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Y C Chen

Publications and source records attributed to Y C Chen.

At least 163 records · Page 9Linked to original sources
PubMed2001

Organ system failures prediction model in intensive care patients with acute renal failure treated with dialysis.

OBJECTIVE: To evaluate the organ system failures hospital mortality predictions in critically ill patients with acute renal failure requiring dialysis. DESIGN: Prospective, cohort study. SETTING: Intensive care units in a tertiary care university hospital in Taiwan. PATIENTS: A total of 112 patients admitted to the intensive care units with acute renal failure who required dialysis from January 1999 through December 1999. INTERVENTIONS: Collection of information necessary to compute the number of failed organs. MEASUREMENTS AND RESULTS: Of the 112 patients studied, 75 were men and 37 were women. The mean age of survivors and non-survivors was 58.59 +/- 19.91 years and 58.76 +/- 19.62 years. The overall mortality rate was 67%. There were no significant differences between survivors and non-survivors in terms of age, gender, or indication for dialysis. The cause of death in the majority of patients was related to organ system failure during the 24 hours immediately preceding the initiation of acute hemodialysis, and carry mortality rates exceeding 83% with the coexistence of four or more failed organs. The area under the organ system failures prediction model receiver operating characteristic curve equaled 0.772 +/- 0.046. CONCLUSION: We conclude that mortality rate for acute renal failure in intensive care unit patients continues to be high. Organ system failures prediction model performed well and simple in its ability to identify patients who die in hospital. Mortality rate increases as number of failed organ increases.

Acute Kidney Injury↗
PubMed2001

An enormous abdominal mass associated with acute renal failure.

We report a 67-year-old man with acute uric acid nephropathy, secondary to spontaneous tumor lysis syndrome, that presented itself as a huge intra-abdominal tumor that led to acute renal failure, hyperuricemia, and azotemia. Initial finding of hydronephrosis detected by ultrasonography led us to believe that the azotemia and decreasing amount of urine resulted from obstructive uropathy, a common complication of malignancy, caused by either a direct renal invasion or a urinary outflow tract compression because of a tumor mass effect. However, clinical observations and the response to therapeutic intervention confirmed the diagnosis of spontaneous tumor lysis syndrome, which is a rare cause of acute uric acid nephropathy.

Abdominal Neoplasms↗
PubMed2001

Lymphatic tumor emboli of perirenal fat in patient with nephrotic syndrome receiving renal biopsy, ultimately revealed gastric adenocarcinoma with membranous glomerulonephritis.

The association of malignancy with nephrotic syndrome and renal histopathologic abnormalities is well documented. Paraneoplastic proteinuria caused by membranous glomerulonephritis usually is made simultaneously with the diagnosis of a malignant tumor, or the two conditions are diagnosed within a year of each other. We reported a patient who presented with nephrotic syndrome initially. Incidentally, in kidney specimens, pathologic findings showed perirenal fatty tissue with malignancy tumor emboli in lymphatics. Thereafter, gastric adenocarcinoma was diagnosed by gastrointestinal panendoscopy with gastric biopsy under impression of malignancy associated with glomerulonephritis. Patient died of complications of malignancy-related disseminated intravascular coagulation without chemotherapy after confirming diagnosis was made three months later.

Adenocarcinoma↗
PubMed2001

Ticlopidine-induced thrombotic thrombocytopenic purpura: two case reports treated with plasma exchange plus steroids.

Thrombotic thrombocytopenic purpura (TTP) has a high mortality rate if left untreated with plasma exchange promptly. We report two cases of ticlopidine-induced TTP, which lesser dosages of ticlopidine (200-250 mg/day) were prescribed and were treated with plasma exchange (PE) plus steroids. The first case was treated successfully, but the second case did not respond to our treatment and died of a progressive disease complicated with pneumonia. In sum, we recommend careful use of ticlopidine, regardless of the dosages prescribe and regardless of how long the drug is used. Moreover, the adverse effect of ticlopidine should be closely monitored.

Aged↗
PubMed2001

Association between smoking, acetaldehyde dehydrogenase-2 1-1 status, and alcohol drinking among Taiwanese polyvinyl chloride workers.

To study the factors affecting alcohol consumption among Taiwanese workers, we conducted an investigation of the association between alcohol drinking and smoking, aldehyde dehydrogenase-2 (ALDH2) status, alcohol dehydrogenase-2 (ADH2) status, any history of abnormal liver function, and hepatitis B and C viral infection. The subjects included 207 male workers who had been followed-up with respect to liver function periodically since 1992. Information relating to current alcohol consumption and smoking habits was obtained by an interviewer-administered questionnaire in 1996, and any history of liver function and hepatitis B and C virus infection was obtained from previous medical surveillance. Genotypes of ALDH2 and ADH2 were determined by polymerase chain reaction/restriction fragment polymorphism assay. Results have revealed that smoking and ALDH2 1-1 status were associated with current alcohol consumption (respectively: odds ratio, 23.3; P < 0.01 and odds ratio, 14.5; P < 0.05). Neither a history of abnormal liver function nor a history of hepatitis B and/or C infection was associated with current alcohol consumption. It seems that only those with ALDH2 1-1 who are smokers consume alcohol. We conclude that smoking and inherited ALDH2 1-1 are the most important determinants of alcohol consumption. In addition to the medical advice of physicians in their yearly health check-ups, worksite health-promotion programs based on both alcohol consumption habits and smoking cessation should be instituted forthwith, particularly for those who demonstrate the potential for developing liver damage.

Adult↗
PubMed2001

Formation and properties of proton-exchanged and annealed LiNbO3 waveguides for surface acoustic wave.

The proton-exchanged (PE) and annealed PE (APE) z-cut LiNbO3 waveguides were fabricated using H4P2O7. The positive strain, c-axis lattice constant change (delta C/C), was calculated to be about +0.43%, which was almost independent of the exchanged conditions. The penetration depth of H measured by secondary ion mass spectrometry (SIMS) exhibited a step-like profile, which was assumed to be equal to the waveguide depth (d). The surface acoustic wave (SAW) properties of PE and APE z-cut LiNbO3 samples were investigated. The phase velocity (Vp) and electromechanical coupling coefficient (K2) of PE samples were significantly decreased by the increase of kd, where k was the wavenumber (2 pi/lambda). The insertion loss (IL) of PE samples was increased by the increase of kd and became nearly constant at kd > 0.064. The temperature coefficient of frequency (TCF) of PE samples showed an apparent increase with kd, reaching a maximum at kd = 0.292, then slightly decreased at higher kd. The effects of annealing resulted in a restoration of Vp and an improvement of IL.

Journal Article↗
PubMed2001

Polymorphic internal transcribed spacer region 1 DNA sequences identify medically important yeasts.

Species-specific polymorphisms in the noncoding internal transcribed spacer 2 (ITS2) region of the rRNA operon provide accurate identification of clinically significant yeasts. In this study, we tested the hypothesis that ITS1 noncoding regions contain diagnostically useful alleles. The length of ITS1 region PCR products amplified from 40 species (106 clinical strains, 5 reference strains, and 30 type strains) was rapidly determined with single-base precision by automated capillary electrophoresis. Polymorphisms in the PCR product length permitted 19 species to be distinguished by ITS1 alone, compared with 16 species distinguished by using only ITS2. However, combination of both ITS alleles permitted identification of 30 species (98% of clinical isolates). The remaining 10 species with PCR products of similar sizes contained unique ITS alleles distinguishable by restriction enzyme analysis. DNA sequence analysis of amplified ITS1 region DNA from 79 isolates revealed species-specific ITS1 alleles for each of the 40 pathogenic species examined. This provided identification of unusual clinical isolates, and 53 diagnostic ITS1 sequences were deposited in GenBank. Phylogenetic analyses based on ITS sequences showed a similar overall topology to 26S rRNA gene-based trees. However, different species with identical 26S sequences contained distinct ITS alleles that provided species identification with strong statistical support. Together, these data indicate that the analysis of ITS polymorphisms can reliably identify 40 species of clinically significant yeasts and that the capacity for identifying potentially new pathogenic species by using this database holds significant promise.

DNA, Fungal↗
PubMed2001

Mechanism of bradykinin-induced Ca(2+) mobilization in MG63 human osteosarcoma cells.

BACKGROUND: The effect of bradykinin on intracellular free Ca(2+) levels ([Ca(2+)](i)) in MG63 human osteosarcoma cells was explored using fura-2 as a Ca(2+) dye. METHODS/RESULTS: Bradykinin (0.1 nM-1 microM) increased [Ca(2+)](i) in a concentration-dependent manner with an EC(50) value of 0.5 nM. The [Ca(2+)](i) signal comprised an initial peak and a fast decay which returned to baseline in 2 min. Extracellular Ca(2+) removal inhibited the peak [Ca(2+)](i )signals by 35 +/- 3%. Bradykinin (1 nM) failed to increase [Ca(2+)](i) in the absence of extracellular Ca(2+ )after cells were pretreated with thapsigargin (an endoplasmic reticulum Ca(2+) pump inhibitor; 1 microM). Bradykinin (1 nM)-induced intracellular Ca(2+) release was nearly abolished by inhibiting phospholipase C with 2 microM 1-(6-((17 beta-3-methoxyestra-1,3,5(10)-trien-17-yl)amino)hexyl)-1H-pyrrole-2,5-dione (U73122). The [Ca(2+)](i )increase induced by 1 nM bradykinin in Ca(2+)- free medium was abolished by 1 nM HOE 140 (a B2 bradykinin receptor antagonist) but was not altered by 100 nM Des-Arg-HOE 140 (a B1 bradykinin receptor antagonist). Pretreatment with 1 pM pertussis toxin for 5 h in Ca(2+) medium inhibited 30 +/- 3% of 1 nM bradykinin-induced peak [Ca(2+)](i) increase. CONCLUSIONS: Together, this study shows that bradykinin induced [Ca(2+)](i) increases in a concentration-dependent manner, by stimulating B2 bradykinin receptors leading to mobilization of Ca(2+) from the thapsigargin-sensitive stores in a manner dependent on inositol-1,4,5-trisphosphate, and also by inducing extracellular Ca(2+) influx. The bradykinin response was partly coupled to a pertussis toxin-sensitive G protein pathway.

Biological Transport↗
PubMed2001

Pathogenicity of Vibrio alginolyticus isolated from diseased small abalone Haliotis diversicolor supertexta.

Outbreaks of mass mortality among cultured small abalone Haliotis diversicolor supertexta with abscess/ulcers in the mantle occurred in 1998 at Kao-Hsiung, Taiwan. A swarming bacterium, strain H-11 was isolated from the haemolymph of the moribund small abalone using tryptic soy agar supplemented with 3% NaCl and/or thiosulphate citrate bile salt sucrose agar. This strain was characterized and identified as Vibrio alginolyticus on the basis of various biochemical tests. The H-11 strain and its extracellular products were virulent to small abalones with LD50 values of 3.6 x 10(5) colony forming units and 2.96 microg protein/g body weight, respectively.

Animals↗
PubMed2001

Keratometric astigmatism after cataract surgery using small self-sealing scleral incision.

BACKGROUND: To evaluate the corneal refractive changes after a small self-sealing scleral wound. METHODS: A 4 mm self-sealing scleral tunnel incision and implantation of a foldable intraocular lens were adopted during phacoemulsification. A retrospective review of 48 consecutive isolated eyes in 48 patients was performed to assess the postoperative corneal refractive change. Keratometric readings were recorded for 3 months following surgery. RESULTS: At one week postoperatively there was a -0.29 +/- 1.02 (standard deviation) change of Naeser's polar value (against-the-rule shift) in the cylinder keratometry. The cylinder had with-the-rule shift and recovered to the preoperative state at one month postoperatively. The change of Naeser's polar value at the third postoperative month was 0.05 +/- 0.80 (with-the-rule shift) compared with the preoperative polar value. The change of astigmatism at the third postoperative month was -0.38 +/- 0.74 (Diopters) using simple subtraction and -1.01 +/- 0.58 (Diopters) using the Jaffe vector analysis. The axis of astigmatism exhibited a mild against-the-wound shift at 1 week and a gradual with-the-wound shift afterwards. CONCLUSION: The low induced astigmatism, early recovery of corneal curvature and no direct damage to the cornea support the concept and justify the use of a small self-sealing scleral tunnel incision during cataract surgery.

Adult↗
PubMed2001

Antibiotic use in public hospitals in Taiwan after the implementation of National Health Insurance.

BACKGROUND AND PURPOSE: Only limited data is available on the patterns of antibiotic use in hospitals in Taiwan before and after the implementation of national health insurance. This study aimed to determine the patterns of use of antibiotics in public hospitals in Taiwan after the implementation of the National Health Insurance program and to compare these with patterns prior to the implementation. METHODS: Data on the annual use of all antibiotics in public hospitals in Taiwan during the period from fiscal year (FY) 1994-1995 to 1997-1998 were collected and analyzed. Hospitals included seven medical centers, 19 regional hospitals, 53 district hospitals, and eight specialty service hospitals. RESULTS: The annual cost of antibiotics made up 17.4% of the annual cost of all medication used in these hospitals in FY 1994-1995, and decreased year by year to 12.6% in FY 1997-1998. During the study period, 57.4% of the total cost of antibiotics were incurred by medical centers, 24.6% by regional hospitals, 16.2% by district hospitals, and 1.8% by specialty service hospitals. The most commonly used class of antibiotic was cephalosporins, accounting for 48.0% to 54.3% of total antibiotic costs. The second most commonly used class of antibiotic was penicillins, accounting for 15.9% to 17.4% of total antibiotic costs. In FY 1994-1995, the next most commonly used classes of antibiotics were aminoglycosides, fluoroquinolones, and other beta-lactams, respectively, but by FY 1997-1998 these had changed to fluoroquinolones, glycopeptides, and aminoglycosides, respectively. Among the various cephalosporins used, first-generation cephalosporins accounted for 76.1% of all cephalosporins used in FY 1994-1995, which increased year by year to 84.0% in FY 1997-1998. Second-generation cephalosporins accounted for 20.7% of all cephalosporins used in FY 1994-1995, decreasing to 13.2% in FY 1997-1998. CONCLUSION: The introduction of the National Health Insurance program in Taiwan brought about a major change in antibiotic use patterns in public hospitals.

Anti-Bacterial Agents↗
PubMed2001

Comparative study of daily activities of pregnant and non-pregnant women after in vitro fertilization and embryo transfer.

BACKGROUND AND PURPOSE: The purposes of this study were to explore daily activity following embryo transfer (ET) in women who had undergone in vitro fertilization (IVF), and to compare the differences between pregnant and non-pregnant cycles. METHODS: This prospective survey was conducted in a medical center in northern Taiwan. Subjects were women who had completed one IVF cycle. Using a structured questionnaire, the subjects were asked whether they had changed their normal daily activities during the 2-week waiting period following ET. Data were collected on the day of ET and on the day of pregnancy testing before the outcome of the treatment was known. After the results of the pregnancy test were known, subjects were divided into pregnant and non-pregnant groups, with 30 subjects in each group. RESULTS: Of the 60 participants, 56 reported that they had tried to rest in bed for more than 2 hours following ET, and 54 reported that they limited their self-care activity on the day of ET. During the 2-week waiting period following ET, 55 walked at a slow pace, 51 limited their social activity, 47 avoided the use of stairs, 45 limited their self-care activity, and 40 adjusted their work load. However, a comparison of daily activity variables between the two groups yielded no significant differences. CONCLUSIONS: Most subjects reported that they restricted their daily activities following IVF/ET, even though their doctors suggested that they return to their normal routines. Bed rest was not correlated with successful IVF.

Activities of Daily Living↗
PubMed2001

Idiopathic polypoidal choroidal vasculopathy: case report.

In 1990, Yannuzzi et al. introduced a new clinical entity, "idiopathic polypoidal choroidal vasculopathy" (IPCV). There is now a more-widespread worldwide recognition of a higher prevalence and importance of this disorder. We report on the first case of IPCV in Taiwan to our knowledge. A 63-year-old Taiwanese man complained of blurred vision in his right eye for 6 months. The anterior segment and vitreous were normal except for mild nuclear cataract changes. Fundus examination of the right eye showed hard exudates and multiple reddish-orange subretinal lesions in the macula. Fundus examination of the left eye was normal. Fluorescein angiography of the right eye showed multiple hyperfluorescent granular lesions in the macula. Subretinal leakage and pooling of fluorescein were present in the temporal macula. Indocyanine green angiography disclosed multiple aneurysmal dilations at the terminals of branching vascular networks. A hyperfluorescent aneurysmal lesion corresponding to the reddish-orange nodule was observed ophthalmoscopically, and a granular lesion was observed in fluorescein angiography. Focal retinal photocoagulation was applied to the leakage area identified with fluorescein angiography. Two months after photocoagulation was performed, the subretinal fluid had gradually resolved, but a new leakage in the macula was demonstrated with fluorescein angiography. His best corrected vision in the right eye was stable.

Choroid Diseases↗
PubMed2001

Bilateral diffuse uveal melanocytic proliferation in a woman with uterine leiomyoma: case report.

Bilateral diffuse uveal melanocytic proliferation (BDUMP) associated with systemic carcinoma is a rare paraneoplastic syndrome. It was reported to be associated with primary carcinomas of the lung, ovary, colon, gall bladder, esophagus, pancreas, uterus, and cervix. We report a case of BDUMP that occurred in a woman with cervical leiomyoma. The 79-year-old woman experienced bilateral progressive visual loss to hand motion within 2 weeks. Fundus examination showed bilateral exudative retinal detachment and multiple oval red patches. Echographic study showed diffuse thickening of the uveal tracts. Fluorescein angiography showed multiple patches of window defect without late leakage, which was correlated with the oval red patches. After screening for tumor markers and meticulous examinations, an elevated serum level of CA-125 was noted. The only neoplasm found in this patient was a cervical leiomyoma, which has never been reported to be associated with BDUMP. One month after the onset of symptoms, accidental head injury due to poor vision led to right parietal intracerebral hemorrhage and left hemiplegia. Prompt diagnosis of this paraneoplastic syndrome is important to discover the underlying malignancy in patients with no history of cancer. For those cases without malignant neoplasm, attention should be directed to the disability caused by the severe visual loss, which led to accidental head injury and intracerebral hemorrhage in this case.

Aged↗
PubMed2001

[Illness knowledge, social support and self care behavior in adolescents with beta-thalassemia major].

The purpose of this study was to explore the relationships among illness knowledge, social support and self-care behavior in adolescents with beta-thalassemia major. The subjects were 58 beta-thalassemia major adolescents recruited from the pediatric hematology outpatient departments of three hospitals in North Taiwan. All data were analyzed by descriptive statistics, one-way ANOVA, t-test, Pearson correlation, and stepwise multiple regression. The results showed that: (1) Scoring in illness knowledge, the best was treatment knowledge, and the worst was the knowledge of complications and symptoms. (2) The result for social support indicated that the family was the major source of support, and that classmates/friends provided the least support for thalassemic adolescents. (3) Scoring in self care behavior, the best was the medical and chelate therapy, and the worst was the management of problems and coping. (4) Individual characteristic differences, including sex, level of education, length of illness, complications of thalassemia, hospitalization due to thalassemic complications and receiving other treatments were correlated with their illness knowledge, social support or self-care behavior. (5) Illness knowledge, social support which were positively correlated with self-care behavior. (6) 50.0% of the variance in self-care behavior can be explained by emotional support from family, general knowledge of thalassemia, treatment knowledge and appraisal support from family. These findings could provide referential material for nursing research and nursing practice.

Adolescent↗
PubMed2001

[Stressors and coping behaviors of mothers with child receiving open heart surgery].

The purposes of this longitudinal study were to (1) explore the stressors and coping behaviors of mothers having a child with congenital heart disease undergoing open heart surgery, and (2) understand the changes over time in these stressors and coping behaviors as the treatment process progressed. The field method was used to collect data, which was transcribed as a narrative verbal process recording. The records were then analyzed by content analysis. This study had ten subjects chosen by purposive sampling. The results showed that stressors on the mother whose child was undergoing open heart surgery could be inductively categorized as follows: the ill child, the treatment, and the mother herself. The coping behaviors consisted of cognitive behavior, emotional response, and management. At different stages of the 5045 behavior units were coded. There was a significant difference in the contribution of the stressors and coping behaviors at different stages of the treatment process. The findings can help nurses better understand the experience and provide some directions to assist mothers with child undergoing open heart surgery.

Adaptation, Psychological↗