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Biomedical subjects

T R Hsiue

Publications and source records attributed to T R Hsiue.

36 records · Page 2Linked to original sources
PubMed1996

Flavobacterium indologenes bacteremia: clinical and microbiological characteristics.

To our knowledge, Flavobacterium indologenes has never been reported as a cause of bacteremia in humans. F. indologenes bacteremia was diagnosed in 12 patients at a tertiary referral center in southern Taiwan between 1 January 1992 and 31 December 1994. Six of these patients had ventilator-associated pneumonia, two had primary bacteremia, and one patient each had pyonephrosis, peritonitis, biliary tract infection, and surgical wound infection. Five patients (42%) had malignancies, and three (25%) had multiple burns. Polymicrobial bacteremia was diagnosed in eight patients (67%). Two (17%) of the patients in this study died; both had polymicrobial bacteremia. Antimicrobial susceptibility testing of the blood isolates from the 12 patients showed that > 90% of the isolates were susceptible to piperacillin, cefoperazone, ceftazidime, and minocycline. The chromatograms of esterified fatty acids for the isolates were identical. F. indologenes should be considered an etiologic agent of bloodstream infection, especially in hospitalized patients with severe underlying diseases.

Adult↗
PubMed1996

Invasive Streptococcus pneumoniae infection associated with rapidly fatal outcome in Taiwan.

We observed 42 cases of invasive Streptococcus pneumoniae infections from 1991 through 1993 in southern Taiwan. The antimicrobial susceptibilities and distribution of serotypes of the 42 isolates from these invasive infections were determined. Serotypes 14, 3, 6, 23, 15 and 4 were most commonly identified. Serotypes 14 and 6 most frequently caused infections in pediatric patients, while serotypes 3, 14 and 23 were commonly encountered in adults. Overall, 85.7% of the isolates were included in the serotypes represented in the 23-valent pneumococcal vaccine. Three isolates were intermediately resistant to penicillin and none were fully resistant. Resistance rates were: erythromycin, 61.9%; clindamycin, 47.6%; chloramphenicol, 19%; and tetracycline, 73.8%. Resistance to three or more classes of antibiotics was found in 33.3% of the isolates, in which the majority were serotypes 14 and 6 and nontypeable isolates. Bacteremic pneumonia and primary bacteremia accounted for 64.3% of the infections. Mortality was 42.6%. Factors associated with higher mortality included age of > 16 years, the presence of underlying diseases, development of one or more septic complications, bacteremic pneumonia and the presence of serotype 3 isolates. Rapidly fatal outcome (the illness developed less than 48 hours prior to admission and the death occurred within 48 hours of hospitalization) occurred in 12 (66.7%) of the 18 patients who died. All these patients received adequate antibiotic treatment and aggressive intensive care, indicating the fulminant nature of this infection. Mucoid serotype 3 isolates caused rapidly fatal outcomes. Given the severity of these infections despite adequate antibiotic therapy and the vulnerability of patients with altered immune responses, there is a dire need for introduction of new therapeutic options and preventive measures to prevent mortality due to invasive S. pneumoniae infections.

Adolescent↗
PubMed1996

Isoniazid-induced fever.

A rare case of isoniazid (INH)-induced fever is described. A 27-year-old woman diagnosed with miliary tuberculosis (TB) began to receive combined anti-TB treatment including INH, ethambutol, rifampicin and pyrazinamide on the second day of hospitalization. A spiked fever developed in the afternoon of the seventh hospital day. There was no evidence of a hypersensitivity reaction. All examinations including liver function tests, routine biochemistry tests, serum titer of antinuclear antibody and rheumatoid factor were within normal limits. The blood leukocyte count was also within normal range and no evidence of infection at other sites was found. Following the discontinuance of anti-TB agents, the patient's body temperature gradually returned to normal. When the patient was rechallenged with INH, the high fever recurred. The fever subsided again after the discontinuance of INH, and her recovery followed a smooth course thereafter, on combination therapy with rifampicin, ethambutol and pyrazinamide. This experience demonstrates the potential of INH to cause an isolated fever without other manifestations, which may be misdiagnosed as an infectious process. Though it is very rare, INH-induced fever must be considered when fever develops during anti-TB treatment.

Adult↗
PubMed1996

Increased IL-5 and IL-10 transcription in bronchial cells after Sauropus androgynus ingestion.

An outbreak of rapidly progressive obstructive lung disease in Taiwan was noted in some patients regularly ingesting the vegetable Sauropus androgynus because of its perceived weight reducing properties. Bronchoalveolar lavage (BAL) prior to administration of medication was performed in two women who had regularly ingested this vegetable and had developed obstructive ventilatory defects. Both patients showed a significant increase in neutrophils and, to a lesser extent, of eosinophils in the lavage fluid as compared to two unrelated controls. Interleukin (IL)-1 beta, IL-2, IL-5, IL-10, interferon (IFN)-gamma and tumor necrosis factor (TNF)-alpha in cells recovered from BAL fluid were analyzed by reverse transcription-polymerase chain reaction (RT-PCR). Augmented expression of the IL-10 gene was detected in only two patients who had regularly ingested S. androgynus. Our results suggest that altered cytokine expression and infiltration of eosinophils and neutrophils may be involved in the pathology of obstructive lung disease caused by regular ingestion of S. androgynus.

Adult↗
PubMed1995

Involvement of histamine or tumor necrosis factor in early-type hypersensitivity.

A novel early-type hypersensitivity (ETH) reaction, manifested as capillary congestion, increase of vasopermeability, and plasma protein leakage, can be induced within 1 h after challenge of antigen-sensitized mice. The mediators involved in ETH varied among different strains of mice. The poly(Glu60Ala30Tyr10) (GAT)-induced ETH in BALB/c mice was blocked by diphenhydramine (histamine H1 antagonist) and ketanserine (serotonin antagonist), but not by cimetidine (histamine H2 antagonist). These results indicate that both histamine and serotonin are involved, and that the histamine effect is mediated through a H1 receptor. Meanwhile, GAT-induced ETH in B6 mice was inhibited by anti-TNF alpha antibody suggesting that TNF alpha is involved. The mice can be classified into either histamine or TNF alpha type based on the pattern of mediator involved in ETH. A/J and CBA strains as well as BALB/c mice were classified as histamine type while A. TL, B10.BR, and C3H/He in addition to B6 mice were TNF alpha type. The observation that GAT-induced ETH in (BALB/c x B6)F1 mice was inhibited by both diphenhydramine and anti-TNF alpha suggests that the mediation of the actions of histamine or TNF alpha by GAT was genetically controlled and inherited as the dominant trait in (BALB/c x B6)F1 mice. ETH could be passively transferred by heat (56 degrees C, 4 h)-treated anti-GAT sera. Sera derived from the histamine type transferred ETH across the type barrier and histamine was the mediator, irrespective of the type of the recipient. However, sera derived from TNF alpha type only transferred ETH to the mice of the same TNF alpha type and TNF alpha was the mediator.

Animals↗
PubMed1995

Rapidly fatal outcome of bacteremic Klebsiella pneumoniae pneumonia in alcoholics.

Twenty-eight alcoholic patients with community-acquired pneumonia who were admitted to a referral medical center during a 3-year period were reviewed. All were men and with few exceptions were heavy smokers. The overall mortality was 64.3%. The most dramatic group was that of 11 patients (39.3%) with bacteremic Klebsiella pneumoniae pneumonia (BKPP), which had high mortality rate (100%), short onset of illness before hospital admission (42.6 +/- 8.2 h, mean +/- SD), and short survival time after the admission (24.6 +/- 7.9 h). All these 11 patients needed intensive care unit (ICU) management and ventilatory support. ARterial blood gas values showed marked hypoxemia and metabolic acidosis in most of these 11 patients, and presence of shock at arrival in the hospital was noted in 8 patients. Acute renal failure and disseminated intravascular coagulation developed in six patients. Chest radiographs showed pleural effusion and radiographic spread in nearly 50% of patients. Combination chemotherapy consisting of one aminoglycoside and one second- or third-generation cephalosporin was initiated in all patients. The rapidly fatal outcome of these 11 patients with BKPP despite management with adequate antibiotics and intensive care indicated the fulminant nature of this disease. High virulence of the microorganism, altered immune response, and increased susceptibility to infection may all have contributed to the fulminancy in this group of patients. The disease continues to present many difficulties in management.

Adult↗
PubMed1995

Effect of prostaglandins and nitric oxide on basal blood flow and acetylcholine-induced vasodilation in rat diaphragmatic microcirculation.

To assess the effect of prostaglandins and endothelium-derived relaxing factor (EDRF) on diaphragmatic microcirculation under basal conditions and after acetylcholine (ACh) stimulation, we studied a diaphragmatic preparation in anesthetized rats. With bicarbonate-buffered Ringer's solution suffusing the abdominal surface of the left costal diaphragm, laser-Doppler flowmetry was used to record microvascular blood flow (QLDF). Microvascular conductance (CLDF) was derived from QLDF by dividing by the systemic blood pressure. Drugs were applied to the surface of the diaphragm. Four series of experiments were performed. In Series 1 (n = 9), ACh (3 x 10(-5)-10(-3) mol/L) elicited a concentration-dependent increase in QLDF and CLDF. In Series 2 (n = 11), ACh-induced QLDF and CLDF changes were significantly attenuated after 30 minutes suffusion of indomethacin (10(-5) mol/L), although baseline QLDF and CLDF were little affected. In Series 3 (n = 7), following suffusion of N omega-nitro-L-arginine methyl ester (L-NAME) (10(-4) mol/L) for 30 minutes, there was no change in baseline QLDF and CLDF. The ACh-induced QLDF change was abolished, while there was still a slight increase in CLDF (172 +/- 26%) at high concentrations of ACh (10(-3) mol/L). In Series 4 (n = 5), co-administration of indomethacin (10(-5) mol/L) and L-NAME (10(-4) mol/L) for 30 minutes did not completely prevent the increase in CLDF (143 +/- 13%) induced by high concentrations of ACh (10(-3) mol/L). The data suggest low basal activities of both vasodilatory prostaglandins and EDRF in diaphragmatic microvascular beds of the anesthetized rat, while both mediators independently modulate microvascular responses to ACh.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗
PubMed1994

Different effects of strenuous exercise and moderate exercise on platelet function in men.

BACKGROUND: Platelets play an important role in the pathogenesis of cardiovascular diseases. It is also noticed that on one hand, regular exercise can reduce the risk of cardiovascular diseases, and on the other hand, vigorous exercise provokes sudden cardiac death. We therefore hypothesize that various intensities of exercise may affect platelet function differently. METHODS AND RESULTS: Strenuous and moderate exercise (about 50% to 55% of peak oxygen consumption, VO2peak) on a bicycle ergometer in 10 sedentary and 10 physically active healthy young men was executed on two separate occasions. Blood samples were collected before and immediately after exercise. A newly designed tapered parallel plate chamber was used to assess platelet adhesiveness. Platelet aggregation induced by ADP was evaluated by the percentage of reduction in single platelet count. beta-Thromboglobulin (beta-TG) and platelet factor 4 (PF4) were measured by ELISA. In addition, a similar study on 5 patients with stable angina were also conducted. Our results showed that (1) in the sedentary healthy group, platelet adhesiveness and aggregation were increased by strenuous exercise and depressed by moderate exercise; (2) in the active healthy group, platelet adhesiveness and aggregation were enhanced by severe exercise, whereas only aggregation was decreased by moderate exercise; (3) in the patients with stable angina, platelet adhesiveness and aggregation were enhanced by strenuous exercise and adhesiveness was suppressed by moderate exercise; (4) the degree of hemoconcentration induced by acute exercise tended to be related to the severity of exercise in all subjects; and (5) although severe exercise elevated beta-TG and PF4, there were no significant changes in beta-TG, PF4, and the ratio of beta-TG to PF4 in healthy subjects after exercise. CONCLUSIONS: It is concluded that platelet adhesiveness and aggregability may be sensitized by strenuous exercise in both healthy subjects and patients with stable angina. In contrast, platelet function can be suppressed significantly by moderate exercise in the healthy and tends to be depressed in patients with stable angina. The former may increase the risk of cardiac arrest and the latter may protect us from cardiovascular diseases. In addition, the effects of acute exercise tend to be more pronounced in the sedentary than in the active.

Adult↗
PubMed1994

Differential effects of nitric oxide synthesis inhibitor on rat diaphragmatic microcirculation under basal conditions and after vasodilator stimulation.

To assess the effect of endothelium-derived relaxing factor (EDRF) on the diaphragmatic microcirculation under basal conditions and after vasodilator stimulation, prepared diaphragms from anesthetized rats were studied. With bicarbonate-buffered Ringer's solution suffusing the diaphragm, the microcirculatory blood flow was recorded by laser-Doppler flowmetry (QLDF). Drugs were applied to the surface of the diaphragm. Five series of experiments were performed. In Series 1, the effects of acetylcholine (ACh, 10(-4) M) and sodium nitroprusside (SNP, 3 x 10(-6) M) were measured before and after 15 minutes suffusion of N omega-nitro-L-arginine methyl ester (L-NAME, 10(-4) M). Trend analyses revealed that the vasodilator effect of SNP was not affected, while that of ACh was abolished by L-NAME. In Series 2, both ACh and SNP elicited a concentration-dependent increase in QLDF. In Series 3, following 15 minutes suffusion with L-NAME (10(-4) M), there was no change in baseline QLDF and the ACh-induced QLDF change was abolished, while the effect of SNP was maintained. In Series 4, five minutes of pretreatment with L-arginine (L-arg, 10(-2) M), followed by co-administration of L-arg (10(-2) M) and L-NAME (10(-4) M) for another 15 minutes, did not prevent the inhibitory effect on ACh-induced QLDF change by L-NAME. In Series 5, 20 minutes application of L-arg (10(-2) M) alone did not affect baseline QLDF. Also, L-arg did not influence the ACh-induced vasodilating response, whereas it slightly increased the SNP-induced vasodilating response.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗
PubMed1993

Effect of mode of activation of human eosinophils on tracheal smooth muscle contraction in guinea pigs.

We studied the relationship between mode of activation of isolated human eosinophils and in situ responsiveness in isolated tracheal smooth muscle (TSM) of guinea pigs. Human peripheral blood eosinophils were activated with either 10(-7) M phorbol myristate acetate (PMA) or 10(-6) M formyl-methionyl-leucyl-phenylalanine (fMLP) + 5 micrograms/ml cytochalasin B (CYB), and activation was confirmed by measurement of eosinophil peroxidase (EPO) secretion by kinetic assay. EPO secretion was similar after activation with fMLP+CYB (10.2 +/- 3.2% of total eosinophil content) and PMA (10.0 +/- 2.8% of total content; P = NS). Topical application of 6 x 10(6) eosinophils/cm2 activated with fMLP+CYB to the TSM segment caused 0.51 +/- 0.14 g/cm active tension (AT) in five preparations (P < 0.03 vs. baseline); cells activated with PMA caused no contractile response (0.04 +/- 0.03 g/cm AT, P = NS vs. baseline). Both PMA- and fMLP+CYB-activated cells caused augmentation of muscarinic responsiveness of guinea pig trachealis. The dose of intravenous acetylcholine required to cause a threshold response (ED0.3) was -7.3 +/- 0.1 log mol/kg at baseline vs. -8.7 +/- 0.5 log mol/kg after treatment with fMLP+CYB-activated eosinophils (P = 0.05) and -6.9 +/- 0.1 log mol/kg at baseline vs. -7.5 +/- 0.1 log mol/kg after PMA-activated cells (P < 0.01). Both AT and augmented muscarinic responsiveness were blocked by pretreating the eosinophils with 200 microM A-63162, an inhibitor of 5-lipoxygenase, before activation with fMLP+CYB. We demonstrate that eosinophils activated comparably (as assessed by EPO secretion) cause augmented muscarinic responsiveness and/or direct contraction of guinea pig TSM through secretion of a product of the 5-lipoxygenase pathway.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetamides↗
PubMed1993

Impaired sensorineural function after allergen-induced mediator release.

We tested the hypothesis that allergen-induced mediator release augments the magnitude of isocapnic dry gas hyperpnea-induced bronchoconstriction in sensitized guinea pigs. Male Hartley guinea pigs were sensitized by spontaneous inhalation of ovalbumin (OA) aerosol on days 0 and 7 of the study. On day 14, sensitized animals again breathed OA aerosol and were prospectively divided into a group that exhibited labored breathing (LB), presumably reflecting OA-induced inflammatory mediator release, and a group that did not exhibit LB at this time. Control guinea pigs breathed saline aerosol on days 0, 7, and 14. Bronchoalveolar lavage on day 17 disclosed relative eosinophilia in OA+LB, but not in OA-LB, animals. On day 17, the bronchoconstrictor responses to increasing intravenous (i.v.) doses of acetylcholine (ACh), substance P (SP), neurokinin A (NKA), and capsaicin, as well as dry gas hyperpnea, were measured in vivo in animals from each group. Control and OA-LB guinea pigs exhibited similar responses, but OA+LB animals demonstrated augmented bronchoconstriction induced by i.v. administration of ACh, SP, or NKA. However, despite their augmented responsiveness to these exogenous constrictor agonists, OA+LB animals displayed no greater bronchoconstriction after dry gas hyperpnea or i.v. capsaicin administration. It is known that both dry gas hyperpnea and i.v. capsaicin cause bronchoconstriction in guinea pigs by releasing endogenous tachykinins from airway sensory C-fibers. Thus, our results suggest that allergen-induced mediator release impairs endogenous tachykinin release from airway sensory C-fibers in guinea pigs.

Acetylcholine↗
PubMed1993

Bronchoprovocation test by forced oscillation technique: airway hyperresponsiveness in chronic cough and psychogenic dyspnea subjects.

By measuring the respiratory resistance (Rrs) with the forced oscillation technique, we evaluated the airway responsiveness to methacholine in four groups of subjects (30 normal, 21 asthmatic, 60 chronic cough, and 30 psychogenic dyspnea subjects). After evaluating the airway responsiveness of normal and asthmatic subjects, four patterns of dose-response curves were found. All of the asthmatic subjects were responders (types III and IV), whereas all but two of the normal subjects were nonresponders (types I and II). The responders had more bronchoconstriction than the nonresponders who presented with a significant decrease in FEV1 after the test. If airway hyperresponsiveness to methacholine was defined as Cmin < or = 12.5 mg/mL, then this test showed 100% sensitivity, 97% specificity, a positive predictive value of 95.5%, and a negative predictive value of 100%. According to these criteria, 18 of 60 (30%) chronic cough subjects and six of 30 (20%) psychogenic dyspnea subjects had airway hyperresponsiveness. We conclude that bronchoprovocation test by the forced oscillation technique is a simple, safe and time-saving tool for measuring airway hyperresponsiveness. We also found that airway hyperresponsiveness is a common finding in subjects with chronic cough, and is also present in some subjects with psychogenic dyspnea.

Adult↗
PubMed1992

Bronchial responsiveness in an area of air pollution resulting from wire reclamation.

Spirometric data from 86 primary school children living in an area of air pollution resulting from wire reclamation incineration were analysed and compared with 92 non-exposed schoolchildren. There were lower values for forced vital capacity and forced expiratory volume and thus a higher incidence of pulmonary function abnormalities in the children in the polluted area than those in a non-polluted area. There was no significant difference in the prevalence of respiratory symptoms between these two areas when surveyed by a questionnaire. Twenty eight schoolchildren from a non-polluted area and 26 children from the polluted area, who were said to have no respiratory symptoms and for whom consent forms were obtained, were recruited for a bronchial responsiveness test. Nine (35%) of 26 children in the polluted area were responders (less than 50 U) and only one of the control subjects was a responder. The mean (SD) log cumulative dose producing a 35% decrease in respiratory conductance and the minimum cumulative dose required to decrease respiratory conductance from the baseline in the children of the polluted area were significantly lower than that of the control subjects (1.32 (0.37) log units and 1.26 (0.44) log units, respectively, compared with 1.70 (0.10) log unit for both measurements in non-exposed children). These results indicate that air pollution resulting from wire reclamation can produce a detrimental effect on both pulmonary function and bronchial responsiveness in primary schoolchildren who are continually exposed to air pollutants from the time of their birth.

Air Pollutants↗
PubMed1992

Endogenous sensory neuropeptide release enhances nonspecific airway responsiveness in guinea pigs.

To test whether endogenous sensory neuropeptide release results in airway hyperresponsiveness to exogenous bronchoconstrictor stimuli, male Camm-Hartley guinea pigs were exposed either to capsaicin aerosol for 10 min (CAP-AER) or to saline aerosol (SAL-AER) as a control condition. The following day, animals were anesthetized, tracheostomized, and beta-adrenergically blocked with propranolol, and their bronchoconstrictor responses to intravenously administered acetylcholine (ACh), neurokinin A (NKA), or capsaicin were measured. The bronchoconstriction induced by isocapnic dry gas hyperpnea also was assessed. Compared with the SAL-AER control group, the CAP-AER-treated animals exhibited augmented bronchoconstrictor responses to ACh and NKA. In contrast, the SAL-AER and CAP-AER groups had equivalent bronchoconstrictor responses to dry gas hyperpnea and to intravenously administered capsaicin. CAP-AER treatment caused neutrophilic airway inflammation, as reflected in increased numbers of neutrophils in bronchoalveolar lavage fluid obtained from CAP-AER-treated animals. Ablation of airway c-fiber neuron function (by chronic pretreatment with capsaicin prior to capsaicin aerosol inhalation) eliminated the ACh hyperresponsiveness observed in the CAP-AER-treated animals, demonstrating that sensory nerve products play a key role in the development of this nonspecific hyperresponsiveness. Our results demonstrate that sensory nerve stimulation with capsaicin aerosol leads to nonspecific bronchoconstrictor hyperresponsiveness and cellular airway inflammation, and thus disclose another potentially important role of sensory nerves in regulating airway function.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗
PubMed1992

Adult bacteremic pneumonia: bacteriology and prognostic factors.

Bacteremic pneumonia is a highly specified subgroup of pneumonia that is potentially life-threatening. In order to find out the prognostic factors in this subgroup of pneumonia, we conducted a 40-month retrospective analysis of 70 cases in our hospital. The male to female ratio was 54:16. Forty-one cases were community-acquired bacteremic pneumonia (CABP), and 29 cases were nosocomial bacteremic pneumonia (NBP). Both CABP and NBP were predominated by gram-negative bacteria. Klebsiella pneumoniae was the most common microorganism isolated in both CABP and NBP. The overall mortality was 62.9% (44/70). There was no significant difference in the mortality between CABP (61.0%) and NBP (65.5%). After univariate analysis of all possible prognostic factors, 10 variables were found to have significantly poor prognostic values. They were: 1) the presence of septic shock; 2) the use of ventilatory support; 3) the presence of radiologic spread; 4) treatment in an intensive care unit; 5) male gender; 6) the development of adult respiratory distress syndrome; 7) Klebsiella bacteremic pneumonia in patients with an alcohol habit; 8) patients with ultimately fatal underlying diseases; 9) an initial AaDO2 > 200 mmHg; and 10) an initial arterial pH < 7.25.

Adult↗
PubMed1991

Effects of air pollution resulting from wire reclamation incineration on pulmonary function in children.

This study evaluated the effect of long-term air pollution resulting from wire reclamation incineration on pulmonary function in children. General physical examination and the determination of spirometric parameters, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and forced mid-expiratory flow (FEF25-75%) were conducted in 400 primary school children between ages 9 and 11 years who reside in one control and three polluted areas. A survey using ATS-DLD-78-C questionnaire indicated that there were no significant differences in their demographic characteristics among children in the four areas under study. Those who had nonrespiratory diseases that might affect pulmonary function and those who failed to perform spirometric measurements were excluded from the study; therefore, 382 children were included in data analysis. The results revealed that (1) the mean values of FVC and FEV1 (expressed as percentage of predicted values calculated from Polgar's equations) in the polluted areas were significantly lower than the nonpolluted area (p less than 0.05), and (2) the incidence of pulmonary function abnormality in the polluted areas was greater than that of the nonpolluted area (p less than 0.05). The results indicated that air pollution produced by wire reclamation incineration can impair children's pulmonary function.

Air Pollution↗