Search PubMed⌕ Search

Biomedical subjects

K M Chan

Publications and source records attributed to K M Chan.

At least 181 records · Page 10Linked to original sources

Los Angeles County-University of Southern California Medical Center clinical pathology case conference: extreme hypermagnesemia in a neonate.

A preterm male infant born at 33 weeks of gestation developed respiratory depression and apnea at approximately 20 h after birth. Laboratory tests indicated severe hypermagnesemia, acidosis, and hypercalcemia. Cord blood and maternal blood concentrations of magnesium were normal. The effects and possible causes of hypermagnesemia are reviewed. The infant recovered with treatment, although the etiology of his hypermagnesemia remains unknown.

Acidosis↗

Detection of drugs-of-abuse in meconium of a stillborn baby and in stool of a deceased 41-day-old infant.

When blood or urine is unavailable, postmortem meconium or stool from infants or stillbirths can be used to detect drugs-of-abuse, thus providing datum in assessing drug-abuse exposure. Two case reports illustrate how drugs-of-abuse findings in post-mortem specimens were used to substantiate exposure prior to death or a history of maternal drug abuse. The first, a congenital hydrocephalus, born to a non-drug abusing mother, expired at the age of 41 days, had opiates in the stool by screening method, enzyme multiplied immunoassay technique, confirmed by gas chromatographic/mass spectrometric (GC/MS) analysis. Investigation revealed that morphine had been administered for three days prior to death. The second was a stillbirth infant born to a drug abuser. Almost equal amounts of benzoylecgonine were found in different bowel segments, a finding consistent with admitted cocaine use throughout pregnancy.

Adult↗

Acute abdomen: an atypical presentation of pubic osteomyelitis.

A 67-year-old woman was admitted with diffuse lower abdominal and suprapubic pain, with diastasis of the pubic symphysis. She developed an acute abdomen necessitating an exploratory laparotomy. During laparotomy, the pubic lesion was explored, and histology confirmed the diagnosis of pubic osteomyelitis and the presence of Staphylococcus aureus. The patient recovered fully with a four-week course of antibiotic therapy. This case confirms the protean presentation of pubic osteomyelitis, alerting physicians of the necessity to institute prompt treatment is such cases.

Abdomen, Acute↗

PCR-cloning of goldfish and tilapia metallothionein complementary DNAs.

Metallothionein (MT) is believed to be a sensitive and effective "biomarker" for monitoring metal contamination in fish. Comparison of amino acid sequences between flounder MT and trout MT revealed that there is a conserved region at their N-terminals. Using oligonucleotides derived from this conserved region, reverse transcription- polymerase chain reaction (RT-PCR) was performed to obtain MT complementary DNAs (cDNAs) from goldfish, Carassius auratus, and tilapia, Tilapia mossambica. These cDNA probes would be useful in developing sensitive PCR-based methods to detect MT gene expression for monitoring metal pollution in local waters.

Amino Acid Sequence↗

Sequence variation of the amino-terminal antigenic domains of glycoprotein B of human cytomegalovirus strains isolated from Chinese patients.

To study the genetic variation of human cytomegalovirus (HCMV) in Asian populations, the amino-terminal antigenic domains of glycoprotein B of HCMVs isolated from ethnic Chinese transplant patients were cloned and sequenced. The nucleotide and encoded amino acid sequences were compared with published sequences of AD169 and Towne laboratory strains. Within the region sequenced, 9 out of 15 clinical isolates (60%) possessed a peptide configuration similar to that of strain AD169 while 6 isolates (40%) displayed a peptide configuration similar to that of strain Towne. The nucleotide and amino acid identities of AD169-like clinical isolates exhibited variations of 95.4%-99.6% and 95.4%-100% respectively, whereas the identities of Towne-like clinical isolates were within the range of 97.3%-100% and 96.6%-100% at the nucleotide and amino acid levels. The previously defined neutralizing epitope was conserved among the clinical isolates sequenced while unique non-conservative amino acid substitutions were detected in the non-neutralizing epitope within the amino-terminal antigenic domain of glycoprotein B of all AD169-like isolates (Y- > S) and one of the Towne-like isolates (R- > Q).

Amino Acid Sequence↗

A fluorometric assay of peroxidase activity utilizing 2',7'-dichlorofluorescein with thiocyanate: application to the study of salivary secretion.

A sensitive assay for secretory peroxidase activity has been developed utilizing the fluorogenic substrate 2',7'-dichlorofluorescin in the presence of thiocyanate. The assay has been characterized using bovine lactoperoxidase and used to determine the peroxidase activities of salivas and extracts obtained from rat submandibular glands. Comparison of the 2',7'-dichlorofluorescin-thiocyanate assay and the commonly used 2,2'-azinobis(3-ethylbenzthiazoline-6-sulphonic acid) colorimetric assay indicates that the new assay is approx. 50-fold more sensitive. This has enabled measurement of peroxidase activities present in parasympathetic saliva samples which were beyond the detection limit of the colorimetric assay. Despite great differences in the peroxidase activities and protein concentrations of parasympathetic and sympathetic salivas and tissue extracts, the activities per unit protein were very similar. Unlike most other published methods, prior dialysis of samples to remove interference by endogenous thiocyanate is not required. The assay is therefore convenient and will be particularly useful for applications in which sample volume or peroxidase activity is low.

Animals↗

A fluorometric assay of peroxidase activity utilizing 2',7'-dichlorofluorescein with thiocyanate: application to the study of salivary secretion.

A sensitive assay for secretory peroxidase activity has been developed utilizing the fluorogenic substrate 2',7'-dichlorofluorescein in the presence of thiocyanate. The assay has been characterized using bovine lactoperoxidase and used to determine the peroxidase activities of salivas and extracts obtained from rat submandibular glands. Comparison of the 2',7'-dichlorofluorescein-thiocyanate assay and the commonly used 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) colorimetric assay indicates that the new assay is approx. 50-fold more sensitive. This has enabled measurement of peroxidase activities present in parasympathetic saliva samples which were beyond the detection limit of the colorimetric assay. Despite great differences in the peroxidase activities and protein concentrations of parasympathetic and sympathetic salivas and tissue extracts, the activities per unit protein were very similar. Unlike most other published methods, prior dialysis of samples to remove interference by endogenous thiocyanate is not required. The assay is therefore convenient and will be particularly useful for applications in which sample volume or peroxidase activity is low.

Animals↗

Endogenous skeletal muscle antioxidants.

Skeletal muscle is susceptible to oxidative deterioration due to a combination of lipid oxidation catalysts and membrane lipid systems that are high in unsaturated fatty acids. To prevent or delay oxidation reactions, several endogenous antioxidant systems are found in muscle tissue. These include alpha-tocopherol, histidine-containing dipeptides, and antioxidant enzymes such as glutathione peroxidase, superoxide dismutase, and catalase. The contribution of alpha-tocopherol to the oxidative stability of skeletal muscle is largely influenced by diet. Dietary supplementation of tocopherol has been shown to increase muscle alpha-tocopherol concentrations and inhibit both lipid oxidation and color deterioration. Dietary selenium supplementation has also been shown to increase the oxidative stability of muscle presumably by increasing the activity of glutathione peroxidase. The oxidative stability of skeletal muscle is also influenced by the histidine-containing dipeptides, carnosine and anserine. Whereas carnosine and anserine are affected by diet less than alpha-tocopherol and glutathione peroxidase, their concentrations vary widely with species and muscle type. In pigs, beef, and turkey muscle, carnosine concentrations are greater than anserine, while the opposite is true in rabbit, salmon, and chicken muscle. Anserine and carnosine are found in greater concentrations in muscle high in white fibers, with chicken white muscle containing over fivefold more anserine and carnosine than red muscle. Anserine and carnosine are thought to inhibit lipid oxidation by a combination of free radical scavenging and metal chelation.

Animals↗

Potent contractile actions of prostanoid EP3-receptor agonists on human isolated pulmonary artery.

1. In 13 of 15 experiments, prostaglandin E2 (PGE2) and sulprostone (a prostanoid EP1/EP3-receptor agonist) contracted isolated rings of human pulmonary artery at low concentrations (> or = 5 and > or = 0.5 nM respectively). Tissue was obtained from patients undergoing surgery mainly for carcinoma of the lung. Characterization of the receptors involved was complicated by loss of sensitivity to the contractile PGE action over the experimental period. In contrast, contractile responses to KCl, phenylephrine and the specific thromboxane (TP-) receptor agonist, U-46619, did not decrease with time. 2. The relative contractile potencies for seven PGE analogues, measured during the first few hours after setting up the preparations, were as follows: sulprostone > misoprostol = gemeprost > or = PGE2 > or = GR 63799X > 17-phenyl-omega-trinor PGE2 > or = 11-deoxy PGE1. This ranking indicates that an EP3-receptor is involved. 3. The contractile action of sulprostone was not blocked by the TP-receptor antagonists, EP 169 and GR 32191, and the EP1-receptor antagonist, AH 6809. 4. In two experiments, PGE2 (50 nM) reduced basal tone and sulprostone was a weak contractile agent. Phenylephrine-induced tone was also inhibited by PGE2 (EC50 = 5-20 nM), 11-deoxy PGE1 and butaprost (a selective EP2-receptor agonist); the latter prostanoids were about 2 and 4 times less potent than PGE2 respectively. Interactions with phenylephrine were different in experiments where PGE2 alone was contractile: PGE2 induced contraction superimposed on the phenylephrine response and 11-deoxy PGE1 induced either further contraction or had no effect. Butaprost produced relaxation at high concentrations;this may not be an EP2 action since preparations were highly sensitive to relaxant actions of prostacyclin (IP-) receptor agonists (cicaprost and TEI-9063).5 The study has shown that in the majority of experiments on the human isolated pulmonary artery,the contractile EP3 system outweighed the relaxant EP2 system. However, in two experiments the reverse was true. It is not clear to what extent these differences are due to disease processes affecting the tissues.The findings are discussed in relation to the adverse cardiovascular responses occasionally encountered during treatment of postpartum haemorrhage with sulprostone, and more generally to the clinical use of EP-receptor agonists in man.

Adolescent↗

Isokinetic profile of dorsiflexors and plantar flexors of the ankle--a comparative study of élite versus untrained subjects.

A comparative study was made of the isokinetic characteristics of the ankle (plantar-flexion and dorsiflexion) in young men. Six cyclists, seven gymnasts, 10 soccer players and 25 non-athletic young men were tested on the Cybex II+ dynamometer. Peak torque, torque acceleration energy (TAE), total work and average power were measured. Cyclists had slightly higher (5%) mean plantar flexion than the others, but this was not significant. The situation was reversed for dorsiflexion. Moreover, the average dorsiflexion per unit of plantar flexion was significantly higher in the gymnasts than it was in the cyclists for both torque and work. This suggests that at a specific level of plantar flexion, the gymnasts had stronger dorsiflexion compared with the cyclists and that in sports involving jumping and running, increased attention should be given to strengthening the antagonist muscle groups (dorsiflexors) in order to achieve greater agonist-to-antagonist muscle balance thus preventing injury. The non-athletic subjects had substantially lower endurance capability in both flexors as measured by the endurance ratio. This implies that identifiable specialization in particular muscles results from training or participating in specialized sports.

Acceleration↗

An epidemiological survey on ankle sprain.

Ankle sprain is a common sports injury and is often regarded as trivial by athletes and coaches. This epidemiological study was conducted among three categories of Hong Kong Chinese athletes: national teams, competitive athletes and recreational athletes. This study shows that as much as 73% of all athletes had recurrent ankle sprain and 59% of these athletes had significant disability and residual symptoms which led to impairment of their athletic performance. This study indicates that a proper approach towards injury prevention and a comprehensive rehabilitation programme are required.

Adolescent↗

In vivo secretory responses of submandibular glands in streptozotocin-diabetic rats to sympathetic and parasympathetic nerve stimulation.

Submandibular gland responses to sympathetic and parasympathetic nerve stimulation were studied in streptozotocin-diabetic rats. Morphologically, the acinar cells in control glands were relatively uniform in size and contained electron-lucent granules. The granular ducts were distinguished by the presence of electron-dense granules. With the exception of intracellular lipid droplets and the presence of a few autophagosomes in diabetic glands, no consistent differences in acinar cell structure were observed. In contrast, the diameter of the granular ducts and the granule content of their cells were less in diabetic glands. At 3 weeks sympathetic flow rate, salivary protein concentration, and total protein output were unaffected by diabetes. Sympathetic flow rate was greater at 3 months, and the concentration of protein in the saliva was lower. In 6-month diabetic rats flow rate remained increased, but protein concentration and total protein output were reduced. The decrease in salivary protein concentration at 3 and 6 months was accompanied by a reduction in secretory granule release from acinar and granular duct cells. No consistent differences in flow rate, protein concentration, protein output, or secretory granule release were observed following parasympathetic stimulation. We conclude that the effects of diabetes on nerve-stimulated flow rate and protein release depend on the duration of diabetes and the type of stimulation, and are independent of one another.

Animals↗

Comparative analysis of the NS 1 gene sequences of dengue-1 viruses prototype Hawaii strain and Thai isolate TH-Sman, and determination of the intratypic variation of NS 1 protein among dengue-1 viruses.

In view of a previous report on significant antigenic and biophysical differences between the purified soluble complement-fixing antigens of dengue-1 virus strains Hawaii and TH-Sman, the NS 1 genes of both virus isolates were cloned, sequenced, and compared in an attempt to define the genetic basis for the observed differences. Sequence comparison revealed ten encoded amino acid differences between the NS 1 genes of both viruses. Three of these amino acid differences, which are associated with a change in charge distribution, are clustered within the major antigenic region previously defined by studies of recombinant dengue-1 NS 1 protein expressed in E. coli. In parallel, the NS 1 sequences of both Hawaii and TH-Sman isolates were also aligned and compared with two other published dengue-1 NS 1 protein sequences to determine the intratypic variation of dengue-1 NS 1 antigen. Pairwise comparisons between the encoded amino acid sequences revealed a variability of 1.1% to 3.1% difference in the NS 1 protein among dengue-1 strains, which is comparable to that reported for dengue-1 envelope protein (0.2% to 3.6% difference) but less than that of dengue-2 NS 1 protein (0.6% to 7.4% difference).

Amino Acid Sequence↗

Asynchronous reformation of individual kallikrein-related secretory proteinases in rat submandibular glands following degranulation by cyclocytidine.

Time scales for the reformation of the secretory granules in granular tubules and their constituent proteinases were assessed after inducing a massive degranulation by intraperitoneal injection of cyclocytidine in conscious animals. The minimum working dose of cyclocytidine to produce the maximum degranulation and depletion of proteinase activity, at 3 h after injection, was 75 mg/kg. Histologically, although most granular tubule cells then appeared to be extensively degranulated, isolated individual cells showing little or no degranulation always persisted. Acinar cells also showed some depletion of secretory material. At 15 h after injecting cyclocytidine the formation of new granules had begun in the granular tubule cells, but it was not extensive or uniform in adjacent cells; however, the acinar cells already appeared to be regranulated. The pattern of granule reformation in granular tubule cells progressed gradually, so that 7-10 days after cyclocytidine-induced degranulation the cells were mostly packed with granules and showed similar appearances to those of normal resting control glands. Individual proteinases in extracts of the glands were assayed specifically using fluorogenic oligopeptide amidase substrates, with and without appropriate inhibitors. This revealed a 95% reduction in total proteinase activity 3 h after cyclocytidine (75 mg/kg). In the same extracts, acinar peroxidase was reduced by 28%. Peroxidase levels recovered to control values within 15 h after cyclocytidine but recovery of proteinases progressed more gradually and did not occur uniformly for the different constituent proteinases. Tissue kallikrein (rK1) showed the most rapid recovery and had reached levels approaching normal within 3 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Ancitabine↗

Frequency of cocaine and phencyclidine detection at a large urban public teaching hospital.

To assess the value of the current NIDA cutoff concentrations for screening assays that detect urinary cocaine metabolites and phencyclidine (PCP), we collected data on concentrations of these drugs in newborns and patients admitted to the Los Angeles County + University of Southern California Medical Center from July 1, 1991, to December 31, 1991. Less than 2% of the patients were positive for PCP. However, 16.5% of the newborns and 25.1% of the remaining age groups tested positive for cocaine metabolites. Among specimens that tested negative with the screening assays, approximately 3% (182 specimens, with 15 from newborns) clearly contained detectable amounts (between 50 and less than 300 ng/mL) of benzoylecgonine by GC/MS, while less than 0.6% had detectable amounts (10-25 ng/mL) of PCP. The mothers of 7 of the 15 newborns also had detectable benzoylecgonine at various concentrations. This indicates that a lower screening cutoff concentration may be desirable for cocaine metabolites in hospitalized patients. Among those patients positive for cocaine metabolites or PCP, most were males between 20 and 39 years old. The urine drug concentrations in this population were 4-300 times greater than the cutoff concentrations for the screening assays.

Adolescent↗

Evaluation of medical students in radiology. Written testing using uncued multiple-choice questions.

RATIONALE AND OBJECTIVES: Evaluation of uncued multiple-choice questions (UMCQ) was compared with traditional multiple-choice questions (MCQ) for assessing medical student performance during radiology electives. Methods for analyzing and improving the quality of UMCQ examinations are described. METHODS: The authors compared the performance of radiology medical students on similarly constructed MCQ and UMCQ tests. For the UMCQ examination, the reliability (coefficient alpha), standard error of measurement, item difficulty index, and corrected item-to-total test coefficient (point biserial correlation) were analyzed. RESULTS: Students' level of performance was lower on UMCQs (mean percent correct score = 68.9 +/- 10.2 standard deviation [SD]) than on MCQs (mean percent correct score = 75.6 +/- 12.4 SD). Coefficient alpha for the UMCQ format was .7690 (standard error of measurement mean = 4.89%). Analysis of the item difficulty index and point biserial correlation for each test item provided information for improving the quality of the UMCQ examination. CONCLUSIONS: Because the UMCQ measures students' abilities to recall critical information without providing cues, this format can be used to overcome some of the limitations of conventional MCQs. With simple computerization, analysis of UMCQ testing instruments provides important feedback to both the examinees and the examiner.

Education, Medical, Undergraduate↗

Partial patellectomy for patellar fracture: tension band wiring and early mobilization.

Partial patellectomy for patellar fracture was performed in 56 patients. The patellar tendon-to-bone repair was reinforced by a figure-of-eight tension band wire loop from the patella down to the tibial tubercle. Early mobilization and weight bearing of the injured extremity was initiated within the first postoperative week. Thirty-one patients treated between 1977 and 1980 were reviewed retrospectively at an average of 22 months (range 3-49 months). Twenty-five patients treated between 1984 and 1987 were studied prospectively: Knee function was monitored at 5.5 weeks after injury, at 3 months, and at final follow-up at a mean of 25 months (range 8-48 months). Satisfactory knee function was recovered by 3 months. No disruption of knee extensor mechanism was encountered. Complications were frequent in the retrospective series. A high percentage of patients had radiological osteoarthritis after the fracture. This could be due to alteration of the patellofemoral articulation after part of the patella was excised.

Adolescent↗