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Tsai JP, Wu SW, Hung TW, Kao WT, Hong CL, Lian JD, Chang HR. Diagnostic performance of serum cystatin C and serum creatinine in the prediction of chronic kidney disease in renal transplant recipients. Transplant Proc 2011; 42:4530-3. [PMID: 21168730 DOI: 10.1016/j.transproceed.2010.09.150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Accepted: 09/30/2010] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) has adverse impacts on mortality and morbidity of renal transplant recipients. Serum cystatin C (sCysC) is a novel marker in predicting the CKD. We therefore compare sCysC and serum creatinine (sCr) with the aim of improving the detection of CKD in renal transplant recipients. METHODS We enrolled 106 renal transplant recipients and estimated glomerular filtration rates (GFR) using the Cockcroft-Gault (GFR(CG)) and the abbreviated Modification of Diet in Renal Disease (GFR(aMDRD)) formulae. We defined CKD as the presence of structural or functional kidney damage, irrespective of the diagnosis. Comparisons of sCysC and sCr in detecting CKD were analyzed. RESULTS sCysC correlates with sCr significantly (r = 0.87; P < .001). The receiver operating characteristic curve demonstrates that sCysC has a better specificity and area under the curve, but less sensitivity than sCr in predicting CKD in renal transplant recipients if GFR is estimated by GFR(CG). Additionally, if GFR was estimated by GFR(aMDRD), the role of sCysC or sCr in prediction of CKD was comparable. CONCLUSION sCysC may be better than sCr to detect CKD in renal transplant recipients using the GFR(CG).
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Affiliation(s)
- J-P Tsai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
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2
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Hong CL, Jia YB, Yang XE, He ZL, Stoffella PJ. Assessing lead thresholds for phytotoxicity and potential dietary toxicity in selected vegetable crops. Bull Environ Contam Toxicol 2008; 80:356-361. [PMID: 18311529 DOI: 10.1007/s00128-008-9375-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Accepted: 01/29/2008] [Indexed: 05/26/2023]
Abstract
Lead tolerance and accumulation in shoots and edible parts varied with crop species and soil type. The critical Pb concentrations at 10% yield reduction were 24.71, 28.25, and 0.567 mg kg(-1) for pakchoi, celery, and hot pepper, respectively under hydroponic conditions, whereas were 13.1, 3.83, 0.734 mg kg(-1) grown in the Inceptisol and 31.7, 30.0, 0.854 mg kg(-1) in the Alluvial soil, respectively. Based on the threshold of human dietary toxicity for Pb, the critical levels of soil available Pb for pakchoi, celery, and hot pepper were 5.07, 8.06, and 0.48 mg kg(-1) for the Inceptisol, and 1.38, 1.47, and 0.162 mg kg(-1) for the Alluvial soil, respectively. Similarly, the total soil Pb thresholds were different from vegetable species and soil types.
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Affiliation(s)
- C L Hong
- College of Natural Resources and Environmental Science, Zhejiang University, Hangzhou, 310029, China
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Ho ACY, Chung HS, Lu PP, Hong CL, Yang MW, Liu HP. Facilitation of alternative one-lung and two-lung ventilation by use of an endotracheal tube exchanger for pediatric empyema during video-assisted thoracoscopy. Surg Endosc 2004; 18:1752-6. [PMID: 15809783 DOI: 10.1007/s00464-003-9128-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2003] [Accepted: 05/26/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND Video-assisted thoracoscopic surgery (VATS) has emerged as an innovative and popular procedure for the management of postpneumonic empyema in children refractory to medical response. Alternative uses of two- and one-lung ventilations have been required during VATS. This study evaluated the efficacy of alternating one- and two-lung ventilation through intraoperatively through the same single-lumen endobronchial tube using a tube exchanger during a thoracoscopic procedure for pediatric empyema. METHODS Between May 1995 and August 2001, 62 consecutive pediatric patients undergoing VATS for evacuation of the loculated empyema cavity were studied. The same single-lumen endobronchial tube was used, with an indwelling endotracheal tube exchanger in place for readjustment of the tube position to provide alternation of one- and two-lung ventilations in a thoracosopic procedure. Duration of operation, heart rate, mean arterial pressure, peak airway pressure, an partial pressure of oxygen (PaO(2)) and carbon dioxide (PaCO(2)) changes during one- and two-lung ventilations were recorded. The quality of lung deflation and inflation was rated by the surgeon using direct visualization as excellent, fair or poor. RESULTS The mean operating time was 90 min (range, 50-120 min). No differences were found in heart rate, mean arterial pressure, or PaO(2) during one- and two-lung ventilations. Peak airway pressure and PaCO(2) during two-lung ventilation were significantly higher than during one-lung ventilation. The quality of lung deflation and inflation was judged excellent for all the patients. CONCLUSIONS The VATS procedure can be performed safely and effectively in children using proper anesthetic technique. Retention of a tube exchanger within a single-lumen endobronchial tube an easily provide alternative one- and two-lung ventilations without inducing any significant airway flow obstruction during the operation.
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Affiliation(s)
- A C Y Ho
- Department of Anesthesia, Chang Gung Memorial Hospital, 5, Fu-shin Street, Kweishan, Taoyuan, 333, Taiwan.
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Chen HJ, Lin TC, Hong CL, Chiang LC. Analysis of 3,N(4)-ethenocytosine in DNA and in human urine by isotope dilution gas chromatography/negative ion chemical ionization/mass spectrometry. Chem Res Toxicol 2001; 14:1612-9. [PMID: 11743744 DOI: 10.1021/tx015551x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The promutagenic etheno DNA adducts have been detected in tissue DNA of rodents and humans from various exogenous and endogenous sources. While other etheno DNA adducts have been detected and quantified by isotope dilution gas chromatography/negative ion chemical ionization/mass spectrometry (GC/NICI/MS), similar analysis for 3,N(4)-ethenocytosine (epsilonCyt) has not been available. In this report, a GC/NICI/MS assay was developed for detection and quantification of epsilonCyt in DNA and in human urine samples. The stable isotope of epsilonCyt with 7 mass units higher than the normal epsilonCyt was synthesized and used as internal standard of the assay. The adduct-enriched fraction of DNA hydrolysate was derivatized with pentafluorobenzyl bromide before GC/NICI/MS analysis with selective ion monitoring at [M - 181](-) fragments of pentafluorobenzylated epsilonCyt and its isotope analogue. One femtogram (S/N > 40) of pentafluorobenzylated epsilonCyt was detected when injected on column with selective ion monitoring mode. The limit of quantification for the entire assay was 7.4 fmol of epsilonCyt, which was approximately one thousand times lower than that of the HPLC/fluorescence assay for the nucleoside 3,N(4)-etheno-2'-deoxycytidine in DNA. Analysis of chloroacetaldehyde-treated calf thymus DNA by both GC/NICI/MS and HPLC/fluorescence methods provided similar adduct levels and thus verified the assay. This GC/NICI/MS method was used for analysis of epsilonCyt in two smokers' urine samples and the average level of epsilonCyt was 101 +/- 17 pg/mL/g of creatinine. Thus, quantification of epsilonCyt in DNA and in urine by this highly specific and ultrasensitive isotope dilution GC/NICI/MS assay may facilitate research on the role of epsilonCyt in carcinogenesis and in cancer development.
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Affiliation(s)
- H J Chen
- Department of Chemistry, National Chung Cheng University, 160 San-Hsing, Ming-Hsiung, Chia-Yi 62142, Taiwan.
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Tso AS, Chung HS, Wu CY, Li JY, Hong CL, Yang MW, Lui PW. Anesthetic management of a patient with relapsing polychondritis--a case report. Acta Anaesthesiol Sin 2001; 39:189-94. [PMID: 11840586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Relapsing polychondritis is a rare multisystem disorder of uncertain etiology. It is characterized by recurrent and progressive destruction of both elastic and hyaline cartilages as well as connective tissue. Respiratory tract involvement is associated with high mortality and morbidity. General anesthesia may be required in these patients for tracheostomy, bronchoscopy, nasal reconstruction, aortic valve replacement, and recent tracheobronchial stenting which they usually sustain. Tracheostomy was once the most likely surgical procedure in relapsing polychondritis. However, this procedure is only effective in patients with upper subglottic involvement. In cases of extensive tracheobronchial involvement, tracheostomy is ineffective because the distant tracheal collapse below the tracheostomy is still unresolved. We would like to report a case of relapsing polychondritis with tracheobronchial involvement, who underwent an emergent tracheostomy. Tracheostomy with continuous positive airway pressure (CPAP) effectively improved her airway collapse. Herein, we also discuss the anesthetic management after review of the current literature.
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Affiliation(s)
- A S Tso
- Department of Anesthesia, Chang Gung Memorial Hospital, Linkou, 5 Fu-Shin St., Kweishan, Taoyuan, Taiwan, R.O.C
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Hong CL, Ho AC, Liu HP, Chung HS, Chen CH, Tso AS, Yang MW. Diagnosis of progressive compression of the aortic true lumen with intraoperative transesophageal echocardiography during repair of dissection of thoracic aorta--a case report. Acta Anaesthesiol Sin 2001; 39:183-7. [PMID: 11840585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
We report an incident of progressive compression of the true lumen of aorta which happened immediately after cardiopulmonary bypass (CPB) and was diagnosed with intraoperative transesophageal echocardiography (TEE) in a patient undergoing an emergent repair of type A aortic dissection under femoral perfusion. During the CPB period, intraoperative TEE revealed gradual expansion of the false lumen which nearly obstructed the true lumen of the dissected aorta. The possible mechanism was related with distension of the false lumen by a dominant flow from retrograde femoral perfusion of CPB. With the application of intraoperative TEE, we could easily detect the hemodynamic changes of thoracic aorta and find the real causes so as to solve the perfusion abnormalities.
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Wang YL, Hong CL, Chung HS, Ho AC, Yu CL, Liu HP, Lee YH, Tan PP. Massive hemoptysis after the initiation of positive pressure ventilation in a patient with pulmonary tuberculosis. Anesthesiology 2000; 92:1480-2. [PMID: 10781296 DOI: 10.1097/00000542-200005000-00040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Y L Wang
- Department of Anesthesia, Chang Gung Memorial Hospital, Taiwan, Republic of China
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Chen CH, Hong CL, Kau YC, Lee HL, Chen CK, Shyr MH. Fatal hyperkalemia during rapid and massive blood transfusion in a child undergoing hip surgery--a case report. Acta Anaesthesiol Sin 1999; 37:163-6. [PMID: 10609352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
We report a girl who developed severe and fatal hyperkalemia following rapid and massive blood transfusion during surgery. She was 7-year-old, 20-kg in weight, and received wide resection of the femoral bone with custom prosthesis implant because of malignant femoral osteosarcoma. During the procedure, bleeding was active and profuse and amounted to about 3,000 mL in 4 h, eventuating in shock. Despite rapid transfusion with 15 units of packed red blood cells (RBC) still she remained hypotensive and hypovolemic. When we switched to give her whole blood, actually 100 mL having been given, widening of QRS complex followed immediately by cardiac arrest developed. Cardiopulmonary resuscitation although started at once was unsuccessful. At this juncture, arterial blood gas analysis showed acidosis and severe hyperkalemia (10.3 mmol/L), possibly resulting from transfusion of blood of older storage. The case reminded us once again the importance and necessity of the use of potassium-low blood component (fresh, saline-washed RBCs) in case of massive and rapid blood transfusion especially in pediatric patients with hypovolemia and low cardiac output.
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Affiliation(s)
- C H Chen
- Department of Anesthesia, Chang Gung Memorial Hospital, Taiwan, R.O.C
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Lin WT, Cheng KC, Liu HP, Hsieh JR, Hong CL, Wu RS, Tan PP. Alternation of one-lung and two-lung ventilations with the same single-lumen endobronchial tube during thoracoscopic surgery--a case report. Acta Anaesthesiol Sin 1998; 36:229-33. [PMID: 10399519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
One-lung ventilation is sometimes necessary for procedures performed through thoracotomy. Single lumen endobronchial tube has been used purposefully for one lung ventilation since 1931. However, there are no reports on intra-operative alternation of one-lung and two-lung ventilations through the same single lumen endobronchial tube as it can only provide unilateral lung ventilation. We present a case in whom a tube exchanger was used to readjust tube position so as to provide alternation of one-lung and two-lung ventilations in a thoracoscopic procedure.
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Affiliation(s)
- W T Lin
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
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Affiliation(s)
- F J Lu
- Department of Biochemistry, College of Medicine, National Taiwan University, Republic of China
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Abstract
A high incidence of bladder cancer (23.53/100,000 population per annum from 1981-1985) was found in an endemic area of peripheral vascular disease known as black foot disease (BFD) on the southwest coast of Taiwan. The average incidence of bladder cancer in the whole of the Taiwan area was 2.29/100,000 during the same period. The incidence of female bladder cancer (21.10/100,000) in this area was also high. The ratio of male to female bladder cancer in the BFD endemic area and the neighbouring area was 1.24 and 1.09, lower than that in the whole Taiwan area (2.75) and elsewhere around the world. The high content of arsenic and the high concentration of a "fluorescent substance" in artesian well water in this area are the only 2 related factors identified so far. Determination of the actual carcinogen requires further investigation.
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Affiliation(s)
- H S Chiang
- Department of Urology, Taipei Medical College, Taiwan, Republic of China
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Chi WO, Hong CL. A Rapid Synthesis of 2,3,11,11a-Tetrahydro-6H-pyrazino[1,2-b]isoquinoline-1,4-diones Through an Amido Iminium Ion Cyclization. Aust J Chem 1990. [DOI: 10.1071/ch9900773] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
7,10-Dimethoxy-6-methyl-2,3,11,11a-tetrahydro-6H-pyrazino[1,2-b]isoquinoline-1,4-diones (5) and (6) were synthesized from glycine anhydride and 2,5-dimethoxybenzaldehyde through an amido iminium ion cyclization reaction. This method for the construction of the tetrahydroisoquinoline ring will be useful for the synthesis of saframycins.
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Chiang HS, Hong CL, Guo HR, Lee EF, Chen TY. Comparative study on the high prevalence of bladder cancer in the blackfoot disease endemic area in Taiwan. Taiwan Yi Xue Hui Za Zhi 1988; 87:1074-80. [PMID: 3235966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Hong CL, Huang PC. Analysis of body weight gain and estimation of additional energy costs during normal pregnancy in Taiwan and Japan. Taiwan Yi Xue Hui Za Zhi 1987; 86:649-56. [PMID: 3655710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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