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Biomedical subjects

R C Chen

Publications and source records attributed to R C Chen.

At least 19 recordsLinked to original sources

Effects of concanavalin A on desensitization kinetics of GABA responses in Achatina fulica neurons.

The effects of the lectin concanavalin A (Con A), on the kinetics of desensitization of the responses of voltage clamped Achatina fulica LP5 neuron to microperfused acetylcholine (ACh) and GABA were compared. Both ACh and GABA elicited increases in chloride conductance which decayed biphasically during prolonged applications of these agonists; an initial rapid decay was followed by a later slow decay. Con A (5 micrograms/ml) accelerated both the fast and the slow decays of responses to ACh. Con A (5 micrograms/ml) also accelerated the fast decay of responses to GABA, but the slow decay was unaffected, even by 20 micrograms/ml or more of the lectin. It is suggested that, at least in the case of GABA receptor, the fast and slow decays involve distinct desensitization kinetics. The effects of Con A on the desensitization of the ACh and GABA responses were reversed by D-mannose, a competitive and specific inhibitor of Con A binding to membrane sugar residues. These results provide further evidence that receptor desensitization can be influenced by perturbing the sugar moieties associated with the subunits comprising these signalling macromolecules. The carbohydrate residues may play an important role in regulating desensitization of transmitter receptors.

Acetylcholine

Source localization of averaged and single EEG spikes using the electric dipole model.

A scheme for localizing the epileptic focus is proposed. The scheme is on the basis of a model with an electric dipole inside a four-layer inhomogeneous spherical model of head and utilizes a nonlinear programming algorithm applying the gradient projection method. Various initial estimates are used to prove the stability of the implemented dipole model. Fourteen single spike data and the averaged spike data are used to localize the epileptic focus. The results of the usage of the averaged spike data show that the dipole position is compatible with visual inspection of experienced clinical physicians. The results of the usage of the single spike show that 11 of the 14 single spikes have dipole locations near the result of the averaged spike but the estimated dipole moments differ markedly from one another. The localization results of the other three single spikes show that the dipole position is strongly affected by the background EEG. This kind of interference generally causes the eccentricity of the dipole to deviate from its anatomically meaningful value. According to our results, the electric dipole model is concluded to be valuable for the clinical application of localizing epileptic foci.

Algorithms

Evaluation of parametric methods in EEG signal analysis.

In this paper, a well designed database, considering statistical characteristics and including all types of Electroencephalogram (EEG) is built. 900 EEG segments, each with a short interval (1.024 sec) in this database are clustered into eight classes. Three tests of white noise for evaluating the efficiency of autoregressive (AR) and autoregressive-moving average (ARMA) models are proposed. The Akaike information criterion (AIC) is used for determining orders of AR and ARMA models. The AR model requires a higher model order (8.67 on the average) than the ARMA model (6.17 on the average). However, it is found that about 96% of the 900 segments can be efficiently represented by the AR model, and only about 78% of them can be efficiently represented by ARMA model. We therefore conclude that the AR model is preferred for estimating EEG signals.

Algorithms

The value of ultrasound measurement of gallbladder wall thickness in predicting laparoscopic operability prior to cholecystectomy.

We prospectively analysed 51 consecutive cases who underwent laparoscopic cholecystectomy from June 1992 to February 1993. There were 35 cases of chronic cholecystitis and 16 cases of acute cholecystitis. All underwent pre-operative ultrasonography, complete blood cell count, liver function test and endoscopic retrograde cholangiopancreatography. Of those 44 had post-operative ultrasound within the first 2 d and again on the seventh day. In 35 cases of chronic cholecystitis, 31 of 32 cases with a pre-operative gallbladder (GB) wall thickness of less than 6 mm were successfully resected laparoscopically. All three cases with a GB wall thicker than 6 mm were converted to open cholecystectomy. In acute cholecystitis, the wall thickness of the laparoscopic cholecystectomy group ranged from 2 to 9 mm (average 4 mm) and the wall thickness of the conversion group was 4-7 mm (average 6 mm). Post-operative fluid accumulation was noted in 28 (63.6%) cases. There was no correlation between post-operative pyrexia, duration of post-operative pain, clinical complications and the presence of fluid accumulation in the GB fossa. However, of four cases with increasing fluid on the seventh day, three developed complications. We conclude that ultrasonography is valuable in chronic cholecystitis for selecting cases for laparoscopic cholecystectomy.

Adult

Laparoscopic cholecystectomy can disseminate in situ carcinoma of the gallbladder.

BACKGROUND: Early case reports suggest more frequent and rapid recurrences of carcinoma of the gallbladder after laparoscopic cholecystectomy (LC) than after open cholecystectomy. This cancer has a poor prognosis and occurs in 1 percent of patients who undergo cholecystectomies. STUDY DESIGN: A recent community hospital series of gallbladder carcinoma (GBC) was reviewed and the total reported experience of GBC after LC was compiled. Diagnostic findings were compared for patients with GBC and a consecutive series of 24 patients who had LC for benign disease. RESULTS: Nine patients with GBC were found among 928 patients who had undergone cholecystectomy (0.97 percent incidence). Compared to patients without GBC, patients with carcinoma were older, had thicker gallbladder walls, and had more abnormalities detected intraoperatively (all p < or = 0.05). Recurrence of GBC occurred more rapidly after LC, and in diffuse peritoneal and port sites when compared with recurrence patterns after open cholecystectomy. CONCLUSIONS: In patients with GBC, LC may be sufficient when the disease is confined to the gallbladder mucosa and the gallbladder is excised intact without bile spillage. However, patients whose gallbladders are torn during dissection or patients who have invasive tumors should undergo laparotomy and local reexcision. In situ GBC can be implanted if the organ is torn during dissection. When gallbladders with suspicious wall thickening or adhesions are noted at LC, especially in older patients, the procedure should be converted to open cholecystectomy.

Aged

Anticardiolipin antisera from lupus patients with seizures reduce a GABA receptor-mediated chloride current in snail neurons.

The effects of circulating anticardiolipin (ACL) antisera in lupus patients on the LP5 central neuron of snail were studied. Both GABA and glutamate increased a chloride conductance of the LP5 neuron. The ACL antisera decreased the GABA-elicited responses in a concentration dependent manner while it had no effect on glutamate-elicited responses. The ACL antisera affected neither the resting membrane current, nor the membrane conductivity of neuron. Antisera without the activity of anticardiolipin did not decrease the GABA-elicited responses. The seizure incidence of the patients with higher ACL antisera levels is also higher. It is concluded that ACL antisera inhibited the GABA ionophore receptor complex in a snail central neuron.

Animals

Interactions of anticholinesterases with Achatina fulica acetylcholine responses and electrogenic sodium pump.

The dose-dependent effects of the anticholinesterases, neostigmine and mycotoxin territrem-B, were determined on: (i) Cl(-)-responses of voltage clamped Achatina fulica neurons to microperfused acetylcholine; (ii) the 4 K(+)-induced outward currents evoked by an electrogenic sodium pump in the same neuron; and (iii) acetylcholinesterase activity of Achatina fulica ganglionic homogenates. Both compounds at low doses potentiated the peak acetylcholine responses. However, they had different effects at higher (> 1 microM) doses in that neostigmine now antagonized acetylcholine responses, while territrem-B still produced a maximal potentiation. At all doses neostigmine produced a dose-dependent inhibition of acetylcholinesterase activity. The cholinolytic effect of high doses of neostigmine was associated with the inhibition of 4 K(+)-induced current in the same neuron, while territrem-B neither altered the K(+)-induced current nor antagonized acetylcholine responses. The cholinolytic effect of neostigmine was completely antagonized by the inhibition of electrogenic sodium pump by ouabain or by perfusion with K(+)-free solution. These results suggest that neostigmine at high concentrations inhibits the electrogenic sodium pump and that the cholinolytic effect of high doses of neostigmine is secondary to this action. Territrem-B, on the other hand, had no effect on the electrogenic sodium pump and had no effect on the neuronal membrane properties other than to inhibit acetylcholinesterase. Thus, territrem-B may be a useful tool for studying the interaction between acetylcholinesterase and acetylcholine receptors.

Acetylcholine

Noninvasive hemodynamic classification of carotid-cavernous sinus fistulas by duplex carotid sonography.

The hemodynamic classification of the CCF has important implications for prognosis and therapy, but satisfactory criteria for such a differentiation are still lacking. We studied the application of extracranial duplex sonography in 14 cases of CCF with emphasis on the hemodynamic parameters of the RI and flow volume and made a correlation with the angiographic findings. We conclude with proposed duplex sonographic criteria for hemodynamic classification: (1) small RI with increased flow volume in the ICA: direct ICA-cavernous sinus fistulas (type A); (2) normal RI and flow volume in the ICA and ECA: dural branch of ICA-cavernous sinus fistulas (type B); (3) small RI with or without increased flow volume in the ECA: dural branch of ECA-cavernous sinus fistulas (type C) or dural branches of ICA- and ECA-cavernous sinus fistulas (type D). Application for assessment of the therapeutic effectiveness was also demonstrated.

Arteriovenous Fistula

Carbon dioxide-enhanced ultrasonography of liver tumors.

CO2 gas-enhanced ultrasonography was performed in 37 patients (47 studies) for the purpose of detecting small tumors and evaluating differential diagnosis. With conventional ultrasonography, 62 lesions were identified in 25 patients with HCC, 13 tumors were identified in eight patients with hemangioma, and multiple tumors were found in four patients with metastatic adenocarcinoma. CO2-enhanced ultrasonography detected five additional hemangiomas, 12 additional nodules in HCC, and the same number of metastatic nodules. The patterns of CO2 enhancement were characterized as homogeneous, heterogeneous, rim, internal spotted, negative, and mixed (more than one pattern in one lesion). The rim enhancement pattern was found to be specific for hemangioma. The internal spotted enhancement pattern was found exclusively in HCC. All the lesions that demonstrated negative enhancement were treated HCC. All the metastatic tumors demonstrated the mixed rim and internal spotted enhancement pattern. We suggest that CO2-enhanced ultrasonography is a useful tool in detecting small liver tumors. It can also help in the differentiation among various hepatic tumors.

Adenocarcinoma

The value of duplex and continuous wave Doppler sonography for evaluation of the extracranial vertebral arteries: a prospective comparison with angiography.

BACKGROUND: The role of duplex sonography in the detection of the extracranial vertebral arteries is not well established. The purpose of this study was to determine the practical possibilities of vascular sonography for non-invasive investigation of the vertebral arteries. METHODS: The extracranial vertebral artery was divided into the pretransverse segment, the intertransverse segment C6-C2, and the atlas loop. The first two segments were examined by duplex probe and the third segment, by continuous-wave probe. Sixty vertebral arteries were studied for detecting vessel diameter, peak systolic as well as diastolic frequency shifts, flow direction and Doppler flow characteristics. A blind angiographic comparison was also performed for the sake of confirming morphological findings and flow direction. RESULTS: Duplex imaging could detect more than 90% of the vertebral arteries. The mean value of vessel diameter was 3.3 +/- 0.6 mm for the right vertebral artery and 3.5 +/- 0.5 mm for the left. Peak systolic as well as diastolic frequency shifts expressed in KHz was 1.4 +/- 0.4 versus 1.6 +/- 0.5 and 0.5 +/- 0.2 versus 0.5 +/- 0.2 in the right and the left vertebral arteries respectively. A 74% agreement in vessel size was obtained by both duplex scanning and angiography. A 100% accuracy was obtained for blood flow direction through means of a Doppler signal. Abnormal findings included stenosis or occlusion (four arteries), hypoplasia or aplasia (two arteries), and subclavian steal phenomenon (two arteries); Six of these eight were correctly predicted by confirmation of the angiographic findings. CONCLUSIONS: A combination of duplex and continuous wave Doppler sonography was affirmed in this study as a relatively accurate screening technique for detection of vertebral artery abnormalities.

Adult

Effects of territrem-B on cholinergic responses of snail neuron.

Effects of territrem-B (TRB), a mycotoxin isolated from a rice culture of Aspergillus terreus, on the central neuron of the snail Achatina fulica were studied electrophysiologically. Territrem-B potentiated the acetylcholine (ACh) induced current of the neuron, while it had no effect on GABA or L-glutamate elicited currents. TRB and neostigmine increased the peak amplitude of the response elicited by the first perfusion of ACh and depressed the increase in current produced by a second perfusion. TRB and neostigmine showed different dose-dependent effects on ACh responses. The results suggested that TRB is a good tool for studying the physiological role of AChE in central neurons.

Acetylcholine

Risk factors on the occurrence of response fluctuations and dyskinesias in Parkinson's disease.

We studied the risk factors that influence the occurrence of response fluctuations and dyskinesias in 194 patients with Parkinson's disease (PD). These factors included age at onset, disease severity at levodopa initiation, duration of illness prior to levodopa therapy and the daily dose of levodopa at the end of study. The first three were fixed covariates and the last one was time-dependent. Patients with age onset before 50 years showed a higher risk of developing response fluctuations (RF) and dyskinesias in univariate analysis. We estimated the combined effects of these covariates through multivariate analysis and found that the age at onset was the sole factor related to the incidence of both complications. Additionally, it was the only variable that could enter the predictive model of stepwise regression. Our observation suggested that age at onset determined the occurrence of RF and dyskinesias. Patients with younger age at onset had higher risk of developing these adverse effects.

Adult

Activity of triciribine and triciribine-5'-monophosphate against human immunodeficiency virus types 1 and 2.

Triciribine (TCN) and its 5'-monophosphate (TCN-P) are novel tricyclic compounds with known antitumor activity; TCN-P is currently in phase II human clinical trials. We now report that these compounds have potent and selective activity against HIV-1 and HIV-2. Using a syncytial plaque assay, TCN and TCN-P were active against HIV-1 at 0.01-0.02 microM and had differential selectivities of 2250 and 1900, respectively, compared to 1850 for AZT. In contrast, TCN and TCN-P had minimal selectivity against human cytomegalovirus (50 and 27, respectively). TCN and TCN-P markedly inhibited HIV-1-induced p24 core antigen production, reverse transcriptase, and infectious virus production in a dose-dependent manner using HIV-1 acutely infected CEM-SS, H9, and persistently infected H9IIIB and U1 cells. In acutely infected PBL cells, TCN and TCN-P inhibited reverse transcriptase and infectious virus production but not p24 core antigen production. Using a microtiter XTT assay, TCN and TCN-P were active against a panel of HIV-1 and HIV-2 strains at IC50 values ranging from 0.02 to 0.46 microM. Evaluation of matched pairs of predrug and postdrug therapy HIV-1 isolates established that AZT-resistant and TIBO-resistant variants of HIV-1 were sensitive to TCN or TCN-P. Furthermore, unlike AZT and other fraudulent nucleosides, neither TCN, TCN-P, nor TCN-TP inhibited the viral reverse transcriptase. Thus, even though triciribine is a nucleoside chemically, it does not act biologically by classic nucleoside modalities but rather by a unique mechanism yet to be elucidated.

Acenaphthenes

A randomized controlled trial on the treatment for acute partial ischemic stroke with acupuncture.

The effectiveness of acupuncture in acute stroke remains largely untested and unproved. A randomized, controlled trial was carried out to study the feasibility of acupuncture in combination with conventional supportive treatment for acute stroke patients. A total of 30 patients, aged 46-74, with the onset of symptoms within 36 h were enrolled into the study after appropriate screening. All patients gave informed consent. Basing on the same supportive treatment, patients were randomly assigned to a treatment with or without acupuncture. The procedure and acupoint selection were discussed and decided through several meetings of a group of senior acupuncture doctors in Taiwan. Acupuncture was applied 3 times/week for 4 weeks. During the study period, there were no problems in conducting this trial in terms of patient availability and acceptance, and physician cooperation. A significantly better neurologic outcome was observed in the acupuncture group on day 28 and day 90. The improvement in neurologic status was greatest in patients with a poor neurologic score at baseline. There were no important side effects except for one episode of dizziness related to acupuncture treatment. The data and results of this study will be used as a guideline for planning a full-scale clinical trial, e.g. sample size calculation, method of randomization with stratification of prognostic factors, choosing acupuncture points and technique of acupuncture.

Acupuncture Points

Subclavian steal phenomenon: a correlation between duplex sonographic and angiographic findings.

Correlation of duplex sonography, angiography of the vertebral artery, and the degree of subclavian or innominate stenosis was carried out in ten patients with the subclavian steal phenomenon. Four successive stages of Doppler waveform were identified by duplex sonography. Three angiographic patterns of decreasing severity, permanent reversal, to-and-fro motion and delayed opacification, were found. Permanent reversal angiograms corresponded to complete reversal or late transient Doppler waveforms. To-and-fro motion and delayed opacification angiograms did not necessarily have a corresponding Doppler pattern. The different stages of subclavian steal phenomenon on duplex sonography correlated significantly with the degree of subclavian or innominate stenosis. Stenosis of at least 60% was found to produce abnormal vertebral artery Doppler sonography, except in one patient. Duplex sonography is considered to be a sensitive and convenient method for detecting abnormal vertebral artery haemodynamics and the subclavian steal phenomenon, but some other factors may be important in producing the Doppler waveforms.

Adult

Effect of cavity depth on stresses in a restored tooth.

Restorative procedures commonly replace lost tooth structure, but redistribution of functional stresses after treatment is not fully understood. Many restorative methods are dictated by the integrity of the remaining tooth structure, because sparse tooth structure can lead to fracture. It is essential to prevent fractures by having a clear concept of the designs for cavity preparations, and to anticipate the stresses of mastication on the remaining tooth structure. Knowledge of various internal parameters of cavity designs would facilitate selection of the appropriate cavity preparation for a specific clinical situation. Three cavity designs and restorations were examined in this study for stresses using the finite element technique. After placement of restorative materials, the dentin experienced a dramatic change in stress gradient immediately below the pulpal wall, and this response was magnified in deeper cavity preparations. Enamel also exhibited major alterations in the stress gradient in all three designs of cavity preparations. The combination of the changes can cause cracks in the remaining tooth structure, leading to cusp fracture immediately adjacent to the deepest portion of the cavity.

Alveolar Process

Is asymptomatic bronchial hyperresponsiveness an indication of potential asthma? A two-year follow-up of young students with bronchial hyperresponsiveness.

To determine the possibility that asymptomatic bronchial hyperresponsiveness (BHR) develops into symptomatic asthma, a two-year follow-up study was conducted in 81 students (48 male, 33 female; 11 to 17 years) who were found to have BHR in a 3,067 population survey (BHR group). Eighty-eight age-matched students (48 male, 40 female) with normal bronchial responsiveness served as control subjects. Daily symptom cards were recorded. Peak expiratory flow rate was measured for 24 h when symptoms occurred. Histamine inhalation tests were performed at the beginning of the study and at the end of the first and the second year. In the BHR group, 58 students remained bronchial hyperresponsive at the end of follow-up. Nine of 31 students with initially diagnosed bronchial asthma had their symptoms relieved entirely, but ten asymptomatic students developed asthma. The incidence of newly diagnosed asthma (12.5 percent in the BHR group or 20 percent in the asymptomatic BHR group) and the total percentage of diagnosed asthma (39.5 percent) in the BHR group were significantly higher than those (2.27 percent, 2.27 percent) in the control group. FVC and FEV1 showed no significant difference between two groups. PD20 FEV1 values in newly diagnosed asthmatics were significantly lower than those in asymptomatic students both at the beginning (3.05 +/- 1.56 mumol vs 6.14 +/- 1.60 mumol, p < 0.05) or the end (3.47 +/- 1.73 mumol vs 6.55 +/- 1.51 mumol, p < 0.05). The percentage of early respiratory illness was significantly higher in those with newly diagnosed asthma (80 percent) than in asymptomatic students (22.3 percent), but atopic index and the percentage of parental asthma showed no difference between two groups. In nine asthmatics whose symptoms were relieved entirely in the two-year follow-up, PD20 FEV1 was undetectable within the cumulative dose of 7.8 mumol of histamine in three students and rose from 4.58 +/- 1.85 mumol to 7.62 +/- 1.02 mumol in the remaining six. The higher the BHR, the more likely the students developed asthma. About 45 percent of asymptomatic students with PD20 < or = 3.2 mumol developed asthma in the following two years and 80 percent of them had a history of early respiratory illness, suggesting that they may have subclinical or potential asthma.

Adolescent