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Biomedical subjects

M H Wu

Publications and source records attributed to M H Wu.

At least 145 records · Page 8Linked to original sources
PubMed1996

Immunohistochemical analysis of nm23-H1 in stage I non-small cell lung cancer: a useful marker in prediction of metastases.

BACKGROUND: About 30% to 40% of patients with pathologic stage I non-small cell lung cancer die within 5 years after complete resection. The identification of subgroups with high risk of recurrence is important. The level of nm23-H1/nucleoside diphosphate kinase expression has been reported to correlate inversely with the metastatic potential of some tumors. METHODS: We examined immunohistochemically the expression of nm23-H1 in 32 stage I non-small cell lung cancers to determine its value in predicting the outcome of the operation. RESULTS: Twelve (37.5%) recurrences and ten deaths occurred in this series. There were eight (25%) distant and four (12.5%) locoregional recurrences. Of the 32 pathologic stage I non-small cell lung cancers, 10 (31.3%) were positive for nm23-H1 gene product. None of the patients with a higher nm23-H1 protein level had detectable distant metastases at the end of this study (chi 2 test, p < 0.05). The median follow-up time to date is only 35 months (range, 18 to 83 months), and so far no significant difference in overall survival rate has been observed between the groups with high and low nm23-H1 protein levels. CONCLUSIONS: The level of nm23-H1 protein is more useful than the T status or histologic type for the prediction of distant metastases, whereby cases may be selected for postoperative adjuvant chemotherapy.

Aged↗
PubMed1996

C-reactive protein for the evaluation of acute abdominal pain.

The diagnostic value of C-reactive protein (CRP) was established in 143 patients with acute abdominal pain, 67 men and 76 women with mean age of 48 +/- 20 years old. Clinical and laboratory variables were collected after the patients' arrival at the emergency department. The attending clinicians did not consider the CRP value during the study period and did not use it for their management. When patients were grouped by final disposition, which was according to severity, only CRP and leukocyte count were identified as significant quantitative variables by multivariate analysis. CRP can detect the serious conditions, ie, in 79% of the hospitalized group, although specificity was 64%, the total accuracy was 73%. When elevated CRP was combined with leukocytosis, the diagnostic value was much improved, with specificity of 89% and positive predictive value of 88%. The sensitivity was improved to 90% when elevated CRP or leukocytosis was used. It is thus concluded that CRP is a helpful quantitative variable for disposition decision-making in patients with acute abdominal pain.

Abdomen, Acute↗
PubMed1996

Electrophysiological mechanisms for the antiarrhythmic action of (-)-caryachine in rat heart.

(-)-Caryachine (CNMe) is a pavine derivative, isolated from Cryptocarya chinensis Hemsl. We wished to illustrate the electrophysiological effect and antiarrhythmic potential of this compound on rat cardiac tissues. Action potential and ionic currents in single ventricular cells were examined by current clamp or voltage clamp in a whole-cell configuration. CNMe concentration-dependently suppressed the maximum rate of rise of the action potential upstroke (V(max)) and prolonged the action potential duration at 50% of repolarization (APD(50)). A voltage-clamp study showed that the suppression of V(max) by CNMe was associated with an inhibition of sodium inward current (I(Na), IC(50), O = 4.1 microM). The prolongation of APD(50) was associated with an inhibition of transient outward current (I(to), IC(50) = 16.1 microM). CNMe reduced the I(Na) with a negative shift of its voltage-dependent steady-state inactivation curves and slowing of its recovery from inactivation. The use-dependent inhibition of I(Na) by CNMe was enhanced at a higher stimulation rate or at a longer prepulse duration. The fraction of fast recovery of I(Na) was reduced, but the recovery time constant of fast recovery component remained unaffected. The inhibition of I(to) by CNMe (10-30 microM) was associated with an acceleration of its time constant of inactivation. According to the analysis of the time course of inhibition of I(to), CNMe inhibited I(to) in a time-dependent manner. In isolated heart, CNMe could effectively inhibit ischemia/reperfusion-induced ventricular tachycardia with an EC(50) of 3.9 microM. The results indicate that CNMe is a strong I(Na) blocker with some I(to) blocking activity. The inhibition of I(Na), and I(to) may contribute to its antiarrhythmic activity against ischemia/reperfusion arrhythmia.

Action Potentials↗
PubMed1996

Results of surgical treatment of 107 patients with complications of pulmonary tuberculosis.

The objective of this study was to evaluate the results of surgical intervention performed on 107 patients with pulmonary tuberculosis complications. Between September 1988 and December 1995, 107 patients underwent a total of 126 operations for major complications of pulmonary tuberculosis. One hundred and twenty-six operations consisted of lobectomies only or plus other lung resections performed in 55 cases, pneumonectomies in 20 cases, segmentectomies in 18 cases, wedge resections in two cases, tracheobronchoplasties in four cases, decortications in two cases, cavernostomies with concomitant muscle transpositions in seven cases, thoracoplasties reserved for the previously failed operations or to be a supplement for pulmonary resections in 18 cases. The operative mortality rate was of 1.8%, and the major complication rate was of 16.8%. Twenty-eight (26.1%) patients with tuberculosis bacilli in sputum before operation have converted except one diabetic patient. In conclusion, surgery is indicated in pulmonary tuberculosis complications that are life-threatening or unresponsive to chemotherapy. Pulmonary resection is the procedure of choice for most cases that require surgery.

Adolescent↗
PubMed1996

Electrophysiological mechanisms for antiarrhythmic efficacy and positive inotropy of liriodenine, a natural aporphine alkaloid from Fissistigma glaucescens.

1. The antiarrhythmic potential and electromechanical effects of liriodenine, an aporphine alkaloid isolated from the plant, Fissistigma glaucescens, were examined. 2. In the Langendorff perfused (with constant pressure) rat heart, at a concentration of 0.3 to 3 microM, liriodenine was able to convert a polymorphic ventricular tachyrhythmia induced by the ischaemia-reperfusion (EC50 = 0.3 microM). 3. In isolated atrial and ventricular muscle, liriodenine increased the contractile force and slowed the spontaneous beating of the right atrium. 4. The liriodenine-induced positive inotropy was markedly attenuated by a transient outward K+ channel blocker, 4-aminopyridine (4-AP) but was not significantly affected by prazosin, propranolol, verapamil or carbachol. 5. In rat isolated ventricular myocytes, liriodenine prolonged action potential duration and decreased the maximal upstroke velocity of phase 0 depolarization (Vmax) and resting membrane potential in a concentration-dependent manner. The action potential amplitude was not significantly changed. 6. Whole-cell voltage clamp study revealed that liriodenine blocked the Na+ channel (INa) concentration-dependently (IC50 = 0.7 microM) and caused a leftward shift of its steady-state inactivation curve. However, its recovery rate from the inactivated state was not affected. The L-type Ca2+ currents (Ica) were also decreased, but to a lesser degree (IC50 = 2.5 microM, maximal inhibition = 35%). 7. Liriodenine inhibited the 4-AP-sensitive transient outward current (Ito) (IC50 = 2.8 microM) and moderately accelerated its rate of decay. The block of Ito was not associated with changes in the voltage-dependence of the steady-state inactivation curve or in the process of recovery from inactivation of the current. Liriodenine also reduced the amplitude of a slowly inactivating, steady-state outward current (Iss) (IC50 = 1.9 microM). These effects were consistent with its prolonging effect on action potential duration. The inwardly rectifying background K+ current (IK1), was also decreased but to a less degree. 8. Compared to quinidine, liriodenine exerted a stronger degree of block on INa, comparable degree of block on IK1, and lesser extent of block on ICa and Ito. 9. It is concluded that, through inhibition of Na+ and the Ito channel, liriodenine can suppress ventricular arrhythmias induced by myocardial ischaemia reperfusion. The positive inotropic effect can be explained by inhibition of the Ito channel and the subsequent prolongation of action potential duration. These results provide a satisfactory therapeutic potential for the treatment of cardiac arrhythmias.

Action Potentials↗
PubMed1996

Catheter ablation of junctional ectopic tachycardia by guarded low dose radiofrequency energy application.

The prognosis of junctional ectopic tachycardia has been poor. A 9-year-old boy with dilated cardiomyopathy and this incessant form of tachycardia underwent RF ablation. Without retrograde atrial depolarization during tachycardia, serials of low dose RF energy were applied near the His-bundle area to find out the arrhythmogenic foci. The optimal site for ablation showed rate acceleration at low dose application and rate slowing down followed by conversion upon increasing the energy. By using this guarded low dose ablation technique, the tachycardia was eliminated without AV block. The LV function also improved.

Cardiomyopathy, Dilated↗
PubMed1996

Incidence of post-transfusion hepatitis in Taiwan before and after introduction of anti-HCV testing.

The effectiveness of second-generation anti-hepatitis C virus antibody (anti-HCV) screening of blood donations for the prevention of non-A, non-B post-transfusion hepatitis (NANB PTH) was assessed. A prospective study of 192 transfusion recipients was performed to compare the incidence of NANB PTH after the introduction of the second-generation anti-HCV test with the incidence before its introduction. We used a polymerase chain reaction to detect HCV-RNA and HBV-DNA in the sera of patients with NANB PTH. The incidence of acute post-transfusion hepatitis C was 11% (8 of 71) before the screening for anti-HCV as compared with 2.5% (3 of 121) after the screening (p < 0.05). Viremia was detected within the first five weeks of infection in 10 patients with acute post-transfusion hepatitis C. However, there was no significant difference in the incidence of non-A, non-B, non-C (NANBNC) PTH before screening (3 of 71, 4.2%) compared with after screening (3 of 121, 2.5%). Usually, NANBNC PTH was not clinically important. Anti-HCV screening of blood donors significantly reduces the incidence of post-transfusion hepatitis C, but not the incidence of NANBNC PTH.

Adolescent↗
PubMed1996

Left common carotid artery arising from the pulmonary artery in a patient with DiGeorge syndrome.

A female infant, born at 33 weeks' gestation with tetralogy of Fallot, died of severe perinatal asphyxia 6 hours after birth. Necropsy disclosed two associated vascular anomalies: a right aortic arch with a left common carotid artery arising from the pulmonary artery (isolated left common carotid artery) and an aberrant left subclavian artery arising from the descending aorta. Agenesis of the thymus and parathyroid gland was also found, suggesting that the child also had DiGeorge syndrome. Origin of the left common carotid artery from the pulmonary artery is exceedingly rare. When planning surgical treatment it is important to be aware of the possibility of this anomaly occurring in association with congenital heart disease, particularly in the presence of tetralogy of Fallot, right sided aortic arch, or DiGeorge syndrome.

Carotid Artery, Common↗
PubMed1996

Anomalous pulmonary venous pathway traversing pulmonary parenchyma. Diagnosis and implication.

STUDY OBJECTIVES: To describe four patients having total anomalous pulmonary venous connection with an intrapulmonary vertical vein, rendering difficulty in diagnosis and surgery. SETTING: a tertiary referral center. PATIENTS AND METHODS: By reviewing medical records, 4 of 25 patients with right atrial isomerism and total anomalous pulmonary venous connection were identified to have an intrapulmonary vertical vein. All four patients underwent echocardiography, catheterization, and angiography. One underwent MRI. Two underwent open-heart surgery and one received a modified Blalock-Taussig shunt. RESULTS: Right atrial isomerism was present in all four patients. On chest x-ray films, an abnormal shadow resembling scimitar syndrome was seen in two patients. Imaging the vertical vein was unsuccessful with an echocardiogram in all four patients. The intrapulmonary course of the vertical vein was depicted with a pulmonary venogram in two patients and with magnetic resonance in one patient. The intrapulmonary segment remained undetected until autopsy in one patient. All four patients died. At autopsy, the pulmonary venous confluence was hypoplastic in all four hearts. The vertical vein was buried in pulmonary parenchyma and drained to superior vena cava with significant obstruction. CONCLUSION: In the presence of right atrial isomerism and total anomalous pulmonary venous connection, there may be an intrapulmonary pulmonary venous connection that may be obstructed. Anastomosing the pulmonary venous confluence to the atrium may be difficult because of hypoplasia of the pulmonary venous confluence.

Anastomosis, Surgical↗
PubMed1996

Clinical presentation and prognostic factors in sodium monofluoroacetate intoxication.

BACKGROUND: The diagnosis of sodium monofluoroacetate intoxication in humans is usually based on a history of ingestion and clinical findings. Although several previous reports have described the clinical course and outcome of patients who ingested this drug, prognostic indicators of short-term survival are not available. METHODS: A retrospective study of 38 consecutive cases of sodium monofluoroacetate poisoning at the National Cheng Kung. University Hospital, 1988-1993, to analyze the clinical findings and to predict mortality. RESULTS: Seven of 38 patients (18%) died. The most common symptom was nausea or vomiting (74%). The most frequent ECG finding was nonspecific ST-T and T wave abnormalities (72%). Hypocalcemia (42%) and hypokalemia (65%) were the common electrolyte abnormalities. The clinical and laboratory characteristics were compared for the survival and mortality groups. Significant differences in hypotension, respiratory rate, pulse rate, creatinine, potassium, elevated alanine aminotransferase, pH, PCO2, APACHE II score, and subjective respiratory distress were noted. Discriminant analysis identified hypotension, increased serum creatinine, and decreased pH as the most important predictors of mortality, with sensitivity of 86% and specificity of 96%. CONCLUSIONS: Hypotension and the early onset of metabolic acidosis and increased serum creatinine are associated with poor short-term survival. These prognostic variables can be useful in the care of patients with suspected sodium monofluoroacetate intoxication. It is suggested that all such patients should be observed intensively for at least 48 h.

Adult↗
PubMed1996

Three- versus four-week administration of benzathine penicillin G: effects on incidence of streptococcal infections and recurrences of rheumatic fever.

OBJECTIVE: To investigate the effects of 3-week versus 4-week administration of benzathine penicillin G (BPG) on the incidence of Group A streptococcal infections and the recurrences of rheumatic fever (RF). STUDY DESIGN: We started, in 1979, randomly allocating all patients with RF to a 3-week or 4-week BPG prophylaxis program. They were examined at the RF clinic, every 3 to 6 months, and at any time they did not feel well. During 1979 to 1989, throat cultures and sera for antistreptolysin O and streptozyme titers were obtained at each clinic visit. Chest radiographs, electrocardiogram, color Doppler echocardiograms, and acute phase reactants were obtained. SUBJECTS: Two hundred forty-nine patients fulfilled the revised Jones criteria and were followed until December 1991: 124 in the 3-week and 125 in the 4-week program. Their age, sex, weight, percentage with history of RF, severity of cardiac involvement, follow-up duration, and compliance to program were comparable. Eight hundred eighty throat cultures were collected in the 3-week program and 770 were collected in the 4-week program. Six hundred sixteen and 627 sera were determined in each program for antistreptolysin O, and 582 and 592 sera for streptozyme titers. RESULTS: True streptococcal infections occurred in both programs: 39 infections in the 3-week program, and 59 infections in the 4-week program (7.5 vs 12.7 per 100 patient-years). Four infections with no antibody response occurred in the 3-week program, and three such infections in the 4-week program. Nine RF recurrences occurred in 8 patients in the 3-week program, and 16 recurrences in 16 patients in the 4-week program. Prophylaxis failure occurred in 2 of 124 patients in the 3-week program, and in 10 of 125 patients in the 4-week program (0.25 vs 1.29 per 100 patient-years). The overall recurrences/infections rate in each program was comparable, 13.6% vs 15.5%, but the recurrences/ infections rate due to prophylaxis failure was higher in the 4-week program than in the 3-week program, 3.0% versus 9.7%. CONCLUSIONS: This 12-year prospective and controlled study documented that streptococcal infections and RF recurrences occurred more often in the 4-week program than in the 3-week program. The risk of prophylaxis failure was fivefold greater in the 4-week program than in the 3-week program.

Adolescent↗
PubMed1996

Eosinophilic gastroenteritis with esophageal involvement.

Eosinophilic gastroenteritis is an unusual disease entity characterized by eosinophilic infiltration of the gut with gastrointestinal disturbance. The disease commonly involves the stomach and small bowel. Esophageal involvement is rarely reported. We present a patient with simultaneous achalasia, pyloric stenosis, and ascites. Macroscopically, the esophagus, stomach and small intestine were involved. Microscopically, the mucosa was involved to the serosa. The patient has remained well under low dose prednisolone treatment for 7 years since his condition was diagnosed.

Ascites↗
PubMed1996

Distribution of thymic hormones in thymic tumors and myasthenic thymus.

To understand the thymic hormone production in thymic tumors and the myasthenic thymus, we have studied the concentrations of two thymic hormones (prothmosin alpha and thymosin beta 4) in these tissues. A total of forty four thymus or thymic tumor tissues were obtained from patients who underwent thoracic operation. These tissues consisted of a control group (n = 25) and three study groups including a thymoma group (N = 8), thymic carcinoma group (n = 3) and myasthenic thymus group (n = 8). The age-related curve of the control group, which provided histologically normal thymic tissues for the production of prothymosin alpha and thymosin beta 4, was established. It was found that in the control group the concentrations (microgram/g tissue) of prothymosin alpha and thymosin beta 4 decreased with age, and that the ranges were from 171 micrograms/g to trace and from 243 micrograms/g to trace, respectively. The amounts were highest at puberty and then gradually decreased, and only trace amounts of both polypeptides were present at age 60. Study cases which deviated from the standard curves were identified. Our results indicated that the contents of thymic hormones significantly increased in the tissues of invasive or non-invasive thymoma, decreased in thymic carcinoma, and were not significantly changed in myasthenic thymus as compared with those of the age-related normal thymus tissues. These findings confirm the notion that only thymomas produce significantly higher thymic hormones.

Adolescent↗
PubMed1996

Mutual confounding and interactive effects between hepatitis C and hepatitis B viral infections in hepatocellular carcinogenesis: a population-based case-control study in Taiwan.

A population-based case-control study was conducted in Taiwan to determine the hepatitis C virus (HCV)-associated risk of hepatocellular carcinoma (HCC) in a hyperendemic area for hepatitis B virus (HBV) infection. A total of 58 recently diagnosed HCC patients and 225 matched community controls, who participated in a community-based liver cancer screening program, were recruited between March 1991 and March 1994. Control subjects were matched to HCC patients by age (+/- 5 years), sex, residence, and date of serum sample collection (+/- 3 months). Serum samples from all study subjects were tested for hepatitis B surface antigen (HBsAg) and antibodies to HCV (anti-HCVs) by enzyme immunoassays, as well as HCV RNA by reverse transcription-PCR assays. Accordingly, patients with HCC were more likely than were controls to be positive for HBsAg (82.8% versus 12.9%, with an odds ratio (OR) of 22.9), anti-HCVs (13.8% versus 4.4%, with an OR of 3.9), and HCV RNA (13.8% versus 5.8%, with an OR of 2.7). After adjustment for anti-HCVs and HCV RNA positivities, the matched ORs associated with HBsAg increased to 27.6 and 28.1, respectively, whereas the corresponding adjusted ORs for anti-HCVs and HCV RNA after controlling for HBsAg status were increased to 8.8 and 6.2, respectively. In the meantime, interactive effects between HCV and HBV on risk were also observed. Compared with those who were negative for both anti-HCVs and HBsAg, the matched ORs associated with the sole positivity of anti-HCVs and HBsAg were 4.0 (95% confidence interval = 0.7-24.0) and 24.6 (95% confidence interval = 9.5-64.1), respectively, whereas 6 HCC cases but none of control subjects were positive for both anti-HCVs and HBsAg. These results indicate that there are mutual confounding and interactive effects between HCV and HBV with respect to their links to HCC in this endemic area of chronic HBV infections.

Adult↗
PubMed1996

Infantile hypertrophic pyloric stenosis after surgery for esophageal atresia with tracheoesophageal fistula.

Infants with esophageal atresia and tracheoesophageal fistula may have other associated anomalies. The development of infantile hypertrophic pyloric stenosis in the postoperative course of esophageal atresia with tracheoesophageal fistula is rarely reported. Because its symptoms may mimick postoperative complications such as gastroesophageal reflux or anastomotic stricture, the diagnosis may be delayed. We report an infant who had surgery for esophageal atresia with tracheoesophageal fistula at birth. The infant presented with nonbilious projectile vomiting at 4 weeks of age. Plain abdominal x-ray, barium upper gastrointestinal series and abdominal ultrasonography all supported the diagnosis of hypertrophic pyloric stenosis. The diagnosis was confirmed during surgery. After pyloromyotomy, the patient's condition improved.

Abnormalities, Multiple↗
PubMed1996

Functional evaluation of esophageal substitutes.

BACKGROUND: The function of esophageal Substitutes is not comparable to the normal esophagus. METHODS: To clarify the difference between esophageal substitutes and the normal esophagus, radionuclide scintigraphy and clinical assessment were used as study methods. The study was conducted in groups of substernal colon (n = 9), substernal ileocolon (n = 6), posterior mediastinal colon (n = 6) and posterior mediastinal gastric tube (n = 14). The control group consisted of normal volunteers (n = 8). RESULTS: Patients with substernal ileocolon did not experience nocturnal regurgitation, which occurred often in other groups. All esophageal substitutes had a decreased clearance ability compared to the normal esophagus. Among these substitutes, the posterior mediastinal gastric tube had the shortest swallowing time, while the substernal ileocolon had the longest. The substernal colon had a significantly prolonged transit time. Among these study groups, neither differences of clearance ability nor those of alimentary reflux reached statistical significance. CONCLUSIONS: From the view point of food transit, it is suggested that a posterior mediastinal gastric tube or posterior mediastinal colon is the first choice of esophageal substitute.

Adult↗
PubMed1996

[119 emergency medical transport of the elderly].

A retrospective analysis of emergency ambulance transports in the EMS-Tainan was made to evaluate the utilization of emergency medical system by the elderly and to determine the factors that may influence these transports. The study group consisted of 4,090 emergency ambulance transports from 1/1/1195 to 30/4/1995. 1,017 patients (24%) were aged over 65. The main characteristics of these elderly patients were as follows: more non-trauma cases, higher severity of triage, and longer total transport time (23.0 +/- 0.5 vs. 18.9 +/- 0.2 minutes) were noted. In addition, 136 (13.4%) of the elderly patients were not received by the EMS network hospital. The most important factors that affect the total transport time in the elderly group were triage classification and trauma, which determined that speed of transport. In the elderly group, female patients tend to be older, of more severe triage classification, more nontrauma-related, have longer total transport time, and have less access to the EMS than male patient. Based on these results, we recommended make efficient transport in order to provide better emergency care for the elderly. A network linking the elder users with EMS dispatch center should improve the efficiency in fulfilling the EMS calls, and further investigation about the value of such a network is warranted. It is also important to establish a competent and countrywide database for EMS users and to pursue ongoing planning in order to evaluate and investigate the needs of EMS for elderly patients in the future.

Aged↗