Biosynthesis of the polygalacturonic acid chain of pectin by a particulate enzyme preparation from Phaseolus aureus seedlings.
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Clostridium↗
Biomedical subjects
T Y Lin
Publications and source records attributed to T Y Lin.
Metabolic function and regeneration of cirrhotic and non-cirrhotic livers after hepatic lobectomy in man.
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Carcinoma, Hepatocellular↗
Successful treatment of severe streptococcal toxic shock syndrome with a combination of intravenous immunoglobulin, dexamethasone and antibiotics.
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Adolescent↗
Outbreak of Candida parapsilosis fungemia in neonatal intensive care units: clinical implications and genotyping analysis.
During a 5-month period, 17 infants hospitalized in neonatal intensive care units of a medical center and a branch hospital developed 18 episodes of Candida parapsilosis fungemia. The mean age at onset was 35 days. Prior to fungemia, all the infants had received hyperalimentation and antibiotics, and 15 infants had had central venous catheters. The presenting symptoms were variable but only vague in 40% of the episodes. Despite administration of antifungal agents, subsequent eradication of fungemia was achieved in only two-thirds of the episodes. None of the environmental samples was positive for C. parapsilosis, while 20% of hand-washing samples of staff working in both units yielded this microorganism. Four genotypes with two main types were identified from 14 outbreak strains and eight genotypes from 14 hand-washing strains, with one type predominant. The results suggest that C. parapsilosis fungemia increases the morbidity and mortality of neonates but does not cause acute lethal events. The outbreak was caused by two main genotypes, possibly via cross-infection by the hands of health care workers.
Candida↗
Reduction of regrowing hair shaft size and pigmentation after ruby and diode laser treatment.
Laser pulses which selectively damage pigmented hair follicles are a useful treatment for hypertrichosis. Clinically, regrowing hairs are often thinner and lighter after treatment. In this study, hair shaft diameter and optical transmission (700 nm) were measured before and after ruby (694 nm) and diode (800 nm) laser irradiation. Hair was collected from 47 and 41 subjects treated with ruby (0.3 ms and 3 ms) and diode (10-20 ms) lasers, respectively. "Responders" were defined as subjects with significant long-term hair loss as determined by hair counts at 9 and/or 12 months after treatment. In ruby laser responders (34/47), regrowing hairs were significantly both thinner (decreased diameter) and lighter (increased transmission). In "nonresponders" (13/47), regrowing hairs were lighter, but not thinner. The regrowing hair shaft absorption coefficient (as calculated assuming Beer's law) was significantly decreased by 0.3 ms ruby laser treatment, but was not changed by 3 ms ruby laser or diode laser treatment. After diode laser treatment, 38 of the 41 subjects were responders and regrowing hairs were both thinner and lighter. These results show that laser treatments can affect structural recovery (size of hair), follicular pigmentation (hair absorption coefficient), or both. Regrowth of thinner hair (decreased shaft diameter) occurs in conjunction with actual loss of hair. After long pulses (3 ms ruby; diode), regrowing hair was thinner and also lighter to an extent related to the decrease in hair diameter. In contrast, short ruby laser pulses (0.3 ms) appeared to be capable of inhibiting follicular pigmentation per se, in addition to affecting the hair diameter. This may account for the complete regrowth of lighter hair in "nonresponders" treated with 0.3 ms pulses. Laser-induced reduction in hair diameter and/or pigmentation are both long-term responses which confer cosmetic benefits in addition to actual hair loss.
Adult↗
Intravenous sulbactam/ampicillin in the treatment of pediatric infections.
A total of 82 patients involving 83 episodes of proven or presumed bacterial infection were treated with sulbactam/ampicillin. These included 36 cases of soft tissue infection or abscess, four cases of joint or bone infection, 20 cases of respiratory tract infection (17 cases of pneumonia, two of otitis media, and one of tonsillitis), 15 urinary tract infections, three cases of enterocolitis, one case of infective endocarditis, two cases of septicemia, and two of peritonitis. The causative pathogen was isolated in 48 cases (49 infections). These pathogens included Staphylococcus aureus 13 cases, Staphylococcus epidermidis one, Streptococcus pyogenes two, Streptococcus pneumoniae two, Viridans group streptococcus two, peptostreptococcus one, Haemophilus influenzae one, Escherichia coli 12, Enterobacter cloacae three, Proteus mirabilis one, Acinetobacter calcoaceticus one, Salmonella spp. two, Shigella sonnei one, Bacteroides fragilis one, and polymicrobial infections of various combinations in five cases. No bacterial pathogens were isolated in 34 infections, 14 cases of pneumonia and 15 soft tissue infections. Sulbactam/ampicillin was given by intravenous bolus in a dosage range of 75-450 mg/kg/day in four divided doses for variable periods of time depending on the type and severity of the infection. Of a total of 83 episodes of infections, 80 (96.4%) cases were either cured or improved. Bacteriologic eradication also occurred in 46 (93.9%) of 49 infections. Side effects were diarrhea in two patients, acute hemolytic anemia in one patient, and transient elevations in SGOT and leukopenia in one patient. Side effects disappeared upon completion of treatment. Sulbactam/ampicillin is a safe and effective antibiotic for the treatment of common pediatric infections.
Adolescent↗
Novel renin inhibitors containing the amino acid statine.
The proteolytic enzyme renin (EC3.4.99.19) cleaves the protein substrate angiotensinogen to yield angiotensin I, the decapeptide substrate transformed by converting enzyme into the pressor substance angiotensin II. Although the contribution of this pathway to the maintenance of normal blood pressure is unclear, it seems to be a major factor in various hypertensive states. Important progress in the control of hypertension has been achieved by development of the potent inhibitors SQ-14,225 (captopril) and MK-421 (enalapril maleate), which block the generation of angiotensin II by the inhibition of angiotensin converting enzyme. An attractive alternative to the inhibition of converting enzyme would be the blockade of the preceding step in the cascade, the renin reaction. We report here new highly potent (IC50 = 10(-9)-10(-8) M) competitive inhibitors of renin in which statine, (3S,4S)-4-amino-3-hydroxy-6-methylheptanoic acid, is incorporated into analogues of the pig renin substrate (Fig. 1).
Amino Acid Sequence↗
Crystallographic study of a beta-lactam inhibitor complex with elastase at 1.84 A resolution.
The continuing discovery and development of beta-lactams as antibiotics has had an unparalleled impact on the overall health and well-being of society. Recently, appropriately substituted cephalosporins were shown to be potent inhibitors of elastase, suggesting a novel therapeutic role for the beta-lactams in the control of emphysema and other degenerative diseases. We have now solved and partially refined at atomic resolution the structure of a complex of porcine pancreatic elastase with the time-dependent irreversible inhibitor 3-acetoxymethyl-7-alpha-chloro-3-cephem-4-carboxylate-1,1-dioxide tert-butyl ester (I), the most potent of the beta-lactam elastase inhibitors yet reported. (Porcine pancreatic elastase is a close relative of the desired drug target, human polymorphonuclear leukocyte elastase.) A mechanism of action is presented, based on the structure and on biochemical evidence (T.-Y.L. et al., in preparation), which clarifies the operational similarities and differences between beta-lactam elastase inhibitors and antibiotics. Features of the reaction include the expulsion of a leaving group at the cephalosporin 3' position and the formation of two covalent bonds with the active site of porcine pancreatic elastase at residues Ser 195 and His 57.
Animals↗
School-aged children with Kawasaki disease: high incidence of cervical lymphadenopathy and coronary artery involvement.
OBJECTIVE: We describe 10 school-aged children with Kawasaki disease (KD) with a high incidence of cervical lymphadenopathy and coronary abnormality. METHODS: Based on a database of 1002 children with KD in Chang Gung Children's Hospital from January 1983 to March 2001, 10 (1%) school-aged patients (five boys, five girls) who met the diagnostic criteria of KD were included for analysis. RESULTS: Cervical lymphadenopathy was noted in all (100%) of these patients. Unilateral neck mass mimicking acute suppurative infections not responding to antibiotic therapy was the initial presentation in nine (90%) of the 10 patients. The mean interval between disease onset and diagnosis was 9.9 +/- 3.3 days (range, 6-15 days). Seven (70%) of these patients responded to one course of high-dose intravenous immunoglobulin (IVIG) therapy (2 g/kg) and oral aspirin (80-100 mg/kg per day), two (20%) required a second course of IVIG, and one (10%) responded to high-dose aspirin treatment only. Coronary artery abnormality (dilatation or aneurysm) was documented by echocardiography in seven (70%) patients (four boys, three girls). In six patients, the coronary artery abnormalities resolved in 1 year, while one patient had persistent right coronary artery aneurysm, which necessitated continued anticoagulant and low-dose aspirin therapy. CONCLUSION: The incidence of school-aged children among patients with KD is about 1% in our hospital. These patients are notable for the high incidence of initial manifestations of unilateral neck mass and coronary artery involvement. This disease should be listed as the differential diagnosis in school-aged children presenting with fever and neck mass that do not respond to antibiotic therapy.
Aspirin↗
Detection of teichoic acid antibodies in children with staphylococcal infections.
The presence of serum antibodies to teichoic acid was evaluated by gel diffusion and enzyme-linked immunosorbent assay in 14 patients with deep-seated staphylococcal infection, in 5 patients with superficial staphylococcal infections, in 10 patients with Gram-positive infections other than staphylococcal and in 12 age-matched, uninfected patients. Serum samples were obtained on admission and serially each week during hospitalization. Teichoic acid antibodies were detected by gel diffusion in only 5 of 14 patients with deep-seated staphylococcal infections, in 1 of 10 patients with other Gram-positive infections and in none of the other patients. With the enzyme-linked immunosorbent assay method all patients with deep-seated staphylococcal infections had concentrations of teichoic acid antibodies of 1:1600 or greater, and these titers were significantly larger than those in the other groups of patients. Using a titer of 1:3200 or greater as a diagnostic level in children with deep-seated Staphylococcus aureus infections, the sensitivity was 93% and the specificity was 89%. For all staphylococcal infections the sensitivity was 79% and the specificity was 96%.
Adolescent↗
Fever during treatment for bacterial meningitis.
The records of 476 infants and children with bacterial meningitis treated between 1979 and 1982 were reviewed. By the sixth hospital day 90% or more of children with pneumococcal or meningococcal infection compared with 72% of children with Haemophilus infection (P less than 0.001) were afebrile. The rates of prolonged fever for 10 days or more, persistent fever for 5 to 9 days and secondary fever were 13, 13 and 16%, respectively. The conditions associated with prolonged fever for 10 days or more were subdural effusion (27%), drug fever (23%) and concomitant arthritis or pneumonia (20%); 15% were of indeterminable cause. The principal conditions associated with persistent fever for 5 to 9 days were other foci of disease (17%), nosocomial infections (16%) and subdural effusion (14%); in 42% the cause was unknown. The conditions associated with secondary fever were nosocomial infections (27%) and subdural effusion (23%); 39% were of indeterminable cause. Neither the duration nor the patterns of fever correlated with neurologic abnormalities at discharge, including hearing deficit.
Child↗
Predictors for extraintestinal infection of non-typhoidal Salmonella in patients without AIDS.
To identify the risks and predictors for extraintestinal infection (EII) in patients with non-typhoidal salmonellosis, we undertook a study of 398 patients with cultures positive for non-typhoidal Salmonella seen at Chang Gung Memorial Hospital and Chang Gung Children's Hospital between November 1993 and October 1994. Salmonella choleraesuis was the most invasive serotype observed. S. panama, S. typhimurium and S. schwarzengrund were the commonest causes of EII among those serotypes usually causing gastroenteritis. Pre-existing underlying disease, particularly immunosuppressive disease, was the most important risk factor that may have predisposed adult patients to have EII. Old age (> or = 60 years) and isolation of invasive serotypes were also frequently associated with EII in adult patients. The characteristics of paediatric patients with a high probability of having EII were: < 3 years of age, abnormal blood test results (a leucocyte count > or = 15,000/mm3 or < 5000/mm3, immature leucocytes > or = 10% of total leucocytes, and a C-reactive protein concentration > or = 50 mg/l); and isolation of invasive serotypes. This information can be an aid to early diagnosis and treatment of EII caused by non-typhoidal Salmonella.
Adolescent↗
Typhoid fever in children: a fourteen-year experience.
From 1982 to 1995, 71 children admitted in our medical center were diagnosed to have typhoid fever by culture or serology. Of the 71 children, most (83%) were aged 5-15 years. These children usually presented with fever and gastrointestinal symptoms, including abdominal pain, diarrhea, nausea or vomiting, and constipation. Hepatosplenomegaly was the most common physical sign observed and abdominal tenderness ranked the second. Thrombocytopenia occurring in 9 patients (13%) was the most common mode of complication. Other complications included intestinal perforation (3%), rectal bleeding (3%), ascites or pleural effusion (4%), and meningitis (1%). The incidence of complications tended to be higher among children 5 years of age or older (p = 0.31). Most patients responded well to appropriate antimicrobial therapies. There was no mortality. Relapse was observed in two children, although both had received 10 days of chloramphenicol therapy. The clinical isolates of Salmonella typhi were susceptible in vitro to all the antibiotics tested, including chloramphenicol, which, however, showed a higher MIC90 level than other drugs tested. In conclusion, there were age-specific differences of typhoid fever in children in terms of the incidence and morbidity and antibiotic resistance of S. typhi has not been a problem in this area at least up to 1995.
Adolescent↗
Prompt recognition of necrotizing fasciitis in a newborn.
We report a 13-day-old female neonate with necrotizing fasciitis, who presented with fever and erythema on her back. Rapidly progressive extension of the erythema to the abdominal wall occurred within 12 hours. Sonography for the lesion showed extensive fascial thickening with fluid accumulation. An abscess was also demonstrated. Necrotizing fasciitis was highly suspected. Under sonographic guidance, pus was aspirated from the abscess. A smear for the aspirated pus revealed a large number of neutrophils and abundant gram-positive cocci. Immediate surgical debridement was done. Cultures from the pus and blood revealed Staphylococcus aureus. The patient was free of symptoms after surgical debridement and aggressive antibiotic therapy. She had skin grafting to reconstruct the debrided wound on the 20th hospital day and was discharged shortly after the debridement of wound.
Fasciitis, Necrotizing↗
Radiographic presentation of pulmonary tuberculosis in young children.
Ten cases of pulmonary tuberculosis (TB) with the isolation of Mycobacterium tuberculosis in patients under 6 years of age occurring between July 1994 and June 1998 were retrospectively reviewed. Radiographs showed air-space consolidation (n = 4), micronodular (n = 3) and miliary lesions (n = 1). Two patients showed non-specific bronchopneumonic infiltrations. Other uncommon radiographic findings include pneumatocele formation and pleural effusion. Lymphadenopathies were detected in 6 (60%) cases using chest radiographs or computed tomography (CT), commonly with involvement of the paratracheal and hilar lymph nodes. However, most lymph node enlargement was not noted in routine postero-anterior (PA) radiographs and usually required a chest CT scan for confirmation. Since lymphadenopathy is common in children with pulmonary TB in Taiwan, we suggest using chest CT scans to detect such pathology in cases of suspected TB if other diagnostic tests are not conclusive.
Child↗
Sonographic and color Doppler sonographic diagnosis of acute osteomyelitis: report of one case.
Acute osteomyelitis in childhood is uncommon. Early diagnosis is often difficult. We present a 7-year-old boy with clinical manifestation of fever and progressive left thigh swelling for one week. Sonography of the left thigh showed periosteal thickening with subperiosteal abscess around the metaphysis of the left distal femur. Tc-99m bone scintigraphy showed increased uptakes at the left distal femur. Osteomyelitis was suspected from the examination of ultrasound and bone scan examinations. His symptoms were not relieved following systemic antibiotic therapy and a follow-up color Doppler sonography showed vascular flows within and around the periosteum indicating active inflammation. He finally received surgical drainage and the operative findings confirmed the diagnosis of osteomyelitis. In conclusion, ultrasound may be a helpful and convenient tool for establishing the early diagnosis of pediatric osteomyelitis. Ultrasound and color Doppler sonography can be used as clinical parameters to evaluate the disease severity and the progression of osteomyelitis in children.
Acute Disease↗
Partial liquid ventilation in normal rabbits: comparison of three kinds of perfluorocarbon.
Perfluorocarbon liquids have been used in liquid ventilation studies and considered an effective technique of gas exchange with less barotrauma when compared with gas ventilation. We compared the effects of partial liquid ventilation (PLV) using 3 kinds of perfluorocarbon liquids (Fluorinert FC 43, FC 77 and FC 84) available in Taiwan in normal rabbits. We were able to achieve adequate oxygenation and ventilation during a 2-hour-duration of PLV using FC 43, FC 77 or FC 84. There was no significant difference in hemodynamic status or laboratory findings between control group and PLV groups. There were also no significant differences before LV and after 2 hours of PLV among PLV groups. Histological study of lung tissue revealed intact and well expanded alveoli, and no significant pathological change after 2 hours of PLV. These results show that PLV using FC 43, FC 77 or FC 84 is an effective technique for maintaining adequate pulmonary gas exchange in normal rabbits.
Animals↗
Pyogenic sacroiliitis in children: report of three cases.
We report three children who were treated for pyogenic infection of the sacroiliac joint. The disease, usually present in late childhood or adolescence, is uncommon and difficult to assess so that the diagnosis is usually delayed. The three patients were two boys and one girl, aged 14, 15 and 12 years, respectively. A detailed history and physical examination are very important for establishment of the diagnosis. All the three cases presented with typical clinical triad of fever, limping gait and buttock pain. Pelvis compression maneuver, which directly stresses the sacroiliac joint, may aggravate the joint pain and suggest this diagnosis. On physical examination, this test is positive in all our cases. Nuclear scintigraphy is useful for localization of early lesions. For detecting abscess formation, magnetic resonance imaging was performed in two cases and computed tomography in one. In one of the patients, computed tomography failed to demonstrate an iliopsoas abscess formation, which was proved by magnetic resonance imaging later. Staphylococcus aureus was isolated from blood in all three patients. Prompt antibiotic therapy reduces complication and operation is rarely needed. With rapid and appropriate medical treatment, all our patients recovered without an sequelae.
Adolescent↗