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Biomedical subjects

T Y Lin

Publications and source records attributed to T Y Lin.

At least 55 records · Page 3Linked to original sources

Ruby laser hair removal: evaluation of long-term efficacy and side effects.

BACKGROUND AND OBJECTIVE: Although several studies on laser-assisted hair removal have been published, data on long-term follow-up are few. The present study investigated the long-term efficacy and safety of normal-mode ruby laser pulses on hair removal. STUDY DESIGN/MATERIALS AND METHODS: The normal-mode ruby laser (Epilaser; 694 nm, 3 msec) was used to treat a wide range of body sites in 51 volunteers. The mean follow-up after the last treatment was 8.37 months. RESULTS: Sixty-three percent of the patients had sparse regrowth. The mean fluence used was 46.5 J/cm(2) in patients who had sparse hair regrowth and 39.3 J/cm(2) in patients who had moderate hair regrowth (P = 0.0127). Transient pigmentary changes occurred most frequently in patients with skin type 4. CONCLUSION: The normal-mode ruby laser is an efficient and safe method for long-term hair reduction, especially in fair-skinned individuals with dark hair. Higher fluences produce greater long-term efficacy. Adverse effects are minimal and transient.

Adolescent↗

Necrotising pneumonitis in children.

UNLABELLED: We retrospectively analysed the clinical features and outcome of children under 17 years of age with necrotising pneumonitis (NP). The radiographs and CT scans of the chest of children under 17 years of age between July 1995 and March 1999 who had complicating community-acquired pneumonia were reviewed. CT scans were obtained for persistent fever, respiratory distress and sepsis despite empiric antibiotic therapy and closed tube drainage. A total of 21 children had the radiographic features of NP of whom 11 (52%) patients were successfully managed using antibiotic therapy with or without closed tube drainage. Ten patients required thoracoscopic decortications and/or lysis of pleural adhesions or debridement of empyema due to refractory pleural sepsis, failure of pulmonary re-expansion and persistent air-leaks. The most common pathogens identified were Streptococcus pneumoniae (n = 3), Staphylococcus aureus (n = 2), and Haemophilus influenzae type b (n = 2). The days of hospital stay, duration of fever and days of C-reactive protein return to normal were significantly less for the medically versus the surgically treated children (P < 0.05). CONCLUSION: The clinical course of necrotising pneumonitis in children following complicated pneumonia is often prolonged despite adequate antibiotic therapy. Necrotising pneumonitis with co-existing multiple loculations, pneumothorax/ bronchopleural fistula in the empyema and extensive pleural peel are poor prognostic factors for medical therapy. Thoracoscopic removal of loculated empyema, lysis of adhesions and/or decortication are effective in relieving tachypnoea, chest pain, and controlling fever and improve the outcome, especially in children with empyema.

Adolescent↗

Dermal sinus with dermoid cyst in the upper cervical spine: case note.

We describe a 5 year-old girl who had a skin dimple of the back of her upper neck. MRI showed a dermal sinus tract in the upper cervical spine, associated with an intramedullary dermoid cyst at C 2-3, and spina bifida. A laminectomy was performed, the dermoid cyst and the sinus tract were completely removed. This congenital complex is very rare.

Cervical Vertebrae↗

Genetic analysis of enterovirus 71 isolated from fatal and non-fatal cases of hand, foot and mouth disease during an epidemic in Taiwan, 1998.

A large scale outbreak of hand-foot-and-mouth disease (HFMD) occurred in Taiwan in 1998, in which more than 80 children died of shock syndrome with pulmonary edema/hemorrhage. Enterovirus 71 was implicated as the cause of this outbreak. In order to understand the virological basis responsible for mortality on this scale, nucleotide sequences of VP1 that is important for serotypic specificity, and the 5'-non-coding region (5'-NCR) that is important for replication efficiency, were analyzed comparatively. Phylogenetic analysis of both VP1 and 5'-NCR of nine EV71 isolates derived from specimens of fatal patients and seven isolates derived from uncomplicated HFMD patients showed that all but one isolate fell into genotype B. The one distinct isolate from a case of uncomplicated HFMD belonged to genotype C that was clustered along with one isolate from Taiwan in 1986. Complete sequence analysis of two selected isolates, one from the spinal cord of a fatal case and one from the vesicle fluid of a patient with mild HFMD, confirmed a high degree (97-100%) of identity in nucleotide sequence throughout the entire genome, except focal regions of 3C and 3'-NCR where the nucleotide homology was 90-91%. The identity of the deduced amino acid sequence in the 3C region that encodes viral proteinase dropped further to 86%, a result of missense mutations at the first nucleotide position of many codons.

5' Untranslated Regions↗

Acute encephalomyelitis during an outbreak of enterovirus type 71 infection in Taiwan: report of an autopsy case with pathologic, immunofluorescence, and molecular studies.

We report a fatal case of enterovirus type 71 (EV 71) infection in an 8-year-old girl during a summer outbreak of hand, foot, and mouth disease in 1998 in Taiwan. The clinical course was rapidly progressive, with manifestations of hand, foot, and mouth disease, aseptic meningitis, encephalomyelitis, and pulmonary edema. The patient died 24 hours after admission. Postmortem study revealed extensive inflammation in the meninges and central nervous system and marked pulmonary edema with focal hemorrhage. Brain stem and spinal cord were most severely involved. The inflammatory infiltrates consisted largely of neutrophils involving primarily the gray matter with perivascular lymphocytic cuffing, and neuronophagia. The lungs and heart showed no evidence of inflammation. EV 71 was isolated from the fresh brain tissues and identified by immunofluorescence method with type-specific EV 71 monoclonal antibody. It was also confirmed by neutralization test and reverse-transcriptase polymerase chain reaction with sequence analysis. The present case was the first example in which EV 71 was demonstrated to be the causative agent of fatal encephalomyelitis during its epidemic in Taiwan.

Antigens, Viral↗

Molecular investigation of two clusters of hospital-acquired bacteraemia caused by multi-resistant Klebsiella pneumoniae using pulsed-field gel electrophoresis and in frequent restriction site PCR. Infection Control Group.

Two molecular typing methods, DNA macrorestriction analysis with XbaI resolved by pulsed-field gel electrophoresis (PFGE) and infrequent restriction site PCR (IRS-PCR) assay with adapters designed for XbaI and HhaI restriction sites, were used to investigate two clusters of hospital-acquired bacteraemia associated with multi-resistant Klebsiella pneumoniae which occurred in a paediatric intensive care unit (PICU). A total of 56 K. pneumoniae isolates were analysed. These included 10 bacteraemic isolates from eight patients, 26 isolates obtained during an epidemiological survey, and 20 epidemiologically non-related isolates incorporated as controls. One major pattern was demonstrated in 22 of the 56 isolates analysed. These included nine of the 10 bacteraemic isolates, a single rectal isolate, two hand culture isolates and 10 sink isolates. All of these 22 isolates illustrated identical antibiograms, whilst the other 34 isolates shared six antibiograms and 31 unique patterns by either PFGE or IRS-PCR assay. The two clusters of bacteraemia appeared to be outbreaks induced by the same strain of K. pneumoniae which may have utilized sinks as reservoirs and been transmitted through the hands of medical personnel to patients. IRS-PCR demonstrates concordant results with PFGE analysis in studying the genetic relationships among K. pneumoniae isolates, and serves as an excellent epidemiological tool for this bacterium.

Bacteremia↗

Candidaemia in special care nurseries: comparison of albicans and parapsilosis infection.

OBJECTIVES: Candidaemia caused by Candida parapsilosis (CP) is being increasingly reported among infants in neonatal intensive care units (NICU). To assess relative severity, clinical manifestations of candidaemia caused by C. albicans (CA) and CP in a NICU were compared. METHODS: Between January 1994 and July 1997, episodes of candidaemia occurring among infants hospitalized in the NICU were identified in a children's hospital. The demographic characteristics, associated risk factors, clinical manifestations and outcome of the infants with CP fungaemia were collected and compared with those of the infants with CA fungaemia. RESULTS: Twenty-four episodes caused by CA and 22 episodes caused by CP were included in this study. No significant differences were found between the two groups for gestational age, birth weight, male gender, post-natal age at onset of candidaemia, frequency of antecedent neonatal events, prior duration of antibiotic therapy and hyperalimentation, as well as presence of central venous catheter (CVC). Infants with CA fungaemia were significantly more likely than those with CP fungaemia to present with hypoxaemia, bradycardia and respiratory distress requiring intubation, and have a longer prior duration of indwelling CVC and a higher dissemination rate. The eradication rate of candidaemia and overall case fatality rate were comparable in both groups. but CP fungaemia did not appear to cause acute lethal events. CONCLUSION: The presenting signs of CP fungaemia are relatively not so severe, but CP fungaemia, which is relatively difficult to eradicate, increases the morbidity and mortality of the infants.

Blood↗

Fluconazole therapy in neonatal candidemia.

We reviewed 62 episodes (from 59 infants) of neonatal candidemia that occurred between January 1994 and June 1999. Except 5 term babies, all infants were premature (median gestational age [GA], 30 weeks) and birth weight was less than 2,500 g (median, 1,300 g). Most infants had reported risk factors and other neonatal problems. The age at onset of candidemia ranged from 15 to 173 days with a median of 34 days. In addition to catheter removal, all but one infants received antifungal agents and candidemia was eradicated subsequently in 46 episodes (75%). Eighteen infants with 19 episodes ever received fluconazole therapy. Fluconazole was administered as the first line agent in 6 episodes and successfully cleared candidemia in 5 episodes. Fluconazole was used as an alternative agent in an additional 13 episodes after amphotericin B (am B) +/- flucytosine were given for a period without a satisfactory result and eradication of candidemia was achieved in 8 episodes subsequently. All 18 infants tolerated fluconazole well and no withdrawal was required on account of its adverse effect. In contrast, am B alone was administered as the first line agent in 55 episodes and successfully cleared candidemia in 32 episodes (58%). This retrospective analysis suggests that fluconazole appears to be safe in neonates and can be used as an alternative agent in treating neonatal candidemia. A large-scaled prospective study may be needed.

Antifungal Agents↗

Hair removal with an 800-nm pulsed diode laser.

BACKGROUND AND OBJECTIVE: Laser hair removal is a relatively new procedure. Our purpose was to study the efficacy and safety of a high-power, pulsed diode laser array for removing unwanted hair. METHODS: A total of 38 subjects were treated with a prototype of the 800-nm diode laser system. Fluences ranging from 10 to 40 J/cm(2) (mean, 33.4 J/cm(2)) were used and 1 to 4 treatments (mean, 2.7) were performed. Evaluation of hair loss was performed at least 4 months after the last treatment (mean, 8.7 months) by a blinded assessment of clinical photographs. RESULTS: A total of 59% of the subjects had only sparse hair regrowth at the final follow-up. Higher fluences and multiple treatments produced greater long-term efficacy. Transient pigmentary changes occurred in 29% of the subjects and were more common in darker skin types IV to VI (P =. 047). CONCLUSION: The 800-nm diode laser is an efficient and safe technique for hair reduction. Adverse pigmentary effects occur, but are transient.

Adult↗

Factors associated with intestinal perforation in children's non-typhi Salmonella toxic megacolon.

BACKGROUND: To evaluate the risk factors for intestinal perforation in children with toxic megacolon caused by non-typhi Salmonella infection. METHODS: During an 11-year period we reviewed the records of children treated for non-typhi Salmonella infection. All of the subjects had positive stool culture for non-typhi Salmonella and were treated with intravenous ceftriaxone during hospitalization. Clinical data reviewed included demographic features, clinical manifestations, laboratory findings, radiologic findings, microbiology, therapeutic effect of hydration and rectal tube placement and the operative findings. Patients with toxic megacolon were defined as those having toxic appearance, diarrhea, high fever (>39 degrees C) and marked colon dilatation with maximal diameter > 1.5 times the width of the vertebra body of the first lumbar spine (L1-VB). To define the risk factors for patients with toxic megacolon complicated by intestinal perforation, patients were divided into two groups for analysis: P group, those complicated with intestinal perforation; and NP group, those without intestinal perforation. Differences in age, sex, severity of diarrhea, duration of fever, hemogram and its differential, culture, stool analysis, serum C-reactive protein (CRP), electrolytes, maximal colon diameter, medical therapy and timing of rectal tube insertion between the two groups were analyzed. Statistical analyses were conducted with chi square tests and multiple logistic regression. RESULTS: A total of 75 patients (P group, 27 patients; NP group, 48 patients) ages 4 months to 6 years were evaluated. With chi square analysis 7 variables were found to be significantly associated with intestinal perforation: age >1 year; fever >5 days; ratio of immature to total neutrophils >20%; serum CRP >200 mg/l; colon diameter >2.5 times the width of L1-VB; inadequate early hydration; and delay in rectal tube insertion. With multivariate analysis age >1 year, serum CRP >200 mg/l and colon diameter >2.5 times of width of L1-VB, inadequate early hydration and delay in rectal tube insertion were the most significant factors associated with intestinal perforation. CONCLUSION: Identification of patients with toxic megacolon associated with non-typhi Salmonella infection at risk for further intestinal perforation is possible. Early effective fluid resuscitation and rectal tube insertion may be helpful to prevent the occurrence of intestinal perforation.

Child↗

Cloning and functional characterization of a constitutively expressed nitrate transporter gene, OsNRT1, from rice.

Elucidating how rice (Oryza sativa) takes up nitrate at the molecular level could help improve the low recovery rate (<50%) of nitrogen fertilizer in rice paddies. As a first step toward that goal, we have cloned a nitrate transporter gene from rice called OsNRT1. OsNRT1 is a new member of a growing transporter family called PTR, which consists not only of nitrate transporters from higher plants that are homologs of the Arabidopsis CHL1 (AtNRT1) protein, but also peptide transporters from a wide variety of genera including animals, plants, fungi, and bacteria. However, despite the fact that OsNRT1 shares a higher degree of sequence identity with the two peptide transporters from plants (approximately 50%) than with the nitrate transporters (approximately 40%) of the PTR family, no peptide transport activity was observed when OsNRT1 was expressed in either Xenopus oocytes or yeast. Furthermore, contrasting the dual-affinity nitrate transport activity of CHL1, OsNRT1 displayed only low-affinity nitrate transport activity in Xenopus oocytes, with a K(m) value of approximately 9 mM. Northern-blot and in situ hybridization analysis indicated that OsNRT1 is constitutively expressed in the most external layer of the root, epidermis and root hair. These data strongly indicate that OsNRT1 encodes a constitutive component of a low-affinity nitrate uptake system for rice.

Amino Acid Sequence↗

Dural cavernous angioma mimicking a meningioma and causing facial pain.

An 18-year-old girl who had severe headaches in the left temporal and facial regions was found to have a small enhanced dural-based parietal convexity mass. On magnetic resonance imaging (MRI), this mass was homogeneously enhanced with "dural tail sign," and was similar to a meningioma. This mass was completely removed surgically, and pathology proved it to be a cavernous angioma without previous hemorrhages. The patient's facial pain was dramatically relieved after surgery. A small dural mass causing severe facial pain is an unusual situation. The lack of hemosiderin in the extra-axial cavernous angioma often leads to the preoperative diagnosis of meningioma.

Adolescent↗

Transcriptional repression by Drosophila methyl-CpG-binding proteins.

C methylation at genomic CpG dinucleotides has been implicated in the regulation of a number of genetic activities during vertebrate cell differentiation and embryo development. The methylated CpG could induce chromatin condensation through the recruitment of histone deacetylase (HDAC)-containing complexes by methyl-CpG-binding proteins. These proteins consist of the methylated-DNA binding domain (MBD). Unexpectedly, however, several studies have identified MBD-containing proteins encoded by genes of Drosophila melanogaster, an invertebrate species supposed to be void of detectable m(5)CpG. We now report the genomic structure of a Drosophila gene, dMBD2/3, that codes for two MBD-containing, alternatively spliced, and developmentally regulated isoforms of proteins, dMBD2/3 and dMBD2/3Delta. Interestingly, in vitro binding experiments showed that as was the case for vertebrate MBD proteins, dMBD2/3Delta could preferentially recognize m(5)CpG-containing DNA through its MBD. Furthermore, dMBD2/3Delta as well as one of its orthologs in mouse, MBD2b, could function in human cells as a transcriptional corepressor or repressor. The activities of HDACs appeared to be dispensable for transcriptional repression by dMBD2/3Delta. Finally, dMBD2/3Delta also could repress transcription effectively in transfected Drosophila cells. The surprisingly similar structures and characteristics of the MBD proteins as well as DNA cytosine (C-5) methyltransferase-related proteins in Drosophila and vertebrates suggest interesting scenarios for their roles in eukaryotic cellular functions.

Alternative Splicing↗

Virus infection in patients with histiocytic necrotizing lymphadenitis in Taiwan. Detection of Epstein-Barr virus, type I human T-cell lymphotropic virus, and parvovirus B19.

The relationship of Epstein-Barr virus (EBV), type I human T-cell lymphotropic virus (HTLV-I), and parvovirus B19 to histiocytic necrotizing lymphadenitis was studied prospectively in 10 Taiwanese patients using materials obtained by fine-needle aspiration and lymph node biopsy. The presence of EBV was detected by in situ hybridization for EBV-encoded RNA expression. Immunocytochemistry was used to detect virus-encoded protein for EBV and parvovirus B19. DNA in situ hybridization and polymerase chain reaction were performed to determine the existence of HTLV-I provirus. Expressions of EBV-encoded RNA and Fas ligand were detected in all cases. Expression of EBV-encoded protein was identified in only 1 case. Neither HTLV-I nor parvovirus B19 was detected in any case.

Adolescent↗

Sonographic evaluation of cellulitis in children.

Within a 3 year period from July 1996 to July 1999, a total of 105 children with clinical diagnosis of cellulitis were evaluated by ultrasonography. Eighty-six children (age range, 17 days to 15 years) fulfilling the sonographic criteria for diagnosis of cellulitis were enrolled into the study. The sonographic features were used to correlate with clinical symptoms and their duration, the peripheral leukocyte count, and the serum C-reactive protein level. Pus aspiration for immediate microscopic and later bacteriologic studies was carried out under sonographic guidance. Ultrasonographic features of cellulitis included subcutaneous tissue thickening without distortion and pus (25 cases, 29%), distortion of subcutaneous tissue without pus accumulation (26 cases, 30%), distortion of subcutaneous tissue with pus accumulation (19 cases, 23%), and distortion of tissue with abscess formation (16 cases, 18%). The presence of sonographic features of tissue distortion with or without pus accumulation, including abscess formation in children with cellulitis, correlated with a longer duration of symptoms (greater than 4 days), the presence of high-grade fever, higher peripheral leukocyte count, and higher serum C-reactive protein levels. Those patients who underwent sonographically guided aspiration or surgical intervention showed a shorter hospital stay and fever duration than those without such aspiration. Our results indicated that ultrasonography is of great value in managing cellulitis by providing information regarding the progression of inflammation. Sonographically guided aspiration of pus may be a treatment of choice, as it may decrease the need for operation.

Adolescent↗

Influenza A virus infection in infants.

Influenza A virus causes a variety of respiratory and nonrespiratory illness in children. The symptomatology varies with different age groups. The purpose of this retrospective study was to define the clinical characteristics of influenza A infection in Taiwanese infants. During the period from December 1997 to February 1998, 37 febrile patients younger than 1 year of age, including five newborns, were admitted to our hospital due to suspicion of sepsis or meningitis. The medical records of these patients were retrospectively evaluated. Influenza A virus was isolated from the specimens of the throat swabs in all patients, whereas no bacterial pathogen was detected. The most common clinical manifestations of these infants were lower respiratory tract infections, including pneumonia, bronchiolitis, and croup. There was no significant difference between the clinical characteristics of infants younger than 3 months and those aged from 3 months to 1 year. The mean duration of fever, peak of body temperature, and duration of hospitalization were 3.41 (+/-1.86) versus 4.4 (+/-2.02) days, 39.0 (+/-0.57) versus 39.9 (+/-0.63) oC, 4.9(+/-1.49) versus 6.3 (+/-3.7) days in infants younger than 3 months and infants aged from 3 months to 1 year, respectively. The older infants aged from 3 months to 1 year had a significantly higher peak body temperature than the infants younger than 3 months (p < 0.05). Two patients with croup had a more severe clinical course, however, the outcomes were good in all patients. During an influenza A virus outbreak, influenza A infection should be included in the differential diagnosis of infants with lower respiratory tract infection.

Age Factors↗