Biomedical subjects

Yung-Kuei Soong

Publications and source records attributed to Yung-Kuei Soong.

At least 19 recordsLinked to original sources

PubMed2007

Transient chorioamniotic membrane separation after fetoscope guide laser therapy for twin-twin transfusion syndrome: a case report.

Chorioamniotic membrane separation (CMS) means that the close attachment of amniotic and chorionic membranes is disrupted, usually following the traumatic entry into the amniotic cavity including fetal therapy. We report a case of twin-twin transfusion syndrome receiving fetoscopic guide laser therapy at gestational age of 19 weeks with partial CMS detected at the fifth week (gestational age of 24 weeks) after surgery and resealed 1 week later. There was no more CMS noted till delivery at gestational age of 34 weeks 6 days. CMS after fetoscope surgery may reseal spontaneously.

Adult↗

PubMed2006

Novel codon-optimized GM-CSF gene as an adjuvant to enhance the immunity of a DNA vaccine against HIV-1 Gag.

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a potent immunomodulatory cytokine. Here we generated a novel codon-optimized murine GM-CSF gene as an adjuvant. The codon-optimized GM-CSF gene significantly increased protein expression levels in all cells tested. Although injection of the wild-type GM-CSF plasmids adjuvanted HIV-1 Gag DNA vaccine induced detectable immune responses, co-administration of plasmids encoding the codon-optimized GM-CSF sequence with the DNA vaccine resulted in a strong antibody and CTL responses and a protective immune response against infection with recombinant vaccinia virus expressing HIV-1 Gag. This novel codon-optimized GM-CSF gene offers a practical molecular strategy for potentiating immune responses to vaccines as well as other immunotherapeutic strategies.

AIDS Vaccines↗

PubMed2006

Use of laparoscopic cytoreductive surgery to treat infertile women with localized adenomyosis.

OBJECTIVE: We report on two infertile women with localized adenomyosis who had successful pregnancies after treatment with laparoscopic cytoreductive surgery. DESIGN: Case report. SETTING: Tertiary care university hospital. PATIENT(S): Two infertile women with localized adenomyosis. INTERVENTION(S): Laparoscopic excision of adenomyotic lesion with/without subsequent hypoestrogenic agent was performed. MAIN OUTCOME MEASURE(S): Pregnancy. RESULT(S): Hypoestrogenic agent with danazol was administered 3 months immediately after surgery in one woman. Both women conceived spontaneously at 30 and 21 months after surgery, respectively. The pregnancies were uneventful, and healthy infants were delivered via cesarean section at term. CONCLUSION(S): Laparoscopic cytoreductive surgery can be an alternative treatment to the use of hypoestrogenic agents or hysterectomy in women with localized adenomyosis, especially for those who want to maintain their fertility and achieve successful pregnancies. Patients may wait up to 21 months after surgery until a pregnancy occurs.

Adult↗

PubMed2006

Maintenance of CD8 effector T cells by CD4 helper T cells eradicates growing tumors and promotes long-term tumor immunity.

Human papillomavirus, particularly type 16 (HPV-16), is present in more than 99% of cervical cancers, and oncogenic HPV infection is one of the most important etiologies. It is now clear that CD4(+) T cells play an important role in controlling HPV-associated lesions because immunocompromised patients have a higher frequency of HPV-associated lesions. In the current study, we characterized the significance of CD4(+) T cells in the generation of E7-specific CD8(+) T cell immune responses in mice vaccinated with SINrep5-E7/HSP70 and boosted with vac-E7/HSP70. In addition, we characterized the contribution of CD4(+) T cells to the long-term antitumor effects. We found that vaccination with CD4 depletion significantly reduced the number of E7-specific CD8(+) T cells in mice. Furthermore, CD4(+) T cells are important for the long-term anti-tumor effects generated by vaccination with SINrep5-E7/HSP70 and booster with vac-E7/HSP70. Thus, CD4 T cells clearly have an important role in successful tumor immunity and maintenance of long-term tumor antigen-specific memory responses in vaccinated mice with established tumors.

Animals↗

PubMed2006

A DNA vaccine encoding a codon-optimized human papillomavirus type 16 E6 gene enhances CTL response and anti-tumor activity.

The HPV oncoproteins E6 and E7 are consistently expressed in HPV-associated cancer cells and are responsible for their malignant transformation. Therefore, HPV E6 and E7 are ideal target antigens for developing vaccines and immunotherapeutic strategies against HPV-associated neoplasms. Recently, it has been demonstrated that codon optimization of the HPV-16 E7 gene resulted in highly efficient translation of E7 and increased the immunogenicity of E7-specific DNA vaccines. Since vaccines targeting E6 also represent an important strategy for controlling HPV-associated lesions, we developed a codon-optimized HPV-16 E6 DNA vaccine (pNGVL4a-E6/opt) and characterized the E6-specific CD8+ T cell immune responses as well as the protective and therapeutic anti-tumor effects in vaccinated C57BL/6 mice. Our data indicated that transfection of human embryonic kidney cells (293 cells) with pNGVL4a-E6/opt resulted in highly efficient translation of E6. In addition, vaccination with pNGVL4a-E6/opt significantly enhanced E6-specific CD8+ T cell immune responses in C57BL/6 mice. Mice vaccinated with pNGVL4a-E6/opt are able to generate potent protective and therapeutic antitumor effects against challenge with E6-expressing tumor cell line, TC-1. Thus, DNA vaccines encoding a codon-optimized HPV-16 E6 may be a promising strategy for improving the potency of prophylactic and therapeutic HPV vaccines with potential clinical implications.

Analysis of Variance↗

PubMed2006

Ectopia cordis in a fetus with trisomy 18.

Trisomy 18 is the second-most common autosomal trisomy and represents one third of the chromosomal trisomies identified prenatally. We present a case of a fetus with trisomy 18 in which thoracoabdominal ectopia cordis was detected prenatally; it was noted as a dominant defect on a sonographic examination performed at 19 weeks' gestation. Furthermore, our case exhibits a rare type of multiple-marker screening result with increased maternal serum alpha-fetoprotein. This case demonstrates the need for thorough sonographic evaluation of the fetal thoracoabdominal wall as early as possible, because fetal ectopia cordis can be the major abnormality of trisomy 18.

Chromosomes, Human, Pair 18↗

PubMed2006

Sonographic prediction of significant intertwin birth weight discordance.

OBJECT: To evaluate the usefulness of sonographic prediction of significant birth weight discordance in twin pregnancies. STUDY DESIGN: Included in the study were live twin pairs with a gestational age of 24 weeks at birth who had received a sonographic examination within 28 days of delivery. Correlation tests and ROC curves were used to evaluate the predictability of significant intertwin growth discordance. RESULTS: A total of 575 twin pregnancies were included in the study. The estimated discordance by sonographic examination proved to be an effective predictor of discordant twin growth. The birth weight discordance estimated by sonography tended to underestimate the degree of discordant twins. CONCLUSION: If a sonographic examination is done within 28 days of delivery, it is a reliable predictor of twin birth weight discordance at the following levels: 15%, 20%, 25% or 30%. In order to obtain a higher sensitivity, the cut-off value of estimated birth weight discordance needs to be decreased by 5%.

Birth Weight↗

PubMed2006

Endoscopic management of cesarean scar pregnancy.

OBJECTIVE: To describe our experiences with the diagnosis and endoscopic treatment of cesarean scar pregnancy. DESIGN: Prospective clinical study. SETTING: Tertiary care university hospital. PATIENT(S): Eleven women treated in our division between 1999 and 2004 who had been diagnosed with cesarean scar pregnancy. INTERVENTION(S): Transvaginal ultrasound was used for diagnosis, and endoscopy (laparoscopy and/or hysteroscopy) was used to treat cesarean scar pregnancy and preserve fertility. MAIN OUTCOME MEASURE(S): Operative blood loss, hospital stay, and time to resolution of serum beta-hCG were recorded. RESULT(S): The gestational age at diagnosis ranged between 6 and 11 weeks. Laparoscopic treatment was used in four women, hysteroscopic treatment in six women, and one woman underwent combined treatment with laparoscopy and hysteroscopy. The average blood loss during surgery was 110.9 mL (range, 20-300 mL), and average hospital stay was 1.7 days (range, 0.25-3 days). No complications occurred, and no blood transfusion was required. All patients' uteri were successfully preserved, and serum beta-hCG levels declined to a normal limit within 4 weeks postoperatively. CONCLUSION(S): When the diagnosis of cesarean scar pregnancy is made in the first trimester, endoscopy can be an alternative surgical treatment; the prognosis is good, and fertility can be preserved.

Adult↗

PubMed2006

Pure XY gonadal dysgenesis and agenesis in monozygotic twins.

OBJECTIVE: To report a case of monozygotic twin sisters who had discordant gonadal dysgenesis although each had a normal 46,XY karyotype. DESIGN: Case report. SETTING: University tertiary hospital. PATIENT(S): Seventeen-year-old twin sisters, one with gonadal agenesis and the other with pure gonadal dysgenesis followed by dysgerminoma. INTERVENTION(S): Blood samples were obtained for karyotyping and short tandem repeat polymorphism analysis (10 markers). Both patients underwent gonadectomy. MAIN OUTCOME MEASURE(S): Both sisters are well at time of report after gonadectomy for the sister with dysgerminoma and diagnostic laparoscope for the other. RESULT(S): Dysgerminoma and atrophic ovarian stromal and tubal structures. CONCLUSION(S): Monozygotic twins can have discordant gonadal dysgenesis even though they are identical genetically.

Adolescent↗

PubMed2006

Interleukin-18 system messenger RNA and protein expression in human endometrium during the menstrual cycle.

OBJECTIVE: To investigate the IL-18 system, including IL-18, IL-18 receptor (IL-18R), IL-18 binding protein (IL-18BP), and IL-18 precursor (proIL-18), mRNA and protein expression in human endometrium during the menstrual cycle. DESIGN: Controlled study. SETTING: Clinical and academic research setting in a university medical center. PATIENT(S): Human endometrium was obtained from surgical specimens of normal cycling women undergoing hysterectomy for benign reasons. INTERVENTION(S): A total of 24 human endometrium samples were obtained at proliferative and secretory phase from surgical specimens of normal cycling women undergoing hysterectomy. Quantitative competitive polymerase chain reaction (QC PCR) and immunohistochemistry were performed. MAIN OUTCOME MEASURE(S): The differences of IL-18 system mRNA and the ratio of antagonist to agonist in both proliferative and secretory phases of endometrium were analyzed. RESULT(S): Our results showed a complete IL-18 system, including mRNA expression and protein production in both proliferative and secretory phases of the endometrium. The QC PCR demonstrated that both IL-18 and IL-18R decreased and IL-18BP increased mRNA expression in human endometrium in secretory phase compared with proliferative phase. A positive correlation of IL-18 and IL-18R in human endometrium was demonstrated in proliferative phase but not in secretory phase. In addition, there is a significantly higher ratio of IL-18BP to IL-18 mRNA levels in secretory endometrium compared with proliferative phase endometrium (P<.05). CONCLUSION(S): The expression and ratio of IL-18 antagonist to agonist may be responsible for embryo implantation.

Endometrium↗

PubMed2006

Association of fetal choroid plexus cysts with trisomy 18 in a population previously screened by nuchal translucency thickness measurement.

OBJECTIVE: The study's aim was to determine any association between choroid plexus cysts (CPCs) and trisomy 18 in a population of fetuses previously screened by nuchal translucency (NT) thickness measurement. METHODS: During the study period (May 1999 to December 2004), 7,795 fetuses had an NT scan and second-trimester fetal anatomical scan at our institution. The prevalence of trisomy 18 was determined among four types of pregnancies: 1) those with isolated CPCs, 2) those with CPCs and enlarged NT, 3) those with CPCs and other ultrasound markers, and 4) those with CPCs, enlarged NT, and other ultrasound markers. The fetal outcome according to NT and presence of CPCs was calculated. Incidence rates of enlarged NT and CPCs in fetuses with trisomy 18 and fetuses with normal chromosomes were also evaluated. RESULTS: For the entire population, ten trisomy 18 cases were diagnosed prenatally (prevalence, 0.13%). Among fetuses with enlarged NT, the likelihood ratio of trisomy 18 was significantly increased in fetuses with CPCs compared with fetuses without such cysts (333.6 versus 15.2, P = .002). However, among fetuses with normal NT, no significant difference was demonstrated for likelihood ratio of trisomy 18 between fetuses with and without CPCs. CONCLUSION: In pregnancies complicated by isolated CPCs, fetal karyotyping is not indicated when no additional anomaly is detected on ultrasonographic examination and first-trimester NT results are normal.

Adolescent↗

PubMed2006

Monozygotic twins discordant for monosomy 21 detected by first-trimester nuchal translucency screening.

BACKGROUND: Chromosomal abnormality in one fetus of a monozygotic twin pregnancy is rare, and discussion of prenatal detection of such a case offers some insight into this clinical problem. CASE: A 28-year-old gravida 1 had ultrasound screening at 11 weeks of gestation that revealed a monochorionic, diamniotic twin pregnancy with increased nuchal translucency (7.7 mm) in one fetus. Subsequent evaluation showed one 45,XY,-21 karyotype and one normal male karyotype. The pregnancy was monozygous by DNA analysis. The affected neonate died 5 minutes after delivery of both twins by cesarean. CONCLUSION: Monochorionic twins discordant for fetal abnormalities can be evaluated with molecular analysis. Study of such cases may reveal the extent to which an early diagnosis can lead to therapeutic interventions to support survival of the viable twin.

Adult↗

PubMed2006

Anaphylaxis to cefazolin during labor secondary to prophylaxis for group B Streptococcus: a case report.

BACKGROUND: Anaphylaxis is an uncommon event during pregnancy, but if it does arise, it can lead to serious fetal consequences even if there are no serious long-term maternal complications. CASE: A parturient developed anaphylaxis in the labor unit shortly after intravenous cefazolin chemoprophylaxis had begun for perinatal group B streptococcal disease. Prompt treatment for anaphylaxis commenced, involving the administration of epinephrine and glucocorticoids, and an emergency cesarean section spared the mother serious morbidity, with a favorable perinatal outcome for the fetus. CONCLUSION: To the best of our knowledge, this case is the first reported one of anaphylaxis to cefazolin in pregnancy secondary to prophylaxis against for B Streptococcus. The case demonstrates that a life-threatening anaphylactic reaction can occur at any time during pregnancy and that all staff in a maternal unit should be familiar with the management of perinatal anaphylaxis.

Adult↗

PubMed2005

Perinatal outcome of fetus with isolated congenital second degree atrioventricular block without maternal anti-SSA/Ro-SSB/La antibodies.

OBJECTIVE: We determined the perinatal outcomes of fetuses with isolated congenital second degree atrioventricular block detected in utero and born to mothers seronegative for anti-SSA/Ro-SSB/La antibodies. METHODS: Isolated second degree atrioventricular block was defined as second degree atrioventricular block detected in utero without the accompanying structural cardiac anomaly, tachyarrhythmia, non-conducted premature atrial beats or long QT syndrome. We review our own cases and search from Medline using keywords such as atrioventricular block, arrhythmia, bradycardia and congenital to collect cases of congenital isolated second degree atrioventricular block. RESULTS: Two cases were from our institution and five cases from a Medline search; in total seven cases of isolated second degree atrioventricular block without maternal anti-SSA/Ro-SSB/La antibodies were analyzed. Six of the seven fetal arrhythmias reverted to sinus rhythm by delivery and did not recur during the follow-up period. The prognosis of the fetus with isolated second degree atrioventricular block without maternal anti-SSA/Ro-SSB/La antibodies is better than that of the fetus with maternal anti-SSA/Ro-SSB/La antibodies or the fetus of congenital long QT syndrome with second degree atrioventricular block detected in utero. CONCLUSION: The fetus with isolated congenital second degree atrioventricular block carries a good prognosis in the absence of maternal anti-SSA/Ro-SSB/La antibodies.

Antibodies, Antinuclear↗

PubMed2005

Prenatal diagnosis of partial trisomy 12q: clinical presentations and outcome.

We present a pregnant woman with a fetus prenatally diagnosed as 46, XY,der(4) t(4;12) (q35.1; q21.2). This defect resulted from the unbalanced segregation of a paternal balanced translocation, t(4;12) (q35.1; q21.2). Prenatal ultrasound revealed borderline ventriculomegaly, a thick nuchal fold, pericardial effusion, arthrogryposis, a single umbilical artery, and micropenis. Fluorescence in situ hybridization (FISH) with whole chromosome painting probe and microarray-based comparative genomic hybridization analysis further confirmed chromosomal gain of terminal 12q. The woman had her pregnancy terminated at 20 weeks of gestational age. When compared with previously reported cases, the proband had characteristics common to the phenotypes of partial trisomy 12q, including an abnormal facial appearance and multiple anomalies. Additionally, this case had previously unreported phenotypes, such as arthrogryposis, a single umbilical artery, and a micropenis. Regarding the outcome of partial trisomy 12q, the fetuses carrying trisomies distal to 12q24 have a good chance of extended postnatal survival. In contrast, the cases with trisomies involving a larger amount of 12q likely die prenatally or within a few days after birth.

Abnormalities, Multiple↗

PubMed2005

Prenatal diagnosis of monosomy 4p14-->pter and trisomy 11q25-->qter: clinical presentations and outcomes.

We present the case of a pregnant woman with low free beta-HCG in maternal serum Down syndrome screening that led to prenatal diagnosis of a fetus with 46,XY,der(4)t(4;11)(p14; q25). This chromosomal aneuploidy resulted from unbalanced segregation of a paternal balanced translocation, t(4;11)(p14;q25). Prenatal ultrasound revealed intrauterine growth restriction, cleft lip and palate, a thick nuchal fold, a single umbilical artery, and pyelectasis. Array-based comparative genomic hybridization and short tandem repeat markers further located the exact breakpoint of translocation. The woman had her pregnancy terminated at 23 weeks of gestational age. The proband had general appearance of Wolf-Hirschhorn syndrome and some unique findings, including single umbilical artery, severe immunoglobulin deficiency, scalp defect, and underlying bony defect. Our case underscores the importance of fetal karyotyping when low maternal serum free beta-HCG is found. It also adds information on the fetal presentations of monosomy 4p14-->pter and trisomy 11q25-->qter.

Abnormalities, Multiple↗

PubMed2005

Enhancement of DNA vaccine potency through linkage of antigen gene to ER chaperone molecules, ER-60, tapasin, and calnexin.

DNA vaccines have emerged as an attractive approach for generating antigen-specific immunotherapy. Strategies that enhance antigen presentation may potentially be used to enhance DNA vaccine potency. Previous experiments showed that chimeric DNA vaccines utilizing endoplasmic reticulum (ER) chaperone molecules, such as Calreticulin (CRT), linked to an antigen were capable of generating antigen-specific CD8+ T cell immune responses in vaccinated mice. In this study, we tested DNA vaccines encoding the ER chaperone molecules ER-60, tapasin (Tap), or calnexin (Cal), linked to human papillomavirus type 16 (HPV-16) E7 for their abilities to generate E7-specific T cell-mediated immune responses and antitumor effects in vaccinated mice. Our results demonstrated that vaccination with DNA encoding any of these chaperone molecules linked to E7 led to a significant increase in the frequency of E7-specific CD8+ T cell precursors and generated stronger antitumor effects against an E7-expressing tumor in vaccinated mice compared to vaccination with wild-type E7 DNA. Our data suggest that DNA vaccines employing these ER chaperone molecules linked to antigen may enhance antigen-specific CD8+ T cell immune responses, resulting in a significantly more potent DNA vaccine.

Animals↗

PubMed2005

Congenital chylothorax in three siblings.

Congenital chylothorax is an uncommon condition, resulting from lymphatic accumulation in the fetal thorax; affected siblings are extremely rare. We report a woman who delivered 3 children with congenital chylothorax; each case was managed differently, including the use of ex utero intrapartum treatment (EXIT) with the third pregnancy.

Adult↗