growth hormone was due to growth hormone-releasing hormone secreted by the endocrine pancreatic tumor or to the possible presence of a pituitary microadenoma as a component of the multiple endocrine neoplasia type I syndrome.

Adenoma, Islet Cell↗
PubMed1989

The diagnostic value of endoscopic ultrasonography in pancreatic disorders.

The introduction of endoscopic ultrasonography (EUS) makes it possible to demonstrate the pancreas in detail by intraluminal scanning. To assess the clinical usefulness of EUS in the diagnosis of pancreatic disorders, 33 patients with various pancreatic disorders were examined by conventional ultrasonography (US) and EUS concomitantly. There were 16 patients with pancreatic carcinomas: 7 chronic pancreatitis, 5 pseudocysts, 2 mucinous cystadenocarcinomas, one each serous cystadenoma, Von-Hippel-Lindau disease, and simple cyst of the pancreas. An Olympus EUS (Japan) radial type machine with a 7.5 MHz transducer with the balloon inflation method was used. The overall diagnostic sensitivity of conventional US (90.9%, 30/33) was as high as that of EUS (93.9%, 31/33), but the latter demonstrated pancreatic parenchyma more clearly. Three patients were misdiagnosed by conventional US. One patient with chronic calcifying pancreatitis, which was initially diagnosed as dilatation of the main pancreatic duct without evidence of calcifications by conventional US, was confirmed to have a trace of calcification by EUS and computed tomography. Two other patients, whose initial diagnosis was pseudocyst, were proved to have mucinous cystadenocarcinoma and serous cystadenoma respectively by EUS, as a result of improved image resolution. Two patients were misdiagnosed by EUS. One patient with carcinoma of the pancreatic head was missed by EUS because of a partially gastrectomized stomach which precluded successful observation. The other patient with cystadenocarcinoma of the pancreatic tail was misdiagnosed as pseudocyst by EUS due to non-visualization of a papillary crescent within a cystic tumor. We conclude that EUS and conventional US were complementary.(ABSTRACT TRUNCATED AT 250 WORDS)

Endoscopy↗
PubMed1989

[Changes in lung compliance and maximal expiratory flow-volume curves when breathing air and an He-O2 mixture in light smokers].

Lung compliance (CL) and maximal expiratory flow-volume curves (MEFV) breathing air and helium-oxygen mixture in 34 healthy nonsmokers and 55 young light smokers were studied. The difference of FEV1%, PEFR and MMEF between smokers and nonsmokers were statistically significant. The results of small airway function tests were compared and analysed. In the 55 smokers, 38(69.1%) showed frequency dependence of dynamic compliance (FDC), only 5(9.1%) had an abnormal V25/HT and 4(7.3%) showed an abnormal MMEF. of 48 smokers (31.3%) had an abnormal volume of isoflow (VisoV), We concluded that among the small airway function tests FDC is the most sensitive one in light smokers.

Adult↗
PubMed1989

Medical dissolution of gallstones by ursodeoxycholic acid: a clinical trial on 14 patients.

Fourteen patients with radiolucent gallstones proved by oral cholecystography (OC) and ultrasonography were treated with daily doses of 600 mg of ursodeoxycholic acid (UDCA) for one year. Among them, 2 patients had complete dissolution of gallstones and another one had partial dissolution. The success rate was 21.4% (3/14). Of the remaining 11 patients who failed to respond to UDCA treatment, calcifications of varied degrees were demonstrated in every gallstone by computed tomography (CT). None of these 14 patients had statistically significant changes in serum lipids, liver function tests and hemograms during the course of treatment and only one (7.1%) patient had transient diarrhea. It was concluded that UDCA was effective and safe for medical dissolution of non-calcified gallstones. However, the underestimation of the calcification of gallstones by OC precluded successful medical dissolution by UDCA. Therefore, meticulous selection of non-calcified gallstones by CT rather than OC as candidates for dissolution may improve the success rate.

Adult↗
PubMed1989

Intestinal capillariasis: report of a case.

Infection with Capillaria philippinensis has not been reported in Taiwan before. It is characterized by chronic diarrhea, abdominal pain and muscle wasting. Because the infection results in a severe disease with a high mortality, early diagnosis is very important. A 58-year-old housewife from Ar-Lien village, Kao-Hsiung County, was admitted to the National Taiwan University Hospital in July 1988, after suffering from diarrhea, lower leg edema and weight loss for one year. The initial symptom was epigastric pain followed by watery diarrhea. Thereafter borborygmus, frequent loose stool passage and weakness persisted. The cause of her malabsorption syndrome went undetected until the ova, larvae and adult worms of C. philippinensis were detected in the direct smear of the patient's stool in August 1988. She received mebendazole 200mg b.i.d. for 20 days. Capillaria ova were no longer detected following the third day of medication. At the second month follow-up, her body weight returned to her pre-morbid state and all laboratory findings returned to normal with the exception of mild anemia. The infection source was not clear.

Animals↗
PubMed1988

Impaired polyglutamylation of methotrexate as a cause of resistance in CCRF-CEM cells after short-term, high-dose treatment with this drug.

Two methotrexate-resistant sublines, CCRF-CEM R3/7 and CCRF-CEM R30/6, were selected from the human leukemia T-lymphoblast cell line, CCRF-CEM, after repeated exposures (7 and 6 times, respectively) for 24 h to constant concentrations (3 and 30 microM) of the drug. Analysis of the mechanism of resistance revealed no differences in levels of dihydrofolate reductase activity, its binding affinity for methotrexate, or in methotrexate transport between the CCRF-CEM parent and methotrexate-resistant cell lines. The development of resistance to methotrexate was associated with a marked decrease in the intracellular level of methotrexate polyglutamates. Although the resistant sublines were able to form substantial amounts of folate polyglutamates when measured with [3H]folic acid, the level of polyglutamates formed was decreased to about 50% of that formed by the parent cell line. No qualitative differences in folate polyglutamates formed were noted between the parental and resistant sublines. This is the first example of a cell line which displays resistance which is solely attributable to defective methotrexate polyglutamate synthesis.

Drug Resistance↗
PubMed1988

Carcinoma of the gallbladder from an anomalous connection between the bile duct and the pancreatic duct.

Anomalous connection between the common bile duct and the pancreatic duct has recently been reported to be associated with cancerous changes of the biliary tract. A 52-year-old Chinese man had a fungating tumor in the gallbladder, and a long common channel between the bile duct and the pancreatic duct. The association of these two rare disease entities especially in a Chinese man may imply a close relationship between pancreatobiliary anomalous connection and the gallbladder cancer. It is thus prudent to monitor patients with such an anomalous connection closely by serial ultrasonic examination. More aggressively, prophylactic cholecystectomy and reconstruction of the biliary tract may be indicated.

Adenocarcinoma↗
PubMed1988

Pancreatic carcinoma associated with chronic calcifying pancreatitis in Taiwan: a case report and review of the literature.

A 62-year-old Chinese woman suffering from pancreatic carcinoma coexisting with chronic calcifying pancreatitis is reported. Ultrasonography and computed tomography disclosed multiple intraductal calcifications in the pancreatic head and body and a tumor at the tail. Laparotomy revealed cancerous peritonitis in addition to verifying the presence of calcifications at the head and body and a cancer at the tail. Histology confirmed adenocarcinoma. The incidence of pancreatic carcinoma in chronic calcifying pancreatitis varied from 0.8 to 25% in a thorough review of the literature. It is emphasized that patients with chronic calcifying pancreatitis should be closely followed for detection of possible coexisting pancreatic malignancies.

Adenocarcinoma↗
PubMed1987

Phase I studies with trimetrexate: clinical pharmacology, analytical methodology, and pharmacokinetics.

Twenty-two patients with advanced solid tumors were treated with a quinazoline folate antagonist, trimetrexate, to determine the toxicity spectrum, the maximal tolerated dose, and the pharmacokinetics of the drug. Negligible toxicity was seen with single doses of 10-70 mg/m2 given as a 1-h infusion. Single doses of 120 mg/m2 infused over 1 h caused moderate to grade 4 toxicity in five of nine patients treated. Two patients who had no toxicity at this level were escalated to a dose of 213 mg/m2 with mild to moderate toxicity. The primary dose-limiting toxicity was myelosuppression. Moderate transaminase elevations, rash, anorexia, nausea and vomiting, and mucositis were occasionally seen. Although there was variation in dose tolerance to this drug, with selected patients able to tolerate higher doses, we consider 120 mg/m2 every 2 weeks to be the maximal tolerated dose, and the recommended Phase II starting dose. Trimetrexate plasma concentration-time curves were best described as biphasic (N = 9) or triphasic (N = 5) in form. The half-life of the terminal elimination-phase was 16.4 h. The mean residence time was 17.8 h. The volume of distribution of the plasma compartment and the volume of distribution at steady-state were 0.17 and 0.62 liter/kg, respectively. Plasma clearance was 53 ml/min. Plasma concentrations as determined by dihydrofolate reductase enzyme inhibition assay and high-performance liquid chromatography were initially identical, but diverged at later times. Divergences were seen also in urinary recovery as determined by the two methods. Both results suggest the appearance of metabolite(s) of trimetrexate which can inhibit dihydrofolate reductase. Measurable objective solid tumor responses were not seen in this Phase I study, although three patients with colon cancer had stable disease lasting 18, 26, and 26 weeks, respectively.

Chromatography, High Pressure Liquid↗
PubMed1987

Trimetrexate: a second generation folate antagonist in clinical trial.

Trimetrexate is a promising new lipophilic antifolate with antitumor and antimicrobial activity, which is currently undergoing clinical trials. It differs from methotrexate in its transport and intracellular retention, and may be useful against tumors resistant to methotrexate because of impaired transport or deficient polyglutamylation. In preclinical studies, it has demonstrated a broader spectrum of antitumor activity than methotrexate, and appears to have synergistic antitumor activity when combined with a number of other agents. In clinical trials, the primary toxicity has been hematologic, with rapid recovery and no evidence of cumulative dose effect. Nonhematologic toxicity has been sporadic. Preliminary results of phase II trials indicate activity against breast, non-small-cell lung, and head and neck tumors. In addition, trimetrexate with simultaneous leucovorin rescue appears to be a promising new treatment for pneumocystis pneumonia in AIDS patients, with minimal toxic side effects.

Animals↗
PubMed1987

Clinicopathologic studies of asymptomatic HBsAg carriers: with special emphasis on carriers older than 40 years.

To investigate the clinicopathologic features of asymptomatic carriers of hepatitis B surface antigen (HBsAg), liver biopsies were obtained in 140 carriers followed-up for more than 6 months. They included 47 older than 40 years and 75 with elevated SGPT values at least once during the follow-up period. Among the 93 carriers younger than 39 years, milder histologic changes than chronic persistent hepatitis (CPH) were seen in most of those with normal SGPT values, while more severe histologic changes (chronic lobular hepatitis, chronic active hepatitis and active cirrhosis) were found in 18 out of 50 with elevated SGPT values. In contrast, when the carriers were more than 40 years of age, the histologic liver changes became "bipolar", i.e., either very mild or quite severe, since among 47 subjects in this group, 37 (79%) had hepatic lesions milder than CPH, and the remaining 10 (21%) had cirrhosis. The positive rate of hepatitis B e antigen (HBeAg) was not significantly different among those with milder and those with more severe histologic changes in the younger group. However, that of the older carriers was significantly higher among those with liver cirrhosis (50% vs. 16.2%, p less than 0.05). The results imply that, in Taiwan where chronic HBsAg carriage usually occurs in early childhood, a poorer prognosis may exist in asymptomatic HBsAg carriers when HBeAg persists beyond the age of 40.

Adult↗