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Biomedical subjects

S H Yang

Publications and source records attributed to S H Yang.

At least 91 records · Page 5Linked to original sources

Intramedullary versus extramedullary tibial alignment guides in total knee arthroplasty.

The intramedullary alignment guide is superior to the extramedullary guide for preparation of the femur in total knee arthroplasty. However, there is controversy over which guide is more appropriate for the tibial sector. We retrospectively compared the accuracy of the intramedullary and extramedullary guides for tibial cutting in patients undergoing total knee arthroplasty. Total knee arthroplasty was performed in 100 knees (68 patients) during a 2-year period. The intramedullary rod was used for preparation of the femur in all cases. For the tibia, each guide system was used in 50 knees. The intramedullary rod was not used in tibias with extreme deformity where the rod could not pass at least two-thirds of the way through the medullary canal. Standing anteroposterior radiographs of the hip to the ankle were taken before surgery and 2 to 6 months postoperatively. The angle formed by the intersection of the tibial mechanical axis and the undersurface of the tibial component (tibial component angle) was measured to check the accuracy of the tibial alignment system. We found no significant differences in the mechanical axis, tibiofemoral alignment, or the tibial component angle between the two groups. The proximal tibial cuts were within 2 degrees of the ideal (90 degrees) in 84% of knees treated with the intramedullary guide, and in 82% of those with the extramedullary guide (p > 0.1). These findings suggest that both guide systems can yield satisfactory alignment. If the tibia is not badly deformed, the intramedullary rod can produce tibial cuts as accurately as the extramedullary system.

Adult↗

Comparison of various expression plasmids for the induction of immune response by DNA immunization.

Intramuscular injection of plasmid DNA is an efficient method to introduce a foreign gene into a live animal. We investigated several factors affecting the gene transfer efficiency and the following immune response by intramuscular injection of plasmid DNA. When the strength of several highly efficient viral promoters was compared in muscle by using the chloramphenicol acetyltransferase (CAT) gene as an indicator, cytomegalovirus (CMV) immediate early promoter was found to be stronger than any other viral promoters including Rous sarcoma virus (RSV), murine leukemia virus (SL3-3) and simian virus 40 (SV40) early promoters. Inclusion of adenovirus tripartite leader (TPL) sequences and a synthetic intron in the 5' untranslated region of mRNA moderately stimulated the CAT expression. On the other hand, the expression of encephalomyocarditis virus (EMCV) VP1 gene was greatly enhanced by the TPL sequences and an intron. The level of humoral immune response by intramuscular injection of various VP1 expression plasmids was compared. The seroconversion rate was highly dependent on the strength of the expression vector. However, the ratio of IgG1 and IgG2a immune response was not significantly variable depending on the strength of the expression vector. Also, the efficiency of the sindbis virus-based DNA vector was examined for the gene expression and immune response. Although a high level of CAT expression was obtained in muscle by using this system, VP1 was not produced as much as the conventional expression vectors. Furthermore, little humoral immune response was elicited by intramuscular injection of VP1-expressing sindbis vector, suggesting that this system was not superior to the conventional vector for DNA immunization.

Animals↗

Clustering of GABAA receptors by rapsyn/43kD protein in vitro.

Rapsyn, a 43-kDa protein on the cytoplasmic face of the postsynaptic membrane, is essential for clustering acetylcholine receptors (AChR) at the neuromuscular junction. When transfected into nonmuscle cells (QT-6), rapsyn forms discrete membrane domains and can cluster AChR into these same domains. Here we examined whether rapsyn can cluster other ion channels as well. When expressed in QT-6 cells, the GABAA receptor (human alpha 1, beta 1, and gamma 2 subunits) and the skeletal muscle sodium channel were each diffusely scattered across the cell surface. Rapsyn, when co-expressed, clustered the GABAA receptor as effectively as it clustered AChR in previous studies. Rapsyn did not cluster co-transfected sodium channel, confirming that it does not cluster ion channels indiscriminately. Rapsyn mRNA was detected at low levels in the brain by polymerase chain reaction amplification of reverse-transcribed RNA, raising the possibility of a broader role for rapsyn.

Animals↗

Angiographic study of moyamoya disease and histological study in the external carotid artery system.

A total of 13 cases of Moyamoya disease were verified by internal and external carotid artery angiography. The biopsy samples were taken from the superficial temporal arteries and middle meningeal arteries in 12 and six cases, respectively. Angiographical and histological studies revealed that both of the internal and external carotid system could be involved in Moyamoya disease. Our studies demonstrated that Moyamoya disease was a type of vascular disease not only confined to the cerebral vessels. We recommend angiography of external carotid system and extracranial segment of internal carotid artery while performing three vascular angiography. Whether superficial temporal artery has been involved in angiography can be used as an indication of indirect cerebrovascular bypass.

Biopsy↗

Role of p38 and JNK mitogen-activated protein kinases in the activation of ternary complex factors.

The transcription factors Elk-1 and SAP-1 bind together with serum response factor to the serum response element present in the c-fos promoter and mediate increased gene expression. The ERK, JNK, and p38 groups of mitogen-activated protein (MAP) kinases phosphorylate and activate Elk-1 in response to a variety of extracellular stimuli. In contrast, SAP-1 is activated by ERK and p38 MAP kinases but not by JNK. The proinflammatory cytokine interleukin-1 (IL-1) activates JNK and p38 MAP kinases and induces the transcriptional activity of Elk-1 and SAP-1. These effects of IL-1 appear to be mediated by Rho family GTPases. To examine the relative roles of the JNK and p38 MAP kinase pathways, we examined the effects of IL-1 on CHO and NIH 3T3 cells. Studies of NIH 3T3 cells demonstrated that both the JNK and p38 MAP kinases are required for IL-1-stimulated Elk-1 transcriptional activity, while only p38 MAP kinase contributes to IL-1-induced activation of SAP-1. In contrast, studies of CHO cells demonstrated that JNK (but not the p38 MAP kinase) is required for IL-1-stimulated Elk-1-dependent gene expression and that neither JNK nor p38 MAP kinase is required for IL-1 signaling to SAP-1. We conclude that (i) distinct MAP kinase signal transduction pathways mediate IL-1 signaling to ternary complex transcription factors (TCFs) in different cell types and (ii) individual TCFs show different responses to the JNK and p38 signaling pathways. The differential utilization of TCF proteins and MAP kinase signaling pathways represents a potential mechanism for the determination of cell-type-specific responses to extracellular stimuli.

3T3 Cells↗

Valgus osteotomy for congenital coxa vara.

Congenital coxa vara is a rare disease which can result in a significant disability if untreated or improperly treated. In this retrospective review of eight patients (12 hips) with congenital coxa vara, there were five boys and three girls. Four patients had bilateral involvement and four had unilateral involvement. At the time of surgery, the average age was 7.9 years. All patients underwent valgus intertrochanteric osteotomy with wires or blade-plates for fixation. The mean Hilgenreiner-epiphyseal angle was 75 degrees before surgery and improved to 25 degrees after surgery. The mean neck-shaft angle improved from 95 degrees to 137 degrees immediately after the osteotomies and was 125 degrees at the final follow-up. At a minimum two year follow-up only three hips in three patients maintained more than 80% correction. These three patients all had developmental coxa vara. The acetabular depth improved significantly in the patients with developmental coxa vara, especially in two patients (three hips) who underwent surgery before 6 years of age. Closure of physeal plates was found in three patients (five hips) before surgery and occurred in two patients (two hips) after surgery. After surgery, only two patients had persistent soreness. One patient walked with a limp, and the other, with multiple epiphyseal dysplasia had significant leg length discrepancy. Our results show that valgus osteotomy can correct varus deformities of the proximal femur and improve function. If performed early, it can also prevent the development of hip dysplasia in patients with developmental coxa vara. However, the response of acetabular development was variable in patients with coxa vara due to skeletal dysplasia, despite valgus osteotomy.

Adolescent↗

Maternal blood C-reactive protein, white blood cell count, and temperature in preterm labor: a comparison with amniotic fluid white blood cell count.

OBJECTIVE: To compare the diagnostic and prognostic performance of maternal blood C-reactive protein, white blood cell count (WBC), and temperature with that of amniotic fluid (AF) WBC in preterm labor. METHODS: One hundred two women with preterm labor and intact membranes were studied. Maternal blood was collected to measure C-reactive protein concentration and WBC, and maternal temperature was also measured. Amniotic fluid obtained by amniocentesis was cultured and WBC determined. Receiver operating characteristic curve, logistic regression, and survival techniques were used for analysis. RESULTS: Patients with acute histologic chorioamnionitis had significantly higher median C-reactive protein concentration, WBC, temperature, and AF WBC than patients without this lesion (P < .05). Receiver operating characteristic curve and survival analysis demonstrated that an elevated C-reactive protein, WBC, or AF WBC was strongly associated with the likelihood of histologic chorioamnionitis, shorter interval to delivery, clinical chorioamnionitis, and neonatal morbidity (P < .05 for each). Of all the tests, AF WBC was the best independent predictor of a positive AF culture (odds ratio [OR] 16.8), interval to delivery (hazard ratio 5.7), clinical chorioamnionitis (OR 15.2), neonatal sepsis (OR 16.8), and significant neonatal complications (OR 7.4), after other confounding variables were adjusted (P < .05 for each). CONCLUSION: An elevated C-reactive protein, WBC, or AF WBC identified patients with intrauterine infection and adverse perinatal outcomes. Amniotic fluid WBC was a better independent predictor of these outcomes than C-reactive protein, WBC, or temperature.

Acute Disease↗

Interleukin-6 concentrations in umbilical cord plasma are elevated in neonates with white matter lesions associated with periventricular leukomalacia.

OBJECTIVE: Periventricular leukomalacia, a common brain white matter lesion in preterm neonates, is a major risk factor for cerebral palsy. Recently, cytokines (i.e., tumor necrosis factor and interleukin-1(beta)) have been implicated as mediators for the development of periventricular leukomalacia. The purpose of this study was to examine the relationship between umbilical cord plasma levels of tumor necrosis factor-alpha, interleukin-1(beta), interleukin-6, and interleukin-1 receptor antagonist and the occurrence of periventricular leukomalacia in preterm neonates. STUDY DESIGN: Umbilical cord blood was collected from 172 consecutive preterm births (25 to 36 weeks). Periventricular leukomalacia-associated lesions were diagnosed by brain ultrasonography within the first 3 days of life. Tumor necrosis factor-alpha, interleukin-1(beta) interleukin-6, and interleukin-1 receptor antagonist were measured by sensitive and specific enzyme-linked immunoassay methods. Umbilical cord arterial pH was measured at birth. Statistical analysis was performed with multiple logistic regression and receiver operating characteristic curve analysis. RESULTS: Periventricular leukomalacia-associated lesions were present in 14.5% (25/172) of infants. Plasma concentrations of interleukin-6 but not of tumor necrosis factor-alpha, interleukin-1(beta), and interleukin-1 receptor antagonist were significantly higher in neonates with periventricular leukomalacia-associated lesions than in those without these lesions (median 718, range < 226 to 32,000 pg/ml vs median < 226, range < 226 to 43,670 pg/ml; p < 0.0001). An interleukin-6 value > or = 400 pg/ml had a sensitivity of 72% (18/25) and a specificity of 74% (108/147) in the identification of periventricular leukomalacia-associated lesions. Multivariate analysis showed that umbilical cord interleukin-6 was an independent risk factor for periventricular leukomalacia (odds ratio 6.2, p < 0.002) after correction for known confounding variables (i.e., gestational age at birth, umbilical artery pH, chorioamnionitis). CONCLUSIONS: Interleukin-6 concentrations in umbilical cord plasma are elevated in neonates with periventricular leukomalacia-associated lesions. Our data support the hypothesis that periventricular leukomalacia may be the result of cytokine-mediated brain injury.

Adult↗

Treatment of posttraumatic chronic high-flow priapisms by superselective embolization of cavernous artery with autologous clot.

Two cases of high-flow priapism that occurred after blunt perineal trauma and lasted for 35 days (case 1) and 40 days (case 2) were successfully treated by embolization of the lacerated cavernous arteries with autologous clots. Cavernous arterial blushes were demonstrated on selective internal pudendal arteriograms in both cases. Case 1 with left cavernous arterial laceration restored 80% of premorbid erectile function with successful intercourse 4 months after superselective embolization. In case 2 with bilateral cavernous arterial lacerations, premorbid erectile function was fully resumed 2 months after bilateral embolization of the cavernous arteries at intervals of 15 days. None developed local or systemic complications.

Adult↗

Clinicopathologic study on clear cell hepatocellular carcinoma.

In order to study the clinicopathologic characteristics of the clear cell variant of hepatocellular carcinoma (HCC), 215 consecutive cases measuring less than 5 cm in diameter were reviewed. The cases were divided into clear cell HCC (20 cases); focal clear cell HCC (77 cases); and non-clear cell HCC (118 cases). Clinical and pathological findings were compared among these groups. Clear cell HCC was moderately differentiated in 80% of cases and the incidence was not related to tumor size. The male to female ratio was 2.3:1, lower than the 6.9:1 of non-clear cell HCC. The association rate with liver cirrhosis was 90%, higher than the 59.3% of non-clear cell HCC. Three- and five-year survival rates, and no recurrence time were 54.5%, 33.3%, and 564 days, respectively, lower than the findings of 74.3%, 46.1%, and 770 days for non-clear cell HCC. But there is no significant difference in prognosis between both groups. Ultrastructurally, clear cells showed abundant glycogen storage and a variable degree of fat vacuoles, with a marked reduction of the number and size of organelles in the 8 cases examined. Non-clear cells of focal clear cell and non-clear cell HCC showed a moderate degree of glycogen storage in 85.7% and 28.6% of the seven cases examined from each group, with significant difference. It was concluded that clear cell HCC occurs mostly in the moderately differentiated form and is characterized by high female prevalence, high rate of association with liver cirrhosis, and has no significant difference in prognosis compared with non-clear cell HCC.

Adenocarcinoma, Clear Cell↗

Modulation of thermal induction of hsp70 expression by Ku autoantigen or its individual subunits.

Previously, we proposed a dual control mechanism for the regulation of the heat shock response in mammalian cells: a positive control mediated by the heat shock transcription factor HSF1 and a negative control mediated by the constitutive heat shock element-binding factor (CHBF). To study the physiological role of CHBF in the regulation of heat shock response, we purified CHBF to apparent homogeneity and showed it to be identical to the Ku autoantigen, a heterodimer consisting of 70-kDa (Ku-70) and 86-kDa (Ku-80) polypeptides. To study further the functional significance of Ku/CHBF in the cellular response to heat shock, we established rodent cell lines that stably and constitutively overexpressed one or both subunits of the human Ku protein, and examined the thermal induction of hsp70 and other heat shock proteins in these Ku-overexpressing ing cells. We show that expression of the human Ku-70 and Ku-80 subunits jointly or of the Ku-70 subunit alone specifically inhibits heat-induced hsp70 expression. Conversely, expression of human Ku-80 alone does not have this effect. Thermal induction of other heat shock proteins in all of the Ku-overexpressing cell lines appears not to be significantly affected, nor is the state of phosphorylation or the DNA-binding ability of HSF1 affected. These findings support a model in which hsp70 expression is controlled by a second regulatory factor in addition to the positive activation of HSF1. The Ku protein, specifically the Ku-70 subunit, is involved in the regulation of hsp70 gene expression.

Animals↗

Cloning and characterization of rat Ku70: involvement of Ku autoantigen in the heat-shock response.

To study the role of the Ku autoantigen in the heat-shock response, we have cloned the 70-kDa subunit (the DNA-binding component of Ku) from a rat cDNA library. The deduced amino acid sequence of rat Ku70 bears extensive homology with the human and murine counterpart (83 and 97% identity, respectively). Overexpression of Ku70 in rat fibroblasts results in the specific repression of hsp-70 upon heat shock. The inhibition of induction of hsp-70 was greatest in cells expressing the highest level of Ku70. Induction of other heat-shock proteins besides hsp-70 by hyperthermia appears normal, as does the activation of the heat-shock transcription factor, HSF-1. It is likely that other factors besides HSF-1 are involved in controlling heat-shock gene transcription. While the formation of the Ku70 and Ku80 complex is important for repair of DNA double-strand breaks our data suggest that the 70-kDa subunit of Ku plays a role in regulating hsp-70 expression.

Amino Acid Sequence↗

Inhibitors of signalling identify differential control processes responsible for selective effects of insulin on the expression of phosphoenolpyruvate carboxykinase and gene 33 in rat H4 hepatoma cells.

Gene 33 and phosphoenolpyruvate carboxykinase (PEPCK) present excellent model systems for the analysis of the differential control of hepatic gene expression by the insulin-regulated signal-transduction pathway(s). We have analysed the importance of specific components in the insulin-regulated transduction pathway(s) towards enhanced gene expression (gene 33) and inhibited gene expression (PEPCK) by examination of the influence of selective inhibitors. Rapamycin, which inhibits the 70 kDa S6 kinase (p70rsk) does not influence the actions of insulin on gene 33 or PEPCK; thus the kinase p70rsk appears to play no direct role in the regulation of expression of these two hepatic genes. Wortmannin, an inhibitor of phosphatidylinositol 3-kinase, differentiates between processes involved in insulin regulation of gene 33 and PEPCK mRNA expression. Although the actions of insulin on gene 33 expression are abolished by wortmannin, the actions of insulin on PEPCK expression are insensitive to wortmannin. The existence of wortmannin-sensitive and rapamycin/wortmannin-insensitive pathways for transducing insulin signals to factors controlling gene expression, and the differential actions on specific genes, presents an initial step towards deciphering the linkage between signalling components and selective control of gene expression.

Androstadienes↗

Aggretin, a novel platelet-aggregation inducer from snake (Calloselasma rhodostoma) venom, activates phospholipase C by acting as a glycoprotein Ia/IIa agonist.

A potent platelet aggregation inducer, aggretin, was purified from Malayan-pit-viper (Calloselasma rhodostoma) venom by ionic-exchange chromatography, gel-filtration chromatography and HPLC. It is a heterodimeric protein (29 kDa) devoid of esterase, phospholipase A and thrombin-like activity. Aggretin (> 5 nM) elicited platelet aggregation with a lag period in both human platelet-rich plasma and washed platelet suspension. EDTA (5 mM), prostaglandin E1 (1 microM) and 3,4,5-trimethoxybenzoic acid 8-(diethylamino)octyl ester ('TMB-8'; 100 microM) abolished its aggregating activity, indicating that exogenous bivalent cations and intracellular Ca2+ mobilization are essential for aggretin-induced platelet aggregation. Neomycin (4 mM) and mepacrine (50 microM) completely inhibited aggretin (33 nM)-induced aggregation; however, creatine phosphate/creatine phosphokinase (5 mM, 5 units/ml) and indomethacin (50 microM) did not significantly affect its aggregating activity. Aggretin caused a significant increase of [3H]InsP formation in [3H]Ins-loaded platelets, intracellular Ca2+ mobilization and thromboxane B2 formation. Neomycin, a phospholipase C inhibitor, completely inhibited both the increase of [3H]InsP and intracellular Ca2+ mobilization of platelets stimulated by aggretin. A monoclonal antibody (6F1) directed against glycoprotein Ia/IIa inhibited platelet shape change and aggregation induced by aggretin. 125I-aggretin bound to platelets with a high affinity (Kd = 4.0 +/- 1.1 nM), and the number of binding sites was estimated to be 2119 +/- 203 per platelet. It is concluded that aggretin may act as a glycoprotein Ia/IIa agonist to elicit platelet aggregation through the activation of endogenous phospholipase C, leading to hydrolysis of phosphoinositides and subsequent intracellular Ca2+ mobilization.

Antibodies, Monoclonal↗

A constitutive heat shock element-binding factor is immunologically identical to the Ku autoantigen.

Analysis of the heat shock element (HSE)-binding proteins in extracts of rodent cells, during heat shock and their post-heat shock recovery, indicates that the regulation of heat shock response involves a constitutive HSE-binding factor (CHBF), in addition to the heat-inducible heat shock factor HSF1. We purified the CHBF to apparent homogeneity from HeLa cells using column chromatographic techniques including an HSE oligonucleotide affinity column. The purified CHBF consists of two polypeptides with apparent molecular masses of 70 and 86 kDa. Immunoblot and gel mobility shift analysis verify that CHBF is identical or closely related to the Ku autoantigen. The DNA binding characteristics of CHBF to double-stranded or single-stranded DNA are similar to that of Ku autoantigen. In gel mobility shift analysis using purified CHBF and recombinant human HSF1, CHBF competes with HSF1 for the binding of DNA sequences containing HSEs in vitro. Furthermore, when Rat-1 cells were co-transfected with human Ku expression vectors and the hsp70-promoter-driven luciferase reporter gene, thermal induction of luciferase is significantly suppressed relative to cells transfected with only the hsp70-luciferase construct. These data suggest a role of CHBF (or Ku protein) in the regulation of heat response in vivo.

Animals↗

Suppression of heat-induced hsp70 expression by the 70-kDa subunit of the human Ku autoantigen.

Expression of the 70-kDa polypeptide of human Ku autoantigen in rat cells is shown to suppress specifically the induction of hsp70 upon heat shock. Thermal induction of other heat shock proteins is not significantly affected, nor is the state of phosphorylation or the DNA-binding ability of the heat shock transcription factor HSF1. These findings support a model in which hsp70 gene expression is controlled by a second regulatory factor in addition to the positive activator HSF1. The Ku autoantigen, or a protein closely related to it, is likely to be involved in the regulation of hsp70 expression.

Animals↗

Highly specific oxidative cross-linking of proteins mediated by a nickel-peptide complex.

The Ni(II) complex of the tripeptide NH2-Gly-Gly-His-COOH is shown to mediate efficient protein-protein cross-linking in the presence of oxidants such as oxone and monoperoxyphthalic acid. Only proteins that associate specifically in solution are cross-linked under these conditions. Preliminary probes of the mechanism of the reaction suggest that the active intermediate may be a high-valent metal complex that attacks aromatic amino acids.

Acetates↗

An abduction-traction frame for the treatment of intertrochanteric fracture of femur.

We present a detailed outline of treatment of intertrochanteric fractures of femur with a new technique on the basis of principles of combined traditional chinese and western medicine. We use pins and an outer fixation frame, which keeps the injured limb in abduction and under traction and at the same time allows for functional exercise of all the joints in the extremity. The procedure is discussed and compared with other different techniques.

Fracture Fixation↗