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Biomedical subjects

M W Ho

Publications and source records attributed to M W Ho.

At least 19 recordsLinked to original sources
PubMed2005

Use of interventional radiology in the management of mediastinitis of odontogenic origin.

Descending necrotising mediastinitis is a rare complication of odontogenic infection. The key to diagnosis is to maintain a high index of suspicion when antibiotics and adequate surgical drainage do not lead to resolution of symptoms. Open thoracic operation to drain mediastinal collections is potentially lethal and interventional radiological techniques are thought to reduce mortality. We report the use of interventional radiology in the diagnosis, monitoring and treatment of this condition and illustrate our experience with three case reports.

Abscess↗
PubMed2001

Implications of quantitative tumor and nodal regression rates for nasopharyngeal carcinomas after 45 Gy of radiotherapy.

PURPOSE: To quantitatively investigate the clinical implications of tumor regression rate (TRR-45) and nodal regression rate (NRR-45) of nasopharyngeal carcinomas (NPC) after receiving 45 Gy of radiotherapy (RT). The values, predictive values, and associated factors of TRR-45 and NRR-45 in NPC are analyzed. METHODS AND MATERIALS: One hundred one patients with newly diagnosed NPC and who were curatively treated by RT alone were included in the study. Tumor volume and nodal volume before treatment and after 45 Gy were obtained from computed tomographic (CT) scans performed at those times and calculated with the assistance of a computer-based imaging analyzing system. TRR-45 (NRR-45) was defined as the ratio of reduced tumor (nodal) volume after 45 Gy to the initial tumor (nodal) volume. TRR-45 (NRR-45) values were stratified into three groups of slow (below 50%), moderate (between 50% and 75%), and rapid (above 75%) change. After conventional RT with 45 Gy, conformal RT for primary tumors was boosted to 70.2-72 Gy for T1-2 tumors, and 75.6-81 Gy for T3-T4 tumors. RT for residual neck masses was boosted by electron beam to 61-75 Gy. RESULTS: The mean value of TRR-45 for all patients was lower than that of NRR-45 for the 78 patients with metastatic neck nodes (70% +/- 4.8% vs. 81% +/- 5%, p = 0.003). The 3-year actuarial neck control rate was better than the primary tumor control rate with statistical significance (98% vs. 85%, p = 0.009). No significant statistical differences concerning local control probability, nodal control probability, or survival rate were found among patients with slow, moderate, or rapid TRR-45 or NRR-45. T-stage was the only significant prognostic factor for locoregional control after multivariate analysis. Tumor volume and T-stage were found to have a statistically significant negative correlation with TRR-45. No associated factor was found to be significantly correlated with NRR-45. CONCLUSION: Slow regression rates of the primary tumor or neck nodes in NPC after receiving 45 Gy of irradiation do not mean ultimately poor radiocurability, but may merely imply slow clearance of the cells damaged during irradiation. The different radiobiological behaviors of the regression rates during treatment, ultimate control probabilities, or associated factors for regression rates of NPC between primary tumors and neck nodes need to be further investigated.

Adult↗
PubMed2001

Regulation of a human chloride channel. a paradigm for integrating input from calcium, type ii calmodulin-dependent protein kinase, and inositol 3,4,5,6-tetrakisphosphate.

We have studied the regulation of Ca(2+)-dependent chloride (Cl(Ca)) channels in a human pancreatoma epithelial cell line (CFPAC-1), which does not express functional cAMP-dependent cystic fibrosis transmembrane conductance regulator chloride channels. In cell-free patches from these cells, physiological Ca(2+) concentrations activated a single class of 1-picosiemens Cl(-)-selective channels. The same channels were also stimulated by a purified type II calmodulin-dependent protein kinase (CaMKII), and in cell-attached patches by purinergic agonists. In whole-cell recordings, both Ca(2+)- and CaMKII-dependent mechanisms contributed to chloride channel stimulation by Ca(2+), but the CaMKII-dependent pathway was selectively inhibited by inositol 3,4,5,6-tetrakisphosphate (Ins(3,4,5,6)P(4)). This inhibitory effect of Ins(3,4,5,6)P(4) on Cl(Ca) channel stimulation by CaMKII was reduced by raising [Ca(2+)] and prevented by inhibition of protein phosphatase activity with 100 nm okadaic acid. These data provide a new context for understanding the physiological relevance of Ins(3,4,5,6)P(4) in the longer term regulation of Ca(2+)-dependent Cl(-) fluxes in epithelial cells.

Calcium↗
PubMed2001

Anaylsis of birefringence during wound healing and remodeling following alkali burns in rabbit cornea.

The use of synthetic inhibitors of metalloproteinases (SIMP) or medroxyprogesterone (MP) can prevent or significantly delay the ulceration of alkali-injured corneas by influencing collagen degradation. We have examined the remodeling of rabbit corneal stroma following alkali injury and have assessed the effect of SIMP and MP treatment. Following a defined alkali injury to the rabbit cornea, animals were divided into three subgroups, one group treated with topical beta-mercaptomethyl tripeptide (SIMP), one treated by subconjunctival injection of MP and one treated with a control solution. The corneal tissue was taken at 3 days, 1, 2, 3, 4, 9 and 26 weeks after alkali injury and prepared for light microscopy and transmission electron microscopy (TEM). A quantitative measurement of birefringence, in terms of the optical path difference (OPD), was made using a modified polarized microscopy technique based on the analysis of interference colours. The results showed that SIMP effectively prevented deep corneal ulceration. MP could delay the ulceration and the corneas treated with MP appeared to have better transparency than the other groups. There was a significant difference of the OPD between the anterior (5.8 +/-0.3 nm) and posterior (7.8 +/-0.4 nm) stroma of the normal cornea (P<0.001). The OPD values from the central corneas from alkali-injured eyes were generally lower than normal during the first 4 weeks and then gradually recovered to the normal level or above, except for the posterior stroma of the MP-treated eyes. We found that the OPD changes were very dependent on the presence of corneal lesions. The stroma near corneal ulceration, scar tissue, calcified stroma and the retro-corneal collagen layer showed a significant reduction of birefringence (lower OPD values). These OPD values remained much lower than normal up to the end of the experiment. TEM showed disrupted corneal stroma in all three groups, with thinner scar tissue in the MP group. The fibril diameters did not change significantly 3 days and 1 week after the alkali burns (27.1+/-2.3 nm in the control group, 27.3+/-2.2 nm in the SIMP group and 27.7+/-2.1 nm in the MP group) and there were no differences compared with 29.7+/-1.7 nm of the normal cornea (P>0.05). After 2 weeks of tissue remodeling, the fibril diameters in alkali-injured corneas showed a large variation (the range was between 11.5 and 80 nm) with a bimodal distribution, especially in the control group. The technique presented here for birefringence evaluation can provide an alternative way to monitor wound healing and tissue remodeling, both visually and quantitatively.

Animals↗
PubMed2001

Microbial flora of root canal-treated teeth associated with asymptomatic periapical radiolucent lesions.

This study aimed to investigate the composition of microflora in endodontically treated teeth associated with asymptomatic periapical lesions in southern Chinese patients. Twenty-four teeth which had received nonsurgical root canal treatment more than 4 years previously, and which presents an acceptable coronal restoration with a periapical radiolucent area, were re-treated nonsurgically. Bacteriological samples were obtained after removal of the old root canal filling. The samples were inoculated on enriched trypticase soy agar and four selective media for incubation at 37 degrees C in both a carbon dioxide-enriched atmosphere and anaerobically. Eighteen teeth that had received gutta-percha root canal fillings were grouped for analysis, 12 (66.7%) of which contained cultivable microorganisms. The total colony forming units per ml of transport medium ranged from 0 to 2.3 x 10(5). The number of bacterial genera recovered ranged between 0 and 6, with facultative gram-positive cocci being the most prevalent group of bacteria isolated. Facultative anaerobic bacteria were present in all, whereas strict anaerobic bacteria were found in 3 out of the 12 teeth with positive growth. The size of the periapical rarefaction did not show any relationship with the quantity of microorganisms recovered. Coagulase-negative staphylococci, streptococci and Pseudomonas aeruginosa were most frequently isolated in this group of patients. The possible origin of these organisms is discussed.

Bacteria↗
PubMed2001

Investigation of an outbreak caused by methicillin-resistant Staphylococcus aureus in a cardiovascular surgery unit by ribotyping, randomly amplifed polymorphic DNA and pulsed-field gel electrophoresis.

An outbreak caused by rapid spread of methicillin-resistant Staphylococcus aureus (MRSA) in an intensive care unit for cardiovascular surgery was investigated by phenotypic and genotypic methods. Fourteen isolates were collected during a 2-month period from clinical and environmental specimens in the unit recently re-opened after reconstruction. The isolates were tested for antibiotic susceptibility patterns and genotyped by automated ribotyping, randomly amplified polymorphic DNA-PCR (RAPD) analysis and pulsed-field gel electrophoresis (PFGE). Automated ribotyping applying EcoRI digestion proved to be of no value in separating the isolates. In contrast, PFGE grouped the isolates into four clusters different from the reference strain. These results fully correlated with the antibiograms. Twelve of the isolates were grouped into two clonally related clusters. RAPD analyses grouped the isolates into five clusters. Except for two isolates of one patient, which had different RAPD patterns, PFGE and RAPD analyses presented very similar results. The results verified the usefulness of PFGE in studies of MRSA epidemics. A combination of these two methods reduces the time to identification of an outbreak and increases the accuracy in detection of intraspecies differences.

Base Sequence↗
PubMed2001

Different treatment outcomes of two intruded permanent incisors--a case report.

Intrusive luxation involves the displacement of the tooth apically into the alveolar socket. This type of injury represents a very complex wound, involving disruption of the marginal gingival seal, alveolar bone, periodontal ligament fibers, cementum and the neuro-vascular supply to the pulp, which results in severely compromised healing and possible complications. The case presented is a report of a 60-year-old lady who fell and intruded her two maxillary central incisors. The healing outcomes of the two central incisors were markedly different from each other even though they sustained similar injuries.

Alveolar Process↗
PubMed2001

Comparative study of ceftibuten and cefixime in the treatment of complicated urinary tract infections.

Between August 1996 and May 1998, a total of 62 patients who had complicated urinary tract infections treated at the Taipei Veterans General Hospital were enrolled into this study. This prospective, randomized, open-labeled trial aimed at comparing the efficacy and safety of ceftibuten and cefixime, prescribed each at a dose of 200 mg twice daily, in treating complicated urinary tract infection. Seventeen patients were later excluded from the analysis because of resistant pathogens (7 patients), uncomplicated urinary tract infection (6), initial culture negative for bacteria (3), and infective endocarditis (1). The remaining 45 patients were categorized into ceftibuten (n=23; mean age, 71.3 years) and cefixime (n=22; mean age, 62.8 years) treatment groups. No significant difference in demographic data and clinical characteristics was found between the 2 groups. The clinical efficacy rate (78.3% vs 77.3%, p=0.9) and bacteriological eradication rate (52.2% vs 63.6%, p=0.08) were similar between the ceftibuten and the cefixime group. Adverse effects caused by ceftibuten treatment included diarrhea and slight elevation of the serum level of liver transaminase in 2 (6.5%) patients. Those caused by cefixime treatment included slight elevation of serum level of liver transaminase in 2 (6.5%) patients and skin rash in 1 (3.2%) patient. All of these adverse effects resolved quickly after the regimen had been completed, and no patient discontinued the regimen because of the adverse effects. The results suggest that oral administration of ceftibuten 200 mg twice daily is as effective and safe as oral administration of cefixime 200 mg twice daily in the treatment of complicated urinary tract infections.

Adult↗
PubMed2000

Neuropeptide Y(5) receptors reduce synaptic excitation in proximal subiculum, but not epileptiform activity in rat hippocampal slices.

Neuropeptide Y (NPY) potently inhibits excitatory synaptic transmission in the hippocampus, acting predominantly via a presynaptic Y(2) receptor. Recent reports that the Y(5) receptor may mediate the anticonvulsant actions of NPY in vivo prompted us to test the hypothesis that Y(5) receptors inhibit synaptic excitation in the hippocampal slice and, furthermore, that they are effective in an in vitro model of anticonvulsant action. Two putative Y(5) receptor-preferring agonists inhibited excitatory postsynaptic currents (EPSCs) evoked by stimulation of stratum radiatum in pyramidal cells. We recorded initially from area CA1 pyramidal cells, but subsequently switched to cells from the subiculum, where a much greater frequency of response was observed to Y(5) agonist application. Both D-Trp(32)NPY (1 microM) and [ahx(8-20)]Pro(34)NPY (3 microM), a centrally truncated, Y(1)/Y(5) agonist we synthesized, inhibited stimulus-evoked EPSCs in subicular pyramidal cells by 44.0 +/- 5.7% and 51.3 +/- 3.5% (mean +/- SE), in 37 and 58% of cells, respectively. By contrast, the less selective centrally truncated agonist, [ahx(8-20)] NPY (1 microM), was more potent (66.4 +/- 4.1% inhibition) and more widely effective, suppressing the EPSC in 86% of subicular neurons. The site of action of all NPY agonists tested was most probably presynaptic, because agonist application caused no changes in postsynaptic membrane properties. The selective Y(1) antagonist, BIBP3226 (1 microM), did not reduce the effect of either more selective agonist, indicating that they activated presynaptic Y(5) receptors. Y(5) receptor-mediated synaptic inhibition was more frequently observed in slices from younger animals, whereas the nonselective agonist appeared equally effective at all ages tested. Because of the similarity with the previously reported actions of Y(2) receptors, we tested the ability of Y(5) receptor agonists to suppress stimulus train-induced bursting (STIB), an in vitro model of ictaform activity, in both area CA3 and the subiculum. Neither [ahx(8-20)]Pro(34)NPY nor D-Trp(32)NPY were significantly effective in suppressing or shortening STIB-induced afterdischarge, with <20% of slices responding to these agonists in recordings from CA3 and none in subiculum. By contrast, 1 microM each of [ahx(8-20)]NPY, the Y(2) agonist, [ahx(5-24)]NPY, and particularly NPY itself suppressed the afterdischarge in area CA3 and the subiculum, as reported earlier. We conclude that Y(5) receptors appear to regulate excitability to some degree in the subiculum of young rats, but their contribution is relatively small compared with those of Y(2) receptors, declines with age, and is insufficient to block or significantly attenuate STIB-induced afterdischarges.

Action Potentials↗
PubMed2000

Abdominal pregnancy presenting as a missed abortion at 16 weeks' gestation.

We report on an abdominal pregnancy that presented as a missed abortion at 16 weeks' gestation and review the literature on the management of abdominal pregnancy. The clinical presentation of abdominal pregnancy varies, and the diagnosis depends on a high index of suspicion. Ultrasonography is useful for early diagnosis of the condition. The management depends on the gestation at presentation; for advanced abdominal pregnancy, surgical intervention is recommended. The treatment of the placenta is a matter of controversy. In general, expectant management is suggested. When the placenta is left behind, the use of prophylactic methrotrexate is not advocated. An awareness of abdominal pregnancy is very important for reducing associated morbidity and mortality.

Abortion, Missed↗
PubMed1999

A prospective randomized study comparing hysteroscopy and curettage (H & C) under local anaesthesia (LA) and general anaesthesia (GA) in Chinese population.

OBJECTIVE: To compare the difference in patient's acceptance of local anaesthesia (LA) and general anaesthesia (GA) hysteroscopy and curettage in Chinese population. DESIGN: A prospective randomized study. SUBJECTS AND METHODS: In the period September 1994 to August 1995, all Chinese women with abnormal uterine bleeding or suspected uterine anomaly who warranted hysteroscopy and uterine curettage were invited to participate in this study with informed consent. They were randomly allocated to the control (i.e. GA) and study (i.e. LA) group. RESULTS: Overall 90% of the controls and 91% of the study group were satisfied with the procedure. The hysteroscopic diagnostic accuracy was 83%. Significantly higher percentage of patients in the study group opted for the same form of admission arrangement if given the choice. CONCLUSION: Hysteroscopy and curettage under LA and GA are equally acceptable in the Chinese population in Hong Kong. The patient satisfaction rate is high in both groups. Hysteroscopic diagnosis is highly accurate in malignant condition (100% sensitivity and 83% specificity).

Adolescent↗
PubMed1998

In vitro formation by reverse dialysis of collagen gels containing highly oriented arrays of fibrils.

Acid extracts of rat tail tendon were subjected to reverse dialysis against 0.5% PEG at 4 degrees C in an attempt to induce liquid crystallization. After 48 h, gel and fibril formation were initiated by continuing dialysis at 20 degrees C against the same PEG solution adjusted to pH 7.4. The inclusion of calcium- or magnesium chloride (final concentration 0.3-33 mM) in the collagen solution before dialysis resulted in strongly birefringent gels that showed a progressive rotation of the slow axis of birefringence with increasing distance from the lateral margin of the gel. The gels contained fibers running predominantly in the plane of the flattened gel and crossing at angles of between 55 degrees and 90 degrees. We suggest that liquid crystallization is responsible for this phenomenon and that it might be possible to exploit this to produce materials for tissue engineering.

Animals↗
PubMed1998

The acupuncture system and the liquid crystalline collagen fibers of the connective tissues.

We propose that the acupuncture system and the DC body field detected by western scientists both in here in the continuum of liquid crystalline collagen fibers that make up the bulk of the connective tissues. Bound water layers on the collagen fibers provide proton conduction pathways for rapid intercommunication throughout the body, enabling the organism to function as a coherent whole. This liquid crystalline continuum mediates hyperreactivity to allergens and the body's responsiveness to different forms of subtle energy medicine. It constitutes a "body consciousness" working in tandem with the "brain consciousness" of the nervous system. We review supporting evidence from biochemistry, cell biology, biophysics and neurophysiology, and suggest experiments to test our hypothesis.

Acupuncture Therapy↗