Biomedical subjects

Y L Lee

Publications and source records attributed to Y L Lee.

At least 73 records · Page 4Linked to original sources

PubMed1998

Low-level colonization and infection with ciprofloxacin-resistant gram-negative bacilli in a skilled nursing facility.

BACKGROUND: We report a 1-year surveillance study that evaluates colonization and infection with ciprofloxacin-resistant gram-negative bacilli (CR GNB) and the relation to quinolone use and other possible risk factors in a proprietary skilled nursing facility (SNF) with no history of outbreaks. METHODS: Rectal swabs obtained quarterly were streaked on MacConkey agar with ciprofloxacin discs (5 microg) to screen for CR GNB and later were speciated and the antimicrobial susceptibilities were confirmed by standardized disc-diffusion tests. RESULTS: The mean prevalence of CR GNB colonization was 2.6% (range 0.9% to 5.3%). The colonization frequency was higher in the last survey than it was in the first survey. CR GNB-colonized strains included Pseudomonas species (21%), but more than half were non-Pseudomonas enterics such as Acinetobacter baumannii (25%), Proteus mirabilis (17%), and Providencia stuartii (13%). None of the patients who had colonization with CR GNB had subsequent infections with the same species. Patients with colonization had more exposure to ciprofloxacin and they were more likely to have been recently admitted from an acute-care hospital and have decubitus ulcers. During the study period, of 336 patients surveyed, 98 (29%) patients developed suspected infections and cultures were done; the infection rate was 4.7 per 1000 patient days. Of these infected patients, 59 (60%) were infected by GNBs; the infection rate was 2.3 per 1000 patient days. Nineteen percent of the GNB infections were treated with a quinolone. (Overall, quinolones constituted about 17% of antibiotic usage in the SNF). Only 3 (5%) of the patients infected with GNB were infected with CR GNB, including Pseudomonas and Providenci a species. The CR GNB infections involved multiple sites, multiple organisms, and long length of stay in the SNF. CONCLUSIONS: The findings indicate that in this community SNF, a low frequency of colonization or infection with CR GNB existed. Whether continued moderate use of quinolones will lead to increasing levels of CR GNB will require further study.

Aged↗

PubMed1998

Significant cholinergic role in secretin-stimulated exocrine secretion in isolated rat pancreas.

Effects of intrapancreatic cholinergic activation by electrical field stimulation (EFS) on secretin-stimulated pancreatic exocrine secretion were investigated in the totally isolated perfused rat pancreas. EFS at 15 V, 2 ms, and 8 Hz for 45 min markedly increased spontaneous pancreatic secretion. This increase was completely inhibited by tetrodotoxin (1 microM) but not by hexamethonium (100 microM). Atropine (2 microM) significantly reduced the EFS-evoked volume flow and amylase output by 52% and 80%, respectively. EFS further increased the secretin (12 pM)-stimulated pancreatic secretion of fluid and amylase. The increases of the two parameters were significantly suppressed by atropine by 28% and 72%, respectively. Interestingly, EFS significantly increased concentrations of somatostatin-like immunoreactivity in portal venous effluents. When pertussis toxin (200 ng/ml) or rabbit antisomatostatin serum (0.1 ml/10 ml; titer of 1:50,000) was intra-arterially administered, EFS further increased the secretin-stimulated pancreatic secretion. In conclusion, the activation of intrapancreatic cholinergic neurons potentiated the secretin action on pancreatic exocrine secretion in the rat. This potentiating effect was significantly reduced by local somatostatin released during EFS that activated intrapancreatic cholinergic tone.

Acetylcholine↗

PubMed1997

Expression of glutamate uptake transporters after dibutyryl cyclic AMP differentiation and traumatic injury in cultured astrocytes.

Our findings indicate that differentiation of primary astrocytes by dibutyryl cyclic adenosine monophosphate (dBcAMP) and scratch injury together resulted in increased glutamate transporter gene expression. Confluent primary cultures were prepared from cerebral cortex of normal new born rat pups. The primary cultures were then divided into four groups each: control and scratch-injured, and dBcAMP-treated control and scratch-injured cultures. Total RNA was extracted at 0, 1, 2, 4, and 7 days after injury. Expression of the electrogenic glutamate transporters, GLAST, GLT-1, and EAAC-1, was quantitated by the reverse transcriptase-polymerase chain reaction method (RT-PCR) and slot blot hybridization followed by densitometric scanning. Triplicate cultures were analyzed for each time-point. Our studies indicate that all these astrocyte cultures expressed the two glial transporters, GLAST and GLT-1, while none of the cultures expressed the neuronal transporter, EAAC-1. The expression of the two transporters in the dBcAMP-treated primary cultures were markedly increased from the non-treated cultures. The dBcAMP-treated cultures had 2- to 4-times increase in levels of GLAST and GLT-1-mRNA expression both before and after scratch injury, as compared to untreated non-injured and injured primary cultures. All of the cultures expressed GLAST in greater proportion than GLT-1.

ATP-Binding Cassette Transporters↗

PubMed1997

Dopamine D4 receptor variants in Chinese sporadic and familial schizophrenics.

Variation in the number of tandem repeats of a 48 base pair (bp) unit was found in the gene of the dopamine D4 receptor (DRD4). The number of repetitions of the 48bp unit was shown to influence the binding of clozapine, which suggests that different alleles may function differently in vivo and affect the pathogenesis of schizophrenia. Genotypes of DRD4 polymorphism were analyzed for 47 schizophrenic probands who had at least one living sibling with a diagnosis of schizophrenia, 35 unaffected siblings of the schizophrenic proband, 42 sporadic schizophrenic patients, and 43 healthy controls without a family history of psychosis. There was no significant difference in genotypic or allelic distributions among the four groups. Significant differences in the frequencies of two- and seven-repeats alleles between the Chinese and Caucasians controls were noted. The present study did not support that a particular allele or genotype of the 48bp-repeat of DRD4 was associated with schizophrenia.

Adult↗

PubMed1997

The thioesterase I of Escherichia coli has arylesterase activity and shows stereospecificity for protease substrates.

A thioesterase I gene was recloned and sequenced from Escherichia coli strain JM109. The overexpressed, matured enzyme from JM109 was purified to homogeneity. The enzyme showed broad hydrolytic activity toward three kinds of substrates including acyl-CoAs, esters, and amino acid derivatives. The enzyme had a kcat/Km value of 0.363 s-1 microM-1, for a typical thioesterase I substrate, palmitoyl-CoA. The arylesterase activity of the enzyme was observed by its ability to hydrolyze several aromatic esters including alpha-naphthyl acetate, alpha-naphthyl butyrate, phenyl acetate, benzyl acetate, and eight p-nitrophenyl esters. In kinetic studies a chymotrypsin-like substrate (an amino acid derivative), N-carbobenzoxy-L-phenylalanine p-nitrophenyl ester (L-NBPNPE), was the best substrate for the enzyme with a catalytic efficiency (kcat/Km) of 4.00 s-1 microM-1, which was 23 times higher than that of the enantiomer D-NBPNPE (0.171 s-1 microM-1). It was concluded that the thioesterase I of E. coli had arylesterase activity and it possessed stereospecificity for protease substrates.

Animals↗

PubMed1997

Bacterial colonization of bone allografts related to increased interval between death and procurement: an experimental study in rats.

Whereas organs from donors must be removed almost immediately after death to maximize organ viability in the recipient, there is a slightly longer window for tissue allograft recovery. To determine the maximum safe interval after death within which bone allografts may be harvested for clinical use, an experimental model was devised using adult Sprague-Dawley (SD) rats and duplicating cadaveric storage techniques. Allografts were procured at increasing time intervals after death. The grafts were then transplanted to 80 living SD rats, and the animals killed at 7 weeks to evaluate any increase in the risk of infection and bacterial colonization. None of the allografts procured within 48 h after death were colonized with bacteria, while 12% of grafts procured at 96 h and 50% of allografts procured at 1 week were colonized. The results suggest that it may be possible to extend the safe period within which cadaveric tissue may be procured for transplantation to up to 96 h following death, provided scrupulous measures to prevent and detect microorganism contamination are followed.

Animals↗

PubMed1997

Rapid differentiation of vaccine strains and field isolates of infectious laryngotracheitis virus by restriction fragment length polymorphism of PCR products.

A procedure was developed for differentiation of vaccine strains and field isolates of infectious laryngotracheitis virus (ILTV) by restriction fragment length polymorphism (RFLP) of DNA fragments amplified from the genome of ILTV by polymerase chain reaction (PCR). RFLP patterns of viral thymidine kinase (TK) gene, glycoprotein C (gC) gene, glycoprotein X (gX) gene and ICP4 gene amplified from different ILT viruses were compared. The results showed that the vaccine strain of tissue-culture-origin (TCO) could be readily distinguished from other ILT viruses. Moreover, two out of the four field isolates could be differentiated from vaccine strains of chicken embryo origin (CEO); but the remaining two field isolates were identical to the CEO vaccine strains. These results suggested that both vaccine-like and vaccine-unlike ILT viruses were involved in the field outbreak of this disease, and that the PCR/RFLP procedure could serve as a fast and sensitive method for the detection and differentiation of vaccine strains and field isolates of ILT viruses.

Alphaherpesvirinae↗

PubMed1997

Surveillance of colonization and infection with Staphylococcus aureus susceptible or resistant to methicillin in a community skilled-nursing facility.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen in acute care hospitals and long-term care facilities. Few studies have been reported in private skilled nursing facilities (SNFs) not experiencing outbreaks of infections caused by MRSA. METHODS: From a 149-bed SNF with no outbreaks, we report a 1-year prospective surveillance study of S. aureus colonization and infection, with focus on S. aureus phenotypes, both methicillin susceptible (MS) and methicillin resistant (MR). Nasal and stool or rectal screening cultures were done on admission, and all patients underwent screening on at least a quarterly basis for 1 year. RESULTS: Overall, 35% of patients were colonized at least once with S. aureus, (72% MS, 25% MR, and 3% mixed phenotypes), 94% of the MRSA were ciprofloxacin resistant. Nasal colonization with any S. aureus was more frequent, but 13% of patients had positive results only in rectal specimens. Twenty-one percent of the newly admitted and 15% of continuing patients acquired colonization during their stay in the SNE Colonization was transient or persistent, persisted longer in the nares compared with colonization in rectal specimens, and was more stable for methicillin-susceptible S. aureus. Nine percent of patients had development of infection with S. aureus. There was no indication that MRSA colonization led to more infections than methicillin-susceptible S. aureus. Of the 13 infected patients in whom cultures had previously been obtained, seven (54%) had been colonized by the same phenotype strains. CONCLUSIONS: In this private SNF, endemic S. aureus infections occur at a low frequency, reflecting a moderate level of colonization with S. aureus. However, a trend showing gradual increases in frequencies of colonization and infection is of concern and suggests that in this SNF, future intervention could become warranted.

Aged↗

PubMed1997

In vivo gene transfer by intravenous administration of stable cationic lipid/DNA complex.

PURPOSE: A stable cationic lipid/DNA complex has been developed for in vivo gene transfer. The formulation capitalizes on a previously described procedure to obtain stable lipid/DNA complexes for in vitro gene transfer (1). METHODS: Conditions for DNA/lipid complex formation were modified to yield a DNA concentration of 1 mg/ml. Heat stable alkaline phosphatase (AP) under a CMV promoter was used as a reporter gene. RESULTS: The resulting complex was completely insensitive to serum inactivation. Tail vein injection of a 80 micrograms DNA into Balb C mice yielded significant levels of reporter enzyme activity in the lung, heart, spleen, muscle, and liver. Less AP activity was observed in the kidney. No AP activity was observed in blood, bone marrow or brain. A titration of the lipid (DOSPA) to DNA-nucleotide ratio showed the optimal molar ratio for in vivo gene transfer to be 1/1. Using this ratio in a dose response study showed approximately 80 micrograms of DNA/mouse yielded the highest level of gene expression. Using this dose at a 1/1 lipid to DNA nucleotide ratio, the time course for alkaline phosphatase activity was determined. Maximal AP activity was observed 24 hours after injection for all tissues. By day 5, the activity dropped approximately 10 fold for all tissues. By day 7, residual activity was detected in the lung, heart, and muscle. Histology of the lung showed both interstitial and endothelial cells to be transfected. In all other tissues, however, endothelial cells were the only transfected cell type. CONCLUSIONS: These results demonstrate that reformulation of an existing cationic lipid can result in the formation of a stable lipid/DNA complex, which is able to reproducibly transfect lung, heart, spleen, and liver upon intravenous administration.

3T3 Cells↗

PubMed1997

Incidence of JC viruria is higher than that of BK viruria in Taiwan.

To investigate the prevalence of human polyomaviruses in Taiwan, urine samples from immunocompetent (healthy), transient immunocompromised (pregnant), and prolonged immunosuppressed (autoimmune disease) individuals were collected throughout the island. The viral DNA in the urine was detected by the polymerase chain reaction (PCR) and Southern blot. The viral genotypes were determined by DNA sequencing within the regulatory region. The overall results, including cases reported previously, show that 13.3% (10/75) of immunocompetent individuals, 26.0% (20/77) of pregnant women, and 37.5% (18/48) of autoimmune disease patients are JCV positive. All of the immunocompetent individuals are BKV negative, but 3.9% (3/77) of the pregnant women and 6.2% (3/48) of autoimmune disease patients are BKV positive. Twenty-four percent (48/200) of the examined urine samples were JCV positive, but only 3% (6/200) were BKV positive. JCV positive individuals were mainly infected with CY (42%) and TW-1 (52%) subtypes. These results suggest that the incidence of urinary excretion of human polyomaviruses in immunosuppressed individuals is higher than that of immunocompetent individuals. The prevalence of JCV appears to be higher than that of BKV in Taiwan. In addition, CY and TW-1 are the predominant subtypes of JCV prevalent in the Taiwanese population.

Adult↗

PubMed1996

Chemokine expression in rat stab wound brain injury.

A traumatic injury to the adult mammalian central nervous system (CNS) results in reactive astrogliosis and the migration of hematogenous cells into the damaged neural tissue. Chemokines, a novel class of chemoattractant cytokines, are now being recognized as mediators of the inflammatory changes that occur following injury. The expression of MCP-1 (macrophage chemotactic peptide-1), a member of the beta family of chemokines, has recently been demonstrated in trauma in the rat brain (Berman et al.: J Immunol 156:3017-3023, 1996). Using a stab wound model for mechanical injury, we studied the expression of two other beta chemokines: RANTES (Regulated on Activation, Normal T cell Expressed and Secreted) and MIP-1 beta (macrophage inflammatory protein-1 beta) in the rat brain. The stab wound injury was characterized by widespread gliosis and infiltration of hematogenous cells. Immunohistochemical staining revealed the presence of RANTES and MIP-1 beta in the injured brain. RANTES and MIP-1 beta were both diffusely expressed in the necrotic tissue and were detected as early as 1 day post-injury (dpi). Double-labeling studies showed that MIP-1 beta, but not RANTES, was expressed by reactive astrocytes near the lesion site. In addition, MIP-1 beta staining was also detected on macrophages at the site of injury. The initial expression of the chemokines closely correlated with the appearance of inflammatory cells in the injured CNS, suggesting that RANTES and MIP-1 beta may play a role in the inflammatory events of traumatic brain injury. This study also demonstrates for the first time MIP-1 beta expression in reactive astrocytes following trauma to the rat CNS.

Animals↗

PubMed1996

Inflammation in EAE: role of chemokine/cytokine expression by resident and infiltrating cells.

Experimental allergic encephalomyelitis (EAE) is an inflammatory demyelinating disease of the central nervous system (CNS) which has many clinical and pathological features in common with multiple sclerosis (MS). Comparison of the histopathology of EAE and MS reveals a close similarity suggesting that these two diseases share common pathogenetic mechanisms. Immunologic processes are widely accepted to contribute to the initiation and continuation of the diseases and recent studies have indicated that microglia, astrocytes and the infiltrating immune cells have separate roles in the pathogenesis of the MS lesion. The role of cytokines as important regulatory elements in these immune processes has been well established in EAE and the presence of cytokines in cells at the edge of MS lesions has also been observed. However, the role of chemokines in the initial inflammatory process as well as in the unique demyelinating event associated with MS and EAE has only recently been examined. A few studies have detected the transient presence of selected chemokines at the earliest sign of leukocyte infiltration of CNS tissue and have suggested astrocytes as their cellular source. Based on these studies, chemokines have been postulated as a promising target for future therapy of CNS inflammation. This review summarized the events that occur during the inflammatory process in EAE and discusses the roles of cytokine and chemokine expression by the resident and infiltrating cells participating in the process.

Animals↗

PubMed1996

Infection surveillance and antibiotic utilization in a community-based skilled nursing facility.

To survey the types of suspect infections, the antibiotic utilization and the patterns of antibiotic resistance among bacterial pathogens in a community Skilled Nursing Facility (SNF), we conducted a 20-month prospective observational surveillance program comprising all 585 patients admitted to a 149-bed private community SNF. Data were collected form medical charts, laboratory reports and nurses reports. Overall, 41% of the patients developed at least one presumptive nosocomial infection, and 54% of the patients received one or more antibiotic treatments. The overall presumptive nosocomial infection rate was 7.2 per 1000 patient days. The most common sites of presumptive nosocomial infection were the urinary tract (38%) and the respiratory tract (28%). The most common pathogens overall were E. coli (25%). Antibiotic groups used most frequently were the quinolones (22% of prescriptions). Thirty-nine percent of the Staphylococcus aureus isolates associated with suspected infections were resistant to methicillin, and of these 94% were also resistant to ciprofloxacin. Most of the resistant S. aureus isolates were from indwelling catheter-associated with UTIs. Infections associated with quinolone resistant strains of gram-negative bacilli were infrequent. No epidemiologic evidence of nosocomial clustering was apparent.

Adolescent↗

PubMed1996

Posture effect on seating interface biomechanics: comparison between two seating cushions.

OBJECTIVE: This study aimed at investigating the effects of sitting posture on ischial pressure and pelvic orientation for two types of cushions. DESIGN: Two types of seating devices, Roho and Polyurethane (PU) Foam cushions, six predefined postures, and two subject groups, Normal and Paraplegic, were tested. Ischial pressure and pelvic orientation were monitored. The sequence in which the cushions were tested were randomized, and the postures were tested according to a preplanned sequence. SETTING: The experiments were carried out in the laboratory of a rehabilitation engineering centre in Hong Kong. PARTICIPANTS: Six paraplegic subjects (referred sample) and 8 normal volunteers were tested. At the time of study, no subjects showed any signs of pressure sore or other health problems. MAIN OUTCOME MEASURES: It was hypothesized that sitting posture could significantly affect pelvic orientation as well as pressure distribution. It was also hypothesized that cushion selection was a critical factor in compensating the adverse effects of postures on pressure distribution. RESULTS: With the paraplegic group, the maximum ischial pressure recorded on Roho for various postures ranged from 88 mmHg for the Trunk-Bent-Forward (PF) posture to 146 mmHg for the Trunk-Bent-Right (PR) posture, whereas on PU foam cushions, the values ranged from 106 mmHg for the PF posture to 221 mmHg for the PR posture. With the paraplegic subjects sitting with their trunks bent laterally, it was found that the mean pressure difference between the left and right ischial tuberosities was more prominent on the PU foam cushion than on the Roho. CONCLUSION: Sitting posture can significantly affect pelvic orientation and ischial pressure. This study was also showed that the Roho cushion was significantly more efficient in compensating the adverse effects of sitting posture on pressure distribution.

Biomechanical Phenomena↗

PubMed1996

Colonization by Staphylococcus aureus resistant to methicillin and ciprofloxacin during 20 months' surveillance in a private skilled nursing facility.

OBJECTIVE: To evaluate endemic colonization with Staphylococcus aureus resistant to methicillin, ciprofloxacin, or both among patients of a private skilled nursing facility, with regard to colonization rate and site, and relation to infection and prior antibiotic use. DESIGN: Prospective quarterly culture surveillance of nares and rectal specimens over 20 months' observation. RESULTS: The mean prevalence was 3.8% in new admissions and 5.4% for in-house patients; cumulatively, 7.5% of the patients were colonized during the study period. The colonization rate remained stable during the study period. Screening of rectal, as well as nares, specimens detected substantially more colonized patients than would have been detected by nasal cultures alone. Five to seven percent of the colonized patients developed later infection with methicillin-ciprofloxacin-resistant S aureus. Colonized patients did not differ significantly from the noncolonized group in prior use of quinolones, but the colonized group was exposed significantly more frequently to other antibiotics than the noncolonized group. Eighty-three percent of methicillin-resistant S aureus (MRSA) isolated from infections and 89% from colonization were also ciprofloxacin resistant. CONCLUSION: Although all infecting and most colonizing isolates of MRSA were resistant to quinolones, the overall rate of colonization remained low and stable despite the continued use of quinolones. The findings suggest that good infection control practice has prevented broader spread of such strains in this facility.

Adolescent↗

PubMed1996

The osteoporotic spine.

With an aging population, osteoporotic vertebral collapse is an increasingly common condition in both the Western and Eastern hemispheres. This review looked into the situation in Hong Kong with the aim of highlighting the major differences in data from the Western. Between 1989 and 1994, 497 patients with osteoporotic vertebral collapse, aged 65 to 94 years old, were admitted under the authors' care, with a female to male ratio of 5:1. More than 1/3 of the patients had fracture involving 1 single vertebra. The mean hospital stay was 5 days, with an additional 6 to 23 days in a convalescent hospital. Complication of spinal cord compression is uncommon and occurred in only 10 patients (2%) in this series who were treated mostly with anterior decompression and iliac crest graft with varying degrees of neurologic recovery. Despite the general benign nature of the problem, the high morbidity and the long hospital stays undoubtedly are significant drains on health care resources.

Aged↗

PubMed1996

The role of insulin in the interaction of secretin and cholecystokinin in exocrine secretion of the isolated perfused rat pancreas.

To investigate the role of insulin in the potentiation effect of secretin and cholecystokinin (CCK) on pancreatic exocrine secretion, the pancreas was isolated from rats and perfused with modified Krebs-Henseleit solution containing glucose at three concentrations. Intraarterial glucose at concentrations of 2.5, 10, and 25 mM produced modest but significant increases in both the pancreatic flow rate and the amylase output in a concentration-dependent manner. The mixture of secretin and CCK at concentrations of 18.5 and 14 pM, respectively, added to the glucose solutions augmented the pancreatic flow rate and amylase output in relation to the glucose concentration. In the streptozotocin-treated pancreas, the mixture of secretin and CCK failed to augment the pancreatic exocrine secretion unless exogenous insulin was added to the perfusate. Secretin markedly potentiated the CCK-induced amylase output when insulin was present in the circulation. However, CCK did not potentiate the secretin-induced flow rate even if insulin was present in the circulation. Insulin did not affect the actions of secretin alone but it potentiated the actions of CCK alone in both the pancreatic flow rate and the amylase output. It is concluded from the above results that insulin intensifies the combined actions of secretin and CCK in pancreatic exocrine secretion by potentiating the CCK action. Furthermore, in the presence of insulin, secretin is able to potentiate the pancreatic enzyme secretion stimulated by CCK.

Amylases↗

PubMed1996

An evaluation of the accuracy of magnetic-resonance-guided Gamma Knife surgery.

An evaluation of the systematic accuracy of magnetic resonance (MR)-guided Gamma Knife surgery was performed. In two experiments, a cylinder phantom filled with dosimeter gel containing ferrous sulfate was fixed to a stereotactic frame. The gel phantom was irradiated with the Gamma Knife with a single shot using 4-mm collimators. The target point was set at the frame center of the stereotactic system giving coordinate values of X = 100, Y = 100, Z = 100. The maximum target dose was 15 Gy. MR imaging was undertaken immediately after the irradiation, using a superconductive 1.5-T MR scanner. Spin echo T1-weighted images, with transaxial, coronal, and sagittal views, were obtained. On the images, points with the highest signals were defined as the target point which received the maximum dose. Within the dose range of the experiment, this definition is based on a linear relationship between the dose to the gel and the T1 relaxation shortening after irradiation. The distances between the frame center and the target point defined on the MR images in the experiments were 0.12 mm (0.2375 pixels) and 0.43 mm (0.8515 pixels), respectively. Both are within the mechanical accuracy of the Gamma Knife. The imaging study confirms the accuracy of the Gamma Knife surgery used in the institution.

Evaluation Studies as Topic↗