Biomedical subjects
Publications and source records attributed to M Tsai.
Patients with isolated total interruption of the arch of the aorta not accompanied by other cardiovascular anomalies may survive to advanced age. Their symptoms and course resemble those of patients with postductal coarctation of the aorta. However, there are basic differences in the pathologic findings in these two types of anomalies that may be of aid in the radiographic diagnosis.
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Nine of 15 elderly male VA outpatients receiving long-term tricyclic antidepressant therapy underwent gradual placebo substitution under double-blind conditions. Three of the 9 (33.3%) experienced a reoccurrence of depressive symptoms on placebo (at 4, 5 and 6 months). None of the 6 remaining on active medication experienced a reoccurrence. The Hamilton Depression Scale and Montgomery Asberg Depression Rating Scale scores indicate a significantly (P less than 0.05) worse outcome for those switched to placebo. The results suggest the need for close follow-up after discontinuation of antidepressant therapy in this population.
Stem cell factor (SCF), the ligand for the receptor (SCFR) that is encoded by the c-kit proto-oncogene, has many important effects in mouse and human mast cell development, survival, and function. SCF can promote mast cell survival by suppressing apoptosis, induce mast cell hyperplasia in murine rodents, experimental primates and humans, directly induce SCFR-dependent mast cell mediator release, and significantly modulate the extent of mast cell activation by Fc epsilon RI-dependent mechanisms. These findings raise several clinical issues and, in some cases, point to potentially significant therapeutic opportunities.
Diarrhea, constipation and subsequent laxative use are chronic problems in long-term enterally fed patients. We have conducted a double-blind randomized crossover study to evaluate the effects of two enteral formulae (Enrich, 12.8 g of dietary fiber per 1000 kcal and Ensure, fiber-free) on stool frequency, fecal weight, laxative use, gastrointestinal tolerance and bowel function in chronic care tube-fed patients. Twenty-eight subjects (24 male, 4 female) completed the study. Mean daily number of stools and mean daily fecal wet weight in Enrich-fed patients were not significantly different from those of patients receiving Ensure. Ensure-fed patients required significantly more laxatives (p = 0.02) than those receiving Enrich. There were 26 reports of diarrhea in the Ensure-fed group as compared to 6 in the Enrich-fed group, and this difference was significant (p = 0.006). Reporting rates for constipation were not significantly different in the two groups. At the end of the study, the bowel function of 57.1% of patients receiving Enrich was improved when compared with that of 14.3% of Ensure-fed patients, and this difference was significant (p = 0.005). These results suggest that the addition of dietary fiber to enteral formulae improves gastrointestinal tolerance and bowel function, and reduces laxative use in long-term enterally fed patients.
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