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Huang YC, Kao LT, Liao TH, Chiu CC, Wen HC. Risk factors of involuntary referral by police to ER psychiatric services for patients with a severe mental illness: A GEE analysis. Schizophr Res 2023; 254:68-75. [PMID: 36801516 DOI: 10.1016/j.schres.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
This study aimed to identify risk factors for involuntary referral by police to emergency room (ER) psychiatric services for community-based patients with a mental illness via a generalized estimating equation (GEE) analysis. The analysis was based on data from the Management Information System of Psychiatric Care (MISPC) system for patients with a severe mental illness in Taipei, Taiwan and registered referral records of the police. Data on 6378 patients aged ≥20 years were used in this study, including 164 patients who were involuntarily referred to the ER by the police and 6214 patients who were not during the period of January 1, 2018 to December 31, 2020. GEEs were utilized to explore possible risk factors of repeated involuntary referral to ER psychiatric services for patients with a severe mental illness. The logistic regressions indicated that patients defined as "severe" according to the Mental Health Act of Taiwan (crude odds ratio (OR): 3.840, 95 % confidence interval (CI): 2.407-6.126), with a disability (crude OR: 3.567, 95 % CI: 1.339-9.501), with two or more family members with a psychiatric disorder (crude OR: 1.598, 95 % CI: 1.002-2.548), with a history of a suicide attempt (crude OR: 25.582, 95 % CI: 17.608-37.167), and with a history of domestic violence (crude OR: 16.141, 95 % CI: 11.539-22.579) were positively associated with involuntary referral to ER psychiatric services. However, age (crude OR: 0.971, 95 % CI: 0.960-0.983) and the MISPC score (crude OR: 0.834, 95 % CI: 0.800-0.869) were inversely associated with involuntary referral to ER psychiatric services. After adjusting for demographics and potential confounders, we found that patients defined as "severe" (Exp (β): 3.236), with a disability (Exp (β): 3.715), with a history of a suicide attempt (Exp (β): 8.706), and with a history of domestic violence (Exp (β): 8.826), as well as age (Exp (β): 0.986) and the MISPC score (Exp (β): 0.902) remained significantly associated with repeated involuntary referral to ER psychiatric services. In conclusion, community-based mentally ill patients with a history of a suicide attempt, with a history of domestic violence, with a severe illness, and with a profound level of disability were highly associated with involuntary referral to ER psychiatric services. We suggest that community mental health case managers identify significant factors associated with involuntary referral to ER psychiatric services to accordingly arrange case management plans.
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Affiliation(s)
- Y C Huang
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan
| | - L T Kao
- Department of Pharmacy Practice, Tri-Service General Hospital, Taipei, Taiwan; School of Pharmacy, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - T H Liao
- Department of Health, Taipei City Government, Taiwan
| | - C C Chiu
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - H C Wen
- School of Healthcare Administration, College of Management, Taipei Medical University, Taiwan.
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Wen PY, Lin KT, Kockum AF, Suri B, Ian H, Chen JC, Mao SY, Chiu CC, Delsing P, Nori F, Lin GD, Hoi IC. Large Collective Lamb Shift of Two Distant Superconducting Artificial Atoms. Phys Rev Lett 2019; 123:233602. [PMID: 31868475 DOI: 10.1103/physrevlett.123.233602] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Indexed: 06/10/2023]
Abstract
Virtual photons can mediate interaction between atoms, resulting in an energy shift known as a collective Lamb shift. Observing the collective Lamb shift is challenging, since it can be obscured by radiative decay and direct atom-atom interactions. Here, we place two superconducting qubits in a transmission line terminated by a mirror, which suppresses decay. We measure a collective Lamb shift reaching 0.8% of the qubit transition frequency and twice the transition linewidth. We also show that the qubits can interact via the transmission line even if one of them does not decay into it.
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Affiliation(s)
- P Y Wen
- Department of Physics, National Tsing Hua University, Hsinchu 30013, Taiwan
- Center for Quantum Technology, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - K-T Lin
- CQSE, Department of Physics, National Taiwan University, Taipei 10617, Taiwan
| | - A F Kockum
- Department of Microtechnology and Nanoscience, Chalmers University of Technology, 412 96 Gothenburg, Sweden
- Theoretical Quantum Physics Laboratory, RIKEN Cluster for Pioneering Research, Wako-shi, Saitama 351-0198, Japan
| | - B Suri
- Department of Microtechnology and Nanoscience, Chalmers University of Technology, 412 96 Gothenburg, Sweden
- Department of Instrumentation and Applied Physics, Indian Institute of Science, Bengaluru 560012, India
| | - H Ian
- Institute of Applied Physics and Materials Engineering, University of Macau, Macau, China
- UMacau Zhuhai Research Institute, Zhuhai, Guangdong 519031, China
| | - J C Chen
- Department of Physics, National Tsing Hua University, Hsinchu 30013, Taiwan
- Center for Quantum Technology, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - S Y Mao
- Institute of Electro-Optical Engineering, National Chiao Tung University, Hsinchu 30013, Taiwan
| | - C C Chiu
- Department of Electrical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan
| | - P Delsing
- Department of Microtechnology and Nanoscience, Chalmers University of Technology, 412 96 Gothenburg, Sweden
| | - F Nori
- Theoretical Quantum Physics Laboratory, RIKEN Cluster for Pioneering Research, Wako-shi, Saitama 351-0198, Japan
- Physics Department, The University of Michigan, Ann Arbor, Michigan 48109-1040, USA
| | - G-D Lin
- CQSE, Department of Physics, National Taiwan University, Taipei 10617, Taiwan
| | - I-C Hoi
- Department of Physics, National Tsing Hua University, Hsinchu 30013, Taiwan
- Center for Quantum Technology, National Tsing Hua University, Hsinchu 30013, Taiwan
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Liu DH, Kuo CH, Wang CT, Chiu CC, Chen TJ, Hwang DK, Kao CL. Age-Related Increases in Benign Paroxysmal Positional Vertigo Are Reversed in Women Taking Estrogen Replacement Therapy: A Population-Based Study in Taiwan. Front Aging Neurosci 2017; 9:404. [PMID: 29311896 PMCID: PMC5732995 DOI: 10.3389/fnagi.2017.00404] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/24/2017] [Indexed: 02/02/2023] Open
Abstract
Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. Numerous investigations have reported an increased BPPV incidence in females and in the aged population. The hormonal characteristics of BPPV patients have not been previously investigated. This study aimed to determine the risk of BPPV in relation to menopause in a population-based study. Materials and Methods: This retrospective population-based study was designed to use a nationwide longitudinal health insurance database to follow and analyze the incidence of and protective factors against BPPV in a Taiwanese population. Data Analyses: Univariate and multivariate analyses were performed to calculate the adjusted hazard ratio (aHR) for the incidence of BPPV using Cox-proportional regression models. Results: In the multivariate analyses, we found that older people (older than 65 years old) were more prone to develop BPPV (aHR: 5.37, 95% CI: 0 4.83–5.97, p < 0.001). The risk of BPPV was analyzed in two specific age subgroups of elderly females. Results revealed that in both age groups (45–65 years old and >65 years old), patients who took estrogen for menopausal syndromes had a significantly lower incidence of BPPV (aHR; 0.01, 95% CI: 0.06–0.23, p < 0.001). Conclusion: Our study provides a novel etiology and possible treatment method for the prevention of BPPV. Further studies may focus on the pathophysiological mechanism of estrogen in BPPV patients and the development of new drugs for the prevention and treatment of BPPV.
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Affiliation(s)
- Ding-Hao Liu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Hua Kuo
- Department of Sports Sciences, University of Taipei, Taipei, Taiwan
| | - Chia-To Wang
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Yilan, Taiwan
| | - Ch-Chih Chiu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - De-Kuang Hwang
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Ophthalmology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chung-Lan Kao
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Chiu CC, Chen JJ, Su SB, Wang JJ. Value of peritoneal cytology in potentially resectable pancreatic cancer (Br J Surg 2013; 100: 1791-1796). Br J Surg 2014; 101:1031. [PMID: 24915792 DOI: 10.1002/bjs.9556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- C C Chiu
- Department of Medical Research, Chi Mei Medical Centre, Tainan and Liouying, PO Box 174 Shan Hua, Tainan County, 741, Taiwan.
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Lai CH, Fung HS, Wu WB, Huang HY, Fu HW, Lin SW, Huang SW, Chiu CC, Wang DJ, Huang LJ, Tseng TC, Chung SC, Chen CT, Huang DJ. Highly efficient beamline and spectrometer for inelastic soft X-ray scattering at high resolution. J Synchrotron Radiat 2014; 21:325-332. [PMID: 24562553 DOI: 10.1107/s1600577513030877] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 11/10/2013] [Indexed: 06/03/2023]
Abstract
The design, construction and commissioning of a beamline and spectrometer for inelastic soft X-ray scattering at high resolution in a highly efficient system are presented. Based on the energy-compensation principle of grating dispersion, the design of the monochromator-spectrometer system greatly enhances the efficiency of measurement of inelastic soft X-rays scattering. Comprising two bendable gratings, the set-up effectively diminishes the defocus and coma aberrations. At commissioning, this system showed results of spin-flip, d-d and charge-transfer excitations of NiO. These results are consistent with published results but exhibit improved spectral resolution and increased efficiency of measurement. The best energy resolution of the set-up in terms of full width at half-maximum is 108 meV at an incident photon energy tuned about the Ni L3-edge.
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Affiliation(s)
- C H Lai
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - H S Fung
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - W B Wu
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - H Y Huang
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - H W Fu
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - S W Lin
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - S W Huang
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - C C Chiu
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - D J Wang
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - L J Huang
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - T C Tseng
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - S C Chung
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - C T Chen
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - D J Huang
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
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Kao SH, Chiu CC, Pao KF, Chu KR. Competition between harmonic cyclotron maser interactions in the terahertz regime. Phys Rev Lett 2011; 107:135101. [PMID: 22026866 DOI: 10.1103/physrevlett.107.135101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Indexed: 05/31/2023]
Abstract
Cyclotron harmonic interactions are a key physics issue of critical importance to the generation of terahertz radiation via the electron cyclotron maser instability for practical magnetic field strengths. We present an inherent mechanism, as well as a deciding factor, which governs the competition between low- and high-harmonic interactions. Multimode simulations reveal the physical process in which a significant advantage develops for the lower-harmonic interaction, which eventually dominates in the fully nonlinear stage. The results also suggest a start-up scenario for persistent higher-harmonic operation.
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Affiliation(s)
- S H Kao
- Department of Physics, National Taiwan University, Taipei, Taiwan
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Chen YF, Lee CS, Lin CC, Su SF, Chen ML, Hsieh CC, Chen HM, Chiu CC, Lu YH, Liang HY, Yen HW, Hwang YS, Lin YT. Twenty-year follow-up of the Carpentier-Edwards standard porcine bioprosthesis in the Oriental population. J Cardiovasc Surg (Torino) 2003; 44:691-9. [PMID: 14735029] [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: 04/28/2023]
Abstract
AIM The 20-year period long-term results of porcine bioprosthetic valve use are limited. In addition, the majority of these reports come from Western countries. Given the scanty information reported in Oriental countries, this study was therefore designed to examine 20-year long-term results in patients who received a Carpentier-Edwards porcine bioprosthetic valve in an effort to contribute further information on the long-term clinical performance of porcine prosthetic valves from a viewpoint of results in the Oriental population. METHODS From July 1979 to April 2001, 82 patients received valve replacement with a standard Carpentier-Edwards porcine valve. There were 40 men and 42 women with a mean age of 42.3+/-15.1 years (range 16 to 73 years). Follow-up time extended more than 20 years (mean 10.9+/-3.2 years, range 0.5 to 21.5 years ) for a total of 719.5 patient-years. RESULTS The overall operative mortality was 16.9% (14 of 83 procedures). At 5, 10, 15, and 20 years, the actuarial survival rate of patients was 71.7%, 66.9%, 55.5%, and 44.4%, respectively. Actuarial estimates of freedom from structural valvular deterioration (SVD) at 5, 10, 15, and 17 years were 96.3%, 64.0%, 24.3%, and 24.3%, respectively; from reoperation 96.3%, 64.5%, 24.5%, and 24.5%; from operated valvular endocarditis 96.8%, 92.6%, 92.6%, and 92.6%; and from overall thromboembolism 96.3%, 88.5%, 67.2%, and 52.2%. In normal sinus rhythm, actuarial estimates of freedom from thromboembolism at 5, 10, 15, and 17 years were 100.0%, 100.0%, 81.8%, and 81.8%, respectively. Whereas for those in patients with atrial fibrillation, the estimates of freedom from thromboembolism were 94.5%, 82.4%, 57.7%, and 38.5%. CONCLUSION This study demonstrates the very satisfactory 20-year period long-term performance of freedom from bleeding events, thromboembolism (except in patients with atrial fibrillation), and valvular endocarditis in Oriental patients undergoing replacement with a porcine valve. However, the remarkable rate of SVD and reoperation ensued at 6 years after bioprosthesis implanted which does not differ from the series reported from Western countries.
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Affiliation(s)
- Y F Chen
- Division of Cardiovascular Surgery and Cardiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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Lane HY, Chiu CC, Kazmi Y, Desai H, Lam YW, Jann MW, Chang WH. Lack of CYP3A4 inhibition by grapefruit juice and ketoconazole upon clozapine administration in vivo. Drug Metabol Drug Interact 2002; 18:263-78. [PMID: 11791889 DOI: 10.1515/dmdi.2001.18.3-4.263] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The drug-food and drug-drug interaction between grapefruit juice (GFJ) and ketoconazole (KETO) was evaluated in schizophrenic patients given a single dose of clozapine (CLZ). CLZ is metabolized primarily by CYP isozymes 3A4 and 1A2 to two principal metabolites, desmethylclozapine (DCLZ) and clozapine N-oxide (CNO). GFJ and KETO are well known potent CYP 3A4 inhibitors in the gastrointestinal tract and hepatic isozymes, respectively. Twenty-one schizophrenic patients participated in the co-administration of CLZ 50 mg and GFJ. After a one-week washout, five patients were given double the GFJ (HGFJ) dose for 7 consecutive days. In another group of five patients, ketoconazole (KETO) 400 mg was given for 7 consecutive days. At the end of the 7-day period for both groups, CLZ was coadministered with the HGFJ and KETO groups. CLZ, DCLZ and CNO were assayed by HPLC. GFJ, HGJF and ketoconazole failed to significantly change CLZ disposition. Metabolites DCLZ and CNO concentrations remained unchanged during the study. The only exception was decreased Cmax in DCLZ and CNO concentrations. These results indicate that CYP 3A4 inhibition may not be clinically significant compared to CYP 1A2, as previous studies show a dramatic increase in CLZ plasma concentrations with fluvoxamine (CYP 1A2 inhibitor). The reasons for the lack of drug-food and drug-drug interactions with CLZ and CYP 3A4 inhibitors can be explained by the higher Ki values for gastrointestinal and hepatic CYP 3A4 isozymes.
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Affiliation(s)
- H Y Lane
- Department of Psychiatry, Tzi-Chi General Hospital and Tzu Chi University School of Medicine, Hualien City, Taiwan
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Lane HY, Chang WH, Chiu CC, Huang MC, Lee SH, Chen JY. A pilot double-blind, dose-comparison study of risperidone in drug-naive, first-episode schizophrenia. J Clin Psychiatry 2001; 62:994-5. [PMID: 11780884 DOI: 10.4088/jcp.v62n1214c] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Time domain cross-correlation analysis of pre-filtered mean arterial blood pressure (MABP) and mean cerebral blood flow velocity (MCBFV) was applied to assess the cerebral autoregulation (CA). Beat-to-beat time series of spontaneous arterial blood pressure and cerebral blood flow velocity were obtained from 13 young normal volunteers with the Finapres device and the transcranial Doppler for periods of approximately 5 min in the supine position. Cross-correlation functions (CCFs) were estimated using a 64 beat wide moving window. Mean CCF patterns were obtained for each subject and for the entire population. The MABP and MCBFV signals were bandpass filtered in the very low-frequency range (VLF, 0.015-0.07 Hz), low-frequency range (LF, 0.07-0.15 Hz) and high-frequency range (HF, 0.15-0.40 Hz) before applying CCF for the purpose of studying the effect of different bandwidths on the resulting mean CCFs. Results revealed that the corresponding time lags of the peak values of the MABP-MCBFV CCFs increased significantly between the LF and HF frequency ranges (LF: -1.20+/-0.91 s, HF: -0.07+/-0.42 s,p < 0.001; paired sign test). The left-shift (negative lag) of the CCF peak between MABP and MCBFV is a result of the phase-lead property. The increasing time lag of the CCF peak indicated evidence of the autoregulatory disturbance. The CCF of pre-filtered spontaneous MABP and MCBFV could be a useful tool to estimate the CA dynamic response.
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Affiliation(s)
- C C Chiu
- Institute of Automatic Control Engineering, Feng Chia University, ROC, Taichung, Taiwan.
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Shyu JS, Chen CJ, Chiu CC, Huang SC, Harn HJ. Correlation of human papillomavirus 16 and 18 with cervical neoplasia in histological typing and clinical stage in Taiwan: an in-situ polymerase chain reaction approach. J Surg Oncol 2001; 78:101-9. [PMID: 11579387 DOI: 10.1002/jso.1128] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES In situ polymerase chain reaction (ISPCR) promises to considerably enhance our ability to detect a few copies of target nucleic acid sequences in fixed tissues and cells. The aim of this study was to investigate cervical carcinoma to determine the human papillomavirus (HPV) types on paraffin-embedded tissue sections by ISPCR and standard in situ hybridization. The results will correlate the morphological characteristics of lesions with viral typing results. METHODS This study examined prevalence of HPV 16 and 18 DNA in biopsies from 85 cervical cancer patients by ISPCR, employing HPV 16, 18 consensus primers. There are 45 patients with squamous cell carcinomas, 13 with adenocarcinoma, 2 with adenosquamous carcinomas, 3 with small cell carcinomas, and 22 carcinoma in situ. The relation between the types of HPV detected, tumor type, and clinical stage were analyzed. RESULTS Fifty-two of 85 biopsies were HPV 16- or 18-positive, HPV 16 being the most prevalent type. Squamous cell carcinoma had a high prevalence of HPV 16 and adenocarcinoma had a high prevalence of HPV 18. HPV 18 was the predominant type among high clinical stage (III-IV) cases while HPV 16 and mixed HPV 16 with HPV18 were significantly correlated with low clinical stage (0-I-II). CONCLUSION Our results indicate that certain malignant cervical tumor phenotypes and stages correlate with specific HPV type, and that ISPCR is a sensitive and fast method to detect HPV in these patients.
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Affiliation(s)
- J S Shyu
- Department of Pathology, Armed Force Taoyuan Hospital, Taoyuan, Taiwan, ROC
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Lane HY, Jann MW, Chang YC, Chiu CC, Huang MC, Lee SH, Chang WH. Repeated ingestion of grapefruit juice does not alter clozapine's steady-state plasma levels, effectiveness, and tolerability. J Clin Psychiatry 2001; 62:812-7. [PMID: 11816871 DOI: 10.4088/jcp.v62n1010] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Grapefruit juice can inhibit the gastrointestinal activity of cytochrome P450 (CYP) 3A4, while its effect on CYP1A2 remains controversial. Several grapefruit juice bioflavonoids also modulate the activity of the drug transporter P-glycoprotein in the gut and in the blood-brain barrier. Both CYP1A2 and CYP3A4 are involved in clozapine metabolism. This study investigated the effects of repeated ingestion of grapefruit juice on multiple-dose pharmacokinetics and pharmacodynamics of clozapine in schizophrenic patients. METHOD Clozapine therapy was initiated for fifteen treatment-resistant schizophrenic inpatients (DSM-IV criteria). The doses were individually titrated from day -35 to day -15 and then kept unchanged from day -14 to day 49. Regular-strength grapefruit juice (250 mL) was coadministered b.i.d. with each clozapine dose from day 15 to day 28. Plasma levels of clozapine and its main metabolites (norclozapine and clozapine N-oxide) were obtained, and clinical efficacy and safety assessments were completed prior to juice administration (days 0, 7, and 14), during the coadministration (days 17, 21, and 28), and after cessation of the juice (days 35, 42, and 49). RESULTS After reaching steady states, plasma concentrations of clozapine and its metabolites and Positive and Negative Syndrome Scale scores were not significantly altered by the effect of grapefruit juice ingestion. The Clinical Global Impressions scale scores, Calgary Depression Scale scores, and side effect profiles (by the Extrapyramidal Symptom Rating Scale, the UKU Side Effect Rating Scale, and thorough examinations including electrocardiography and electroencephalography) also remained constant during the study. CONCLUSION Consumption of regular-strength grapefruit juice, 250 mL b.i.d., for 14 days did not significantly impact clozapine metabolism, clinical efficacy, or tolerability. One reason is that enzymes other than CYP3A4 also mediate clozapine disposition. Also, grapefruit juice inhibits CYP3A4 in the gut, but not in the liver. The preliminary results also suggest that clozapine is unlikely to be a P-glycoprotein substrate. Further rigorous studies are necessary to reconfirm these findings.
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Affiliation(s)
- H Y Lane
- Department of Psychiatry, Tzu-Chi General Hospital and Tzu-Chi University, Taipei, Taiwan
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Abstract
The use of the implanted atrial-based pacemaker to overdrive postsurgical intraatrial reentry tachycardia (IART) was evaluated in a large group of pediatric patients over a 14-year study period. The authors sought to determine the feasibility of this noninvasive technique in the management of this specialized population and to determine factors associated with successful conversion. They examined 128 manual overdrive attempts performed on 22 consecutive patients. There were 10 patients with post-Fontan repair, 7 with post-Mustard/Senning procedure, and 5 with miscellaneous lesion types. The number of IART episodes for overdrive pacing per patient ranged from 1 to 15. The first overdrive pacing attempt was successful in 63% (14/22) of the patients. The mean IART cycle length was 278 +/- 59 ms. The mean pacing rate for effective conversion of IART was 66 +/- 10% faster than the IART rate. By controlling for repeated measures for individual patients, three factors were found to be independently associated with a successful outcome: (1) lesion type other than Fontan surgery (P = 0.007), (2) lack of acceleration of IART with the overdrive attempt (P < 0.001), and (3) patient use of amiodarone with attempt (P = 0.005). There were three procedural complications: two inadvertent overdrive pacing episodes, and one episode of acceleration of IART cycle length and conduction resulting in need for cardioversion. Manual pacemaker overdrive conversion of IART is a useful adjunct in the management of postsurgical IART in the pediatric population and should be considered as an initial treatment option.
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Affiliation(s)
- C C Chiu
- Division of Cardiology, Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, Canada
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Chen HM, Chiu CC, Lee CS, Lai WD, Lin YT. Intractable ventricular tachycardia in a patient with left ventricular epicardial lipoma. J Formos Med Assoc 2001; 100:339-42. [PMID: 11432314] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Primary cardiac lipomas are rare and are often reported as incidental findings during operations or autopsies. Lipoma-induced arrhythmia, especially ventricular tachycardia (VT), is an unusual complication of primary cardiac lipoma. We describe the case of a 43-year-old woman who presented with VT without any cardiac abnormality except for a left ventricular tumor. Electrophysiologic study (EPS) failed to detect the origin of the arrhythmia, although VT could be induced by EPS preoperatively. Due to suspicion of a relationship between the tumor and the VT, wide tumor resection was performed using cardiopulmonary bypass support. The excised lipoma measured about 10 x 8 x 3 cm and weighed 120 g, and was without pathohistologic evidence of malignant change. The patient was well without further postoperative need for antiarrhythmic drugs at 36 months' follow-up, and VT was no longer inducible on subsequent EPS mappings.
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Affiliation(s)
- H M Chen
- Department of Surgery, Kaohsiung Medical University Hospital, 100 Shih-Chuan 1st Road, Kaohsiung, Taiwan
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Abstract
We report two unique cases of persistent fifth aortic arch with a systemic-to-pulmonary connection. All previously reported cases with such a connection in the literature have either been cases of pulmonary atresia or an aortic arch anomaly, and the existence of a fifth aortic arch was a benefit to the underlying great vessel anomaly. However, our two cases did not have this associated great vessel anomaly, and the fifth arch resulted in a large left-to-right shunt with severe pulmonary hypertension and heart failure. The first case was misdiagnosed preoperatively; an accurate diagnosis was made after cardiac surgery. Because of its rarity and complexity, a persistent fifth aortic arch is often ignored and misdiagnosed.
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Affiliation(s)
- C C Chiu
- Department of Surgery, Kaohsiung Medical University, Taiwan
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16
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Chiu CC, Chang HH, Yang CH. Objective auscultation for traditional chinese medical diagnosis using novel acoustic parameters. Comput Methods Programs Biomed 2000; 62:99-107. [PMID: 10764936 DOI: 10.1016/s0169-2607(00)00055-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The goal of this work is to propose novel acoustic parameters of voice for the purpose of providing a quantitative analysis of auscultation in traditional Chinese medical diagnosis. There is rare amount of available literature related to this topic. Four novel acoustic parameters, the average number of zero-crossings, the variations in local peaks and valleys, the variations in first and second formant frequencies, and the spectral energy ratio, are presented to analyze and identify the characteristics among non-vacuity, qi-vacuity, and yin-vacuity subjects. Among these acoustic parameters, two temporal parameters, the average number of zero-crossings and the variations in local peaks and valleys, outperformed other parameters in classifying both non-vacuity and deficient subjects. The spectral energy ratio was adequate for the classification between qi-vacuity and yin-vacuity patients. This research is a first step in an ongoing effort to modernize the auscultation in traditional Chinese medical diagnosis.
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Affiliation(s)
- C C Chiu
- Institute of Automatic Control Engineering, Feng Chia, Taiwan, ROC.
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17
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Chiu CC, Lin YT, Tsai CH, Liang JC, Chiang LC, Wu JR, Chen IJ, Yeh JL. Pharmacological effects of an aldehyde type alpha/beta-adrenoceptor blocking agent with vasodilating properties. Gen Pharmacol 2000; 34:391-400. [PMID: 11483288 DOI: 10.1016/s0306-3623(01)00076-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
KMUP 880723 (0.5, 1.0, and 3.0 mg/kg, iv) produced dose-dependent hypotensive and bradycardia responses in pentobarbital-anesthetized Wistar rats. KMUP 880723 (1.0 mg/kg, iv) also markedly inhibited both the tachycardia effects induced by (-)isoproterenol and arterial pressor responses induced by phenylephrine. In the isolated Wistar rat right atria, left atria, and guinea pig tracheal strips, KMUP 880723 competitively antagonized the (-)isoproterenol-induced positive chronotropic effects, inotropic effects, and tracheal relaxation effects in a concentration-dependent manner. The parallel shift to the right of the concentration-response curve of (-)isoproterenol suggested that KMUP 880723 was a beta(1)/beta(2)-adrenoceptor competitive antagonist. The apparent pA(2) values were 6.89+/-0.10 in the right atria, 7.02+/-0.09 in the left atria, and 6.59+/-0.11 in the trachea, indicating that KMUP 880723 was a nonselective beta-adrenoceptor blocker. In thoracic aorta experiments, KMUP 880723 also produced a competitive antagonism of norepinephrine-induced contraction with a pA(2) value of 7.14+/-0.06. In isolated rat thoracic aorta, KMUP 880723 more potently relaxed the contractions induced by norepinephrine (3 x 10(-6) M) than those by high K(+) (75 mM). In the radioligand-binding assay, the pK(i) values of [3H]CGP-12177 binding to rat ventricle and lung membranes were 6.56 and 6.40, respectively, and the value of [3H]prazosin binding to rat brain membranes was 6.66. These results further confirmed the alpha/beta-adrenoceptor blocking activities of KMUP 880723 reported in the functional studies. We conclude that KMUP 880723 is a nonselective beta-adrenoceptor antagonist with alpha-adrenoceptor blocking-associated vasorelaxant activity.
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Affiliation(s)
- C C Chiu
- Department of Cardiovascular Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
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18
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Abstract
Cardiac fibromas are rare lesions which occur more often in infants and children than in adults. These tumors are benign proliferations of connective tissue most often found in the left ventricular myocardium or septum. In an 8-month-old infant with cyanosis and progressive exertional dyspnea, a huge cardiac tumor obstructing the right ventricular outflow tract (RVOT) was diagnosed by means of 2-dimensional echocardiography and cardiac catheterization. At surgery, a whitish gray solitary tumor measuring 5.0 x 4.5 cm could be well visualized. It was nearly totally resected, and the RVOT was reconstructed with an Equine pericardial patch. Histologic examination classified the tumor as a fibroma. Although surgical mortality in cardiac fibroma with RVOT obstruction is extremely high, early diagnosis and prompt excision of the tumor is mandatory in relieving its dangerous symptoms.
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Affiliation(s)
- J R Wu
- Department of Pediatrics, Kaohsiung Medical University, Taiwan
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19
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Chiu CC, Yeh SJ, Chen CH. Self-organizing arterial pressure pulse classification using neural networks: theoretical considerations and clinical applicability. Comput Biol Med 2000; 30:71-88. [PMID: 10714443 DOI: 10.1016/s0010-4825(99)00023-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [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: 11/29/2022]
Abstract
A self-organizing classification system for the arterial pressure pulse based on the ART2 (adaptive resonance theory) network was developed. The system consists of a preprocessor and an ART2 recognition network. The preprocessor removes the arterial pressure pulse servo component signals from Finapres, detects the systolic pressure points and divides the acquired signals into minimal cardiac cycles. The ART2 network input is the minimal cardiac cycle detected by the preprocessor. The classification results can be used to assist physicians in evaluating the signs of abnormal and normal autonomic control and has shown its clinical applicability for the examination of the autonomic nervous system.
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Affiliation(s)
- C C Chiu
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, ROC.
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20
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Abstract
This research is aimed at building a computerized tongue examination system (CTES) based on computerized image analysis for the purpose of quantizing the tongue properties in traditional Chinese medical diagnosis. The chromatic algorithm is developed to identify the colors of the tongue and the thickness of its coating. The textural algorithm is used to detect the grimy coating. CTES is shown to be significantly consistent within itself with P > 0.05 using the Hotelling multivariate statistical test. The overall rate of correctness for CTES to identify the colors of tongue, verifying the thickness of its coating and detecting of any grimy coating exceeds 86%. Therefore, the CTES is helpful to provide the physicians a systematic and objective diagnostic standard for the tongue diagnosis in the clinical practice and research.
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Affiliation(s)
- C C Chiu
- Institute of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan, ROC.
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21
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Chiu CC, Chen CE, Wang TG, Lin MC, Lien IN. Influencing factors and ambulation outcome in patients with dual disabilities of hemiplegia and amputation. Arch Phys Med Rehabil 2000; 81:14-7. [PMID: 10638869 DOI: 10.1016/s0003-9993(00)90214-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [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: 11/29/2022]
Abstract
OBJECTIVE To determine the ambulatory outcome and predictive factors of successful ambulation training in patients with both hemiplegia and lower extremity amputation. DESIGN A retrospective study. SETTING A rehabilitation center of a university hospital. PATIENTS Twenty-three patients with dual disabilities consecutively admitted to the rehabilitation center from 1984 to 1994. MAIN OUTCOME MEASURES Ambulatory outcome was measured using physical therapists' and physicians' notes at discharge or the last available clinical visit. Ambulation ability was graded as community and noncommunity ambulation, which included indoor ambulation and nonambulation. Several clinical features were reviewed to assess their association with ambulation outcome. RESULTS About two thirds of the 23 patients could be trained to be ambulatory: 10 (43.8%) achieved community ambulation and 5 (21.7%) achieved indoor ambulation. Of the clinical factors, only mental status showed a statistically significant association with good ambulation outcome (p<.05). When odds ratios were considered, several factors, including mild motor involvement, transtibial amputation, amputation before cerebrovascular accident, age younger than 60 years, and the presence of ipsilateral hemiplegia and amputation, showed trends toward association with increased ambulation achievement, although these associations were not statistically significant. CONCLUSION Impaired mental status seemed to be the most influential negative predictive factor of achieving community ambulation. If subjects with dual disabilities are properly selected, satisfactory results of ambulation training will be obtained.
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Affiliation(s)
- C C Chiu
- Department of Physical Medicine and Rehabilitation, National Taiwan University hospital, Taipei, ROC
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22
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Chan PC, Lai JF, Cheng CH, Tang MJ, Chiu CC, Chen HC. Suppression of ultraviolet irradiation-induced apoptosis by overexpression of focal adhesion kinase in Madin-Darby canine kidney cells. J Biol Chem 1999; 274:26901-6. [PMID: 10480899 DOI: 10.1074/jbc.274.38.26901] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.8] [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: 11/06/2022] Open
Abstract
Focal adhesion kinase (FAK) has been implicated to play a role in suppression of apoptosis. In this study, we have demonstrated that UV irradiation induced cleavage of FAK and two of its interacting proteins Src and p130(Cas) in Madin-Darby canine kidney cells, concomitant with an increase in cell death. The cleavage of these proteins upon UV irradiation was completely inhibited by ZVAD-FMK, a broad range inhibitor of caspases, and apparently delayed by Bcl2 overexpression. To examine if FAK plays a role in suppressing UV-induced apoptosis, stable Madin-Darby canine kidney cell lines overexpressing FAK were established. Our results showed that a marked (30-40%) increase in cell survival upon UV irradiation was achieved by this strategy. In our efforts to determine the mechanism by which FAK transduces survival signals to the downstream, we found that a FAK mutant deficient in binding to phosphatidylinositol 3-kinase failed to promote cell survival. Moreover, the expression of the Src homology 3 domain of p130(Cas), which competed with endogenous p130(Cas) for FAK binding, abrogated the FAK-promoted cell survival. Together, these results suggest that the integrity of FAK and its binding to phosphatidylinositol 3-kinase and p130(Cas) are required for FAK to exert its antiapoptotic function.
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Affiliation(s)
- P C Chan
- Institute of Biochemistry, National Chung Hsing University, Taichung, Taiwan, Republic of China
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23
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Huang YC, Wu BN, Lin YT, Chen SJ, Chiu CC, Cheng CJ, Chen IJ. Eugenodilol: a third-generation beta-adrenoceptor blocker, derived from eugenol, with alpha-adrenoceptor blocking and beta2-adrenoceptor agonist-associated vasorelaxant activities. J Cardiovasc Pharmacol 1999; 34:10-20. [PMID: 10413061 DOI: 10.1097/00005344-199907000-00003] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Eugenodilol, derived from natural eugenol, was first investigated with in vivo and in vitro models. In our in vivo study, eugenodilol (0.5, 1.0, and 1.5 mg/kg, i.v.) produced dose-dependent hypotensive and bradycardic responses in pentobarbital-anesthetized Wistar rats. Eugenodilol also inhibited the tachycardia and arterial pressor effects induced by (-)isoproterenol and phenylephrine, respectively. In our in vitro study, eugenodilol competitively antagonized (-)isoproterenol-induced positive inotropic and chronotropic effects and tracheal-relaxation responses on isolated guinea pig tissues in a concentration-dependent manner. The apparent pA2 values were 7.88+/-0.12 for right atria, 7.52+/-0.05 for left atria, and 7.33+/-0.15 for trachea, indicating that eugenodilol was a nonselective beta-adrenoceptor blocker. In thoracic aorta experiments, the apparent pA2 values of alpha-adrenoceptor blockade were 7.05+/-0.25 and 6.87+/-0.08 for eugenodilol and labetalol, respectively. In addition, eugenodilol produced cumulative relaxation responses on isolated guinea pig tracheal strips. The effects were competitively antagonized by ICI 118,551 (10(-8)-10(-6) M), a relatively selective beta2-adrenoceptor antagonist. In the radioligand-binding assay, the Ki values of [3H]CGP-12177 binding to rat ventricle and lung membranes were 9.72 and 48.29 nM, respectively, and the value of [3H]prazosin binding to rat brain membrane was 38.72 nM. These results further confirmed the alpha/beta-adrenoceptors-blocking activities of eugenodilol reported in the functional studies. We conclude that eugenodilol is a novel third-generation beta-adrenoceptor blocker with ancillary blocking activity at alpha-adrenoceptors and weak sympathomimetic activity at beta2-adrenoceptors.
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Affiliation(s)
- Y C Huang
- Department of Pharmacology, Kaohsiung Medical College, Taiwan, Republic of China
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24
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Shyu YC, Chiu CC, Lin FP. Cloning, sequencing, expression and characterization of the manganese superoxide dismutase gene from Vibrio alginolyticus. Biochem Mol Biol Int 1999; 47:803-14. [PMID: 10365251 DOI: 10.1080/15216549900201893] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The sodA gene coding for manganese superoxide dismutase from the marine microorganism Vibrio alginolyticus was cloned, sequenced and over-expressed in Escherichia coli using the pET20b (+) expression vector. The full-length gene was consisted of 603bp open reading frame, which encoded a polypeptide of 201 amino acid residues, with a calculated molecular weight of 22672Da. The deduced amino acid sequence of the sodA showed considerable homology to other Mn-SODs. The recombinant enzyme was efficiently purified from crude E. coli cell lysate by the metal ion affinity chromatography. The recombinant VAMn-SOD resisted thermo-denaturation up to 60 degrees C and was insensitive to inhibitors such as H2O2, NaN3 and diethyldithiocarbamic acid.
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Affiliation(s)
- Y C Shyu
- Institute of Marine Biotechnology, National Taiwan Ocean University, Keelung, Taiwan, R. O. C
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25
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Chen WS, Chiu CC, Liu HY, Lee TL, Cheng JT, Lin CC, Wu YJ, Chang HY. Gene transfer via pollen-tube pathway for anti-fusarium wilt in watermelon. Biochem Mol Biol Int 1998; 46:1201-9. [PMID: 9891853 DOI: 10.1080/15216549800204762] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In order to obtain transgenic fusarium wilt resistant watermelon plants, squash DNA was introduced into the ovaries of watermelon plants via the pollen-tube pathway. The introduction of foreign genes into ovaries was accomplished using co-transformation with the CaMV35S-GUS as a marker. Transformed watermelon plants contained integrated copies of the GUS activity and the seeds of transformed progeny produced a blue color when stained with 5-bromo-4-chloro-3-indolyl glucuronide, whereas seeds from untransformed control plants did not. Of 200 transformed seedlings, ten were wilt resistant. The presence of the GUS activity in the genome of stable transgenic seedlings was confirmed by Southern blot analysis. Furthermore, the generation of random amplified polymorphic DNA (RAPD) fingerprints using primers with embedded restriction sites showed amplification products unique to these transgenic plants. Primers OPA-1 and OPA-9 gave distinct band patterns of genomic DNA using the polymerase chain reaction.
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Affiliation(s)
- W S Chen
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung City, Taiwan, Republic of China
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26
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Harn HJ, Hsieh HF, Ho LI, Yu CP, Chen JH, Chiu CC, Fan HC, Lee WH. Apoptosis in nasopharyngeal carcinoma as related to histopathological characteristics and clinical stage. Histopathology 1998; 33:117-22. [PMID: 9762543 DOI: 10.1046/j.1365-2559.1998.00470.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [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: 11/20/2022]
Abstract
AIMS We investigated the significance of apoptosis, using the terminal deoxynucleotidyl transferase mediated dUTP-digoxigenin nick end-labelling method, in nasopharyngeal carcinoma biopsy samples. METHODS AND RESULTS The apoptotic index (AI) in 50 nasopharyngeal carcinomas was compared with various histopathological features and clinical stage. Also, the AI was correlated with p53, bcl-2 and Ki67 expression by immunohistochemistry. In histopathological studies, the AI was significantly higher in mixed cellular type (MC) than in keratizing squamous cell type (KS) and spindle cell type (SC) (P < 0.001) which worsens prognosis. In tumour stage analyses, AI was higher in early stage (stage 2 and 3) than in high stage (stage 4). In addition, there was a significant correlation between the AI and p53 expression (P < 0.001) but not with proliferative activity (P = 0.15). In NPC containing p53 protein positive tumour cells, there was a significantly higher apoptotic rate. CONCLUSIONS These findings indicate that apoptosis is related to type and stage of nasopharyngeal carcinoma. They also confirm the role of p53 in regulating tumour apoptosis.
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Affiliation(s)
- H J Harn
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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27
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Abstract
The relationship between the pacemaker sensitivity safety factor (PSSF) and atrial under- or oversensing as documented by 24-hour Holter monitoring was examined. Our study comprised 78 transvenous fixed atrial leads implanted between 1983-1995 in 71 children. Overall, 210 Holter reports identified 143 (68%) Holters with normal atrial sensing function, 31 (15%) with undersensing, 32 (15%) with oversensing, and 4 (2%) with both problems. From 161 Holter reports in which the PSSF was available, the incidence of undersensing at a PSSF of 2.0 (range 1.5-2.4) was 25% (14/57). There was a dramatic decline in undersensing when the PSSF was > or = 3 (3%) compared to a PSSF < 3 (21%) (P < 0.001). A PSSF cut-off point of 2.0 best predicted occurrence of undersensing with a sensitivity of 79% and a specificity of 67%. Other variable were also examined by multiple logistic regression analysis, but only PSSF remained highly associated with undersensing (odds ratio [OR] = 0.6, P = 0.03). In contrast, PSSF did not have a significant role in predicting oversensing, but presence of sick sinus syndrome (OR = 10.5) or unipolar lead (OR = 5.6) were significantly associated with oversensing (P = 0.0001). The majority of undersensing problems can be avoided by routinely allowing for at least a threefold or more programmed sensitivity margin. Other factors may increase the risk of oversensing, regardless of the PSSF.
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Affiliation(s)
- C C Chiu
- Division of Cardiology, Hospital for Sick Children, Toronto, Canada
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28
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Wu CS, Lin CJ, Chen TC, Chen PC, Chiu CC. Ménétrier's disease: a new variant with duodenal involvement. Am J Gastroenterol 1997; 92:1041-3. [PMID: 9177528] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Ménétrier's disease is a rare cause of hypertrophic gastropathy, usually confined to gastric body and fundus, which is characterized by giant rugae, hypoalbuminemia, and foveolar hyperplasia. The etiology of this disease is still unknown. We report a case of a 74-yr-old man who had dyspepsia, hypoalbuminemia, weight loss, and diffuse polypoid, nodular lesions affecting the whole stomach and proximal duodenum on gastroscopy and barium meal study. The histology of gastric and duodenal mucosal lesions fulfilled the diagnosis of Ménétrier's disease, that was not described to involve duodenum in the literature. The disease resolved clinically, endoscopically, and pathologically after therapy with famotidine for 3 months. We speculated that extensive pyloric metaplasia and then foveolar hyperplasia of duodenum in this patient might be a variant of Ménétrier's disease with favorable clinical course.
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Affiliation(s)
- C S Wu
- Department of Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China
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29
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Lin CL, Chen YF, Chiu CC, Voon WC, Lee CS, Lin CC. Coexistent mitral stenosis and coronary artery fistula presenting as myocardial ischemia: case report. Kaohsiung J Med Sci 1997; 13:117-22. [PMID: 9099050] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We report a 50-year-old female case of mitral stenosis with congenital coronary artery fistula communicating the left anterior descending artery to pulmonary artery. In reviewing the literature, mitral stenosis associated with coronary artery fistula is rare. The case was initially treated medically for congestive heart failure. The electrocardiogram revealed severe myocardial ischemia and no obvious etiology was found clinically. The coronary angiogram demonstrated the diagnosis of coronary artery fistula. Myocardial ischemia improved markedly after surgical correction of the valvular disease and the fistula. The patient continued to do well during 2 years and 10 months follow up. The concomitant mitral stenosis masked the symptoms of coronary artery fistula, and made us fall to diagnose the condition initially. Valvular heart disease associated with severe myocardial ischemia without obvious atherosclerotic stenosis of coronary artery reminded us of the possibility of coronary artery fistula, though it has rarely been reported.
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Affiliation(s)
- C L Lin
- Division of Cardiovascular Surgery, Kaohsiung Medical College, Taiwan, Republic of China
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30
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Abstract
Aneurysm of the main pulmonary artery is an extremely rare entity. The first successful repair of an aneurysm of the main pulmonary artery was reported in 1971. Since then, surgical correction of the aneurysm of main pulmonary artery has been undertaken in only 6 cases. A thorough survey of the literature, including autopsy cases, medical cases, and surgical cases, shows the aneurysm in the present case to be one of the largest.
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Affiliation(s)
- Y F Chen
- Department of Surgery, Kaohsiung Medical College, Taiwan
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31
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Chen YF, Chiu CC, Lee CS, Lai WT, Hwang YS. Surgical correction of giant patent ductus arteriosus. J Cardiovasc Surg (Torino) 1996; 37:309-12. [PMID: 8698770] [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: 02/01/2023]
Abstract
In reviewing the literature, there was only one report having the ductus over 30 mm in width. Recently, we utilized cardiopulmonary bypass, hypothermia, and low flow through a transpulmonary approach to close 2 cases of giant patent ductus arteriosus. Both cases complicated with systemic pulmonary hypertension. Its outside diameters were 31 mm and 36 mm respectively based on the measurement from magnetic resonance imaging. To our knowledge, its seem the biggest ductus in comparison to previous reports. Both cases survived the operation and doing well for a follow-up time of 5 years and 4 years 10 months respectively.
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Affiliation(s)
- Y F Chen
- Department of Surgery, Kaohsiung Medical College, Taiwan
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32
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Chang CZ, Chen YF, Lin HR, Lin PY, Chiu CC, Lin YT. Postoperative diaphragmatic dysfunction in patients undergoing open-heart surgery. Gaoxiong Yi Xue Ke Xue Za Zhi 1995; 11:626-32. [PMID: 7490796] [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: 01/25/2023]
Abstract
Diaphragmatic elevation after cardiac surgery may result in compromized post operative respiratory function, prolonged ventilator use, longer intensive care unit (ICU) stays, poor quality of life and even mortality. 200 patients receiving open-heart surgery during the two years from October 1990 to October 1992 were studied retrospectively. 26 patients developed postoperative diaphragmatic elevation (Group 2). On the other hand, 174 patients did not (Group 1). The mean age of Group 1 (37.3 +/- 20.0 years) was younger than that of Group 2 (57.4 +/- 9.1 years), P < 0.0001. The mean aortic cross-clamp time was 70.1 +/- 38.1 minutes in Group 1. On the other hand, Group 2 had a longer crossclamp time (84.5 +/- 31.3 Minutes), p < 0.03. Our study revealed that the patients who suffered post operative diaphragmatic dysfunction were older and had a longer aortic crossclamp time than the patients who did not.
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Affiliation(s)
- C Z Chang
- Department of Surgery, Kaohsiung Medical College Hospital, Taiwan, Republic of China
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33
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Abstract
A persistent fifth aortic arch was recognized in a 4-year-old boy by echocardiography, magnetic resonance imaging and angiocardiography. The case was unique in at least two respects: right-sided aortic arch, and systemic-to-pulmonary connection without intracardiac lesion. This rare type of anomaly was correctly diagnosed and successfully repaired by patch closure of the arch. This is the first report of this combination of lesions in the Orient.
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Affiliation(s)
- J R Wu
- Department of Pediatrics, School of Medicine, Kaohsiung Medical College, Taiwan, R.O.C
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34
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Chang DS, Chen YF, Chiu CC, Yen HW. The use of right gastroepiploic artery for the bypass of left anterior descending coronary artery--case reports. Gaoxiong Yi Xue Ke Xue Za Zhi 1995; 11:416-9. [PMID: 7650781] [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: 01/26/2023]
Abstract
The right gastroepiploic artery (RGEA), a branch of the gastroduodenal artery, supplies the greater curvature of the stomach. It is capable of easily reaching the posterior and lateral surface of the heart as a reliable arterial conduit when appropriately harvested. In the previous reports, it has usually been anastomosed to the right coronary artery (RCA) or left circumflex coronary artery (LCX). Here, we present two cases of ischemic heart disease undergoing coronary revascularization. The RGEA was anastomosed to the left anterior decending coronary artery (LAD), which is the most important coronary artery in terms of patient outcome. Thallium-201 myocardial scintigraphy has proven that the RGEA can provide sufficient blood flow to the territory of the LAD. Thus, in coronary artery bypass grafting (CABG), the RGEA is a reliable arterial conduit for LAD revascularization.
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Affiliation(s)
- D S Chang
- Division of Cardiovascular Surgery, Kaohsiung Medical College, Taiwan, Republic of China
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35
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Chiu CC, Chen YF, Lin YT. Surgical treatment of pericardial effusion in cancer patients. Gaoxiong Yi Xue Ke Xue Za Zhi 1995; 11:300-5. [PMID: 7629914] [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: 01/26/2023]
Abstract
31 cancer patients with symptomatic pericardial effusion were treated by subxiphoid pericardiotomy with simultaneous pleuropericardial window creation. There were no patients who died during surgery. In all patients, relief of cardiac compression by the effusion was immediate and complete. 10 patients died of advanced malignancy within 30 days after operation without evidence of recurrent pericardial effusion. During the period of follow-up, another seventeen patients died, and no death was related to pericardial effusion. It is concluded that pleuropericardial window through the subxiphoid approach is the treatment of choice for pericardial effusion in cancer patients. The procedure provides immediate and long-lasting relief of cardiac compression with acceptable mortality and morbidity.
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Affiliation(s)
- C C Chiu
- Department of Surgery, Kaoshiung Medical College Kaohsiung City, Taiwan, Republic of China
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36
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Affiliation(s)
- H H Wang
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei
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37
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Abstract
Electronic imaging of complex cylindrical objects with arbitrary cross sections was investigated, assuming an incident wave upon both penetrable inhomogeneous dielectric cylinders and perfectly conducting cylinders with known shape, and external measurements of the scanned field. By properly processing the scattered held measurements, the dielectric permittivity distribution of the scanned object can be reconstructed. A theoretical formulation was based on proper arrangement of the incident field directions resulting in a set of integral equations derived and solved by the moment method and the unrelated illumination method. Numerical results demonstrate the capability of the imaging algorithm. Good reconstruction results were obtained even in the presence of additive random noise. In addition, noise effects on the reconstruction results were investigated.
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Affiliation(s)
- C C Chiu
- Dept. of Electr. Eng., Tamkang Univ., Tamsui
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38
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Lee KS, Chen YF, Chiu CC, Lin YT, Lee CS, Lai WT. Surgical correction of sinus venosus atrial septal defect associated with partial anomalous pulmonary venous connection to high superior vena cava--case report. Gaoxiong Yi Xue Ke Xue Za Zhi 1994; 10:592-596. [PMID: 7807616] [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: 05/22/2023]
Abstract
A 63-year-old woman complained of general malaise and insomnia initially. Atrial septal defect was diagnosed by transthoracic echocardiography thereafter. She had not received complete cardiac studies until progressive dyspnea was noted half a year later. After a series of examinations, sinus venosus type atrial septal defect (ASD) associated with partial anomalous pulmonary venous connection to high superior vena cava (SVC) and persistent left SVC was documented. Surgical correction was performed later. The postoperative course was smooth and her condition improved gradually at 10-month follow-up.
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Affiliation(s)
- K S Lee
- Division of Cardiovascular Surgery, Kaohsiung Medical College, Taiwan, Republic of China
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39
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Abstract
We report on a promising method for toughening and strengthening the fragile aortic wall that involves the direct application of a 25% glutaraldehyde solution and that has proved to be both technically simple and safe. The operation was successfully employed in 5 patients with acute aortic dissections, 3 with a Stanford type A and 2 with a type B dissection. Histologic examination of the glutaraldehyde-treated portions of the aortic wall showed no detectable difference between them and the sections of untreated aortic wall. All patients survived the operation. The duration of follow-up ranged from 9 to 31 months (mean, 14.0 months). All 5 patients were in good condition at the time of the last follow-up. The preliminary results indicate that the use of a 25% glutaraldehyde solution to strengthen the aortic wall during operations for the repair of acute aortic dissections, regardless of whether they are type A or type B, may reduce the incidence of catastrophic perioperative bleeding and promote favorable results.
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Affiliation(s)
- Y F Chen
- Department of Surgery, Kaohsiung Medical College, Taiwan
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40
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Chen YF, Chiu CC, Wu JR. Correction of aortico-left ventricular tunnel in a small Oriental infant: a brief clinical review. J Cardiovasc Surg (Torino) 1994; 35:71-3. [PMID: 8120083] [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: 01/28/2023]
Abstract
In reviewing 56 cases of aortico-left ventricular tunnel from 39 reported articles, none of the patients operated on were Oriental. In this report, a 4 month-old male infant was successfully operated on. The tunnel was closed with a Dacron patch on the aortic orifice. The child is now free from symptoms, except for mild residual aortic regurgitation, and is developing normally 5 year-11 month after repair. A brief clinical review has been attempted in these reported cases.
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Affiliation(s)
- Y F Chen
- Department of Surgery, Kaohsiung Medical College, Taiwan
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41
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Kuo KK, Chiu CC, Chen YF, Lin YT. Open heart surgery in a patient with an implanted pacemaker: case report. Gaoxiong Yi Xue Ke Xue Za Zhi 1993; 9:113-7. [PMID: 8492352] [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: 01/31/2023]
Abstract
When a patient has a pacemaker and requires operation, surgeons have to consider some possible intraoperative pacemaker complications induced by electrocautery. Electrocautery is commonly used during surgery to achieve hemostasis. However, this very effective tool may introduce innumerable problems in the paced patient, including irreversible damage to the pulse generator, pacemaker reprogramming, induction of a rise in the capture threshold, and ventricular fibrillation. Although electrocautery may be avoided in some surgical procedures, open heart surgery cannot be performed without it. One case is presented to illustrate how to achieve hemostasis while decreasing electric interference and how to protect the permanent pacemaker while avoiding those possible complications during the defibrillation. The purpose of this article is to call attention to potential problems induced by electrocautery and in an effect to facilitate the perioperative management of the paced patient undergoing open heart surgery.
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Affiliation(s)
- K K Kuo
- Division of Cardiovascular Surgery, Kaohsiung Medical College, Taiwan, Republic of China
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42
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Wu CW, Chi CW, Chiu CC, Wu HS, Liu WY, P'eng FK, Wang SR. Can daily dietary arginine supplement affect the function and subpopulation of lymphocytes in patients with advanced gastric cancer? Digestion 1993; 54:118-24. [PMID: 8319840 DOI: 10.1159/000201023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Since arginine can stimulate lymphocyte proliferation in the healthy human, its effect on lymphocyte proliferation in vitro was studied in 7 patients with far advanced gastric cancer. These patients with normal nourishment were ambulatory and could consume a regular diet. A daily dietary supplement of 30 g arginine for 7 days did not alter the total lymphocyte counts or the T/B cell ratio in the peripheral blood. Enhancement of lymphocyte proliferation in response to mitogen stimulation was not observed. Furthermore, an in vitro study on the effect of arginine on phytohemagglutinin-stimulated lymphocyte proliferation showed that lymphocytes from gastric cancer patients had poorer responses than those obtained from normal subjects, despite the supplement in the culture medium with normal serum, patient serum, or fetal bovine serum. Arginine ingestion did not impair liver function and had no detectable side effects except transient nausea in 1 patient. These results indicate that dietary arginine supplement appears safe but does not stimulate lymphocyte function in far advanced gastric cancer patients. The suppressed immune function in gastric cancer patients may be the result of their intrinsic lymphocyte defect.
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Affiliation(s)
- C W Wu
- Department of Surgery, Veterans General Hospital-Taipei, Taiwan, ROC
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43
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Wang SR, Su HL, Chiu CC, Huang MH, Tsai CY, Tsai JJ, Yu CL. Alteration of intracellular DNA and RNA patterns by liver arginase studied with flow cytometry. Zhonghua Yi Xue Za Zhi (Taipei) 1992; 50:267-72. [PMID: 1281752] [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: 12/26/2022]
Abstract
Previous study of lymphocyte proliferation in the presence of liver arginase has indicated that arginine-depletion in the culture medium plays an important role in inhibiting cell proliferation. The inhibitory effect of both liver arginase and arginine-free condition on DNA, RNA and protein syntheses in PHA-stimulated lymphocytes were studied in cultures by measuring the incorporation of labeled precursors. Simultaneously, their influence on DNA and RNA contents in cells stained by acridine orange was investigated by automated flow cytometry. With 3 micrograms/ml arginase, the syntheses of DNA, RNA and protein were markedly inhibited after 72 h of culture. The degrees of inhibition were close to that induced in an arginine-free condition. The DNA and RNA contents of the individual cell, either cultured with 3 micrograms/ml arginase or in arginine-free medium, were arrested in G0/G1 phase. The results of cell arrest in G0/G1 phase were similar whether the cells were cultured for 24, 48 or 72 h.
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Affiliation(s)
- S R Wang
- Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C
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44
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Chen YF, Chiu CC, Chen JS, Lee SH, Lin YT. Successful surgical correction of acute ascending aortic dissection: a case report. Gaoxiong Yi Xue Ke Xue Za Zhi 1992; 8:185-8. [PMID: 1560476] [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: 12/27/2022]
Abstract
The prognosis of patients with acute aortic dissection is extremely poor, especially when involving the ascending aorta. It has long been recognized as a catastrophic cardiovascular event. Acute dissections involving an ascending aorta have approximately a 90 percent acute mortality rate if left untreated or treated medically. Therefore, nearly all patients with acute ascending aortic dissection should be surgically treated immediately after a diagnosis has been established. A 60-year-old man having an acute ascending aortic dissection was successfully operated on with a resection of the dissecting aorta which was replaced with a Dacron graft. The postoperative course was complicated with a respiratory insufficiency and a disruption of the sternal wound. A 4 years follow-up confirmed the patient was in good condition. This is the first successfully operated case of acute ascending aortic dissection at our hospital.
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Affiliation(s)
- Y F Chen
- Department of Surgery, Kaohsiung Medical College, Taiwan, Republic of China
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45
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Yu CL, Tsai CY, Chiu CC, Liao TS, Lin WM, Chiang BN, Han SH, Wang SR. Defective expression of neutrophil C3b receptors and impaired lymphocyte Na(+)-K(+)-ATPase activity in patients with systemic lupus erythematosus. Proc Natl Sci Counc Repub China B 1991; 15:178-85. [PMID: 1668018] [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: 12/28/2022]
Abstract
In our previous report, we demonstrated that the functions of phagocytes and lymphocytes were defective in patients with systemic lupus erythematosus (SLE). In an attempt to further clarify the defective mechanisms of these cells, 25 active SLE, 10 bronchial asthma patients (BA) on corticosteroids and 25 age and sex-matched normal individuals were investigated for the expression of membraneous C3b receptors, ionophore-induced 45Ca(2+)-uptake, mitochondrial potentials and phagocytic activity of neutrophils. We found decreased expression of C3b receptors on SLE PMN in both resting (37.2 +/- 3.7% of the normal controls) and FMLP-stimulated (68.3 +/- 7.1% of the normal controls) conditions, whereas the C3b receptor expression on BA-PMN receiving long-term steroid treatment was not different from normal controls. This suggests that the defective phagocytosis of SLE PMN is in the recognition, but not in the ingestion phase because of the normal function of Ca(2+)-influx and mitochondrial activity in SLE PMN. On the other hand, hyporesponsiveness to PHA stimulation (stimulation index: 127.4 +/- 46.3 in SLE vs. 311.2 +/- 30.4 in normals, p = 0.0077) was a distinct cell-mediated immune abnormality in our SLE patients. We measured the membrane potential of individual cells using 3,3'-dihexyloxacarbocyanin and found hyperpolarization in resting SLE lymphocytes. However, the membrane polarization of SLE lymphocytes became lower than that of normal cells after PHA stimulation for 3 days. A similar tendency was also found in Na(+)-K(+)-dependent ATPase activity in SLE lymphocytes.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C L Yu
- Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C
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46
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Chen WT, Kobayashi Y, Huang TP, Chiu CC, Lin CY. Decreased size of peritoneal macrophage during peritonitis in continuous ambulatory peritoneal dialysis patients. Am J Nephrol 1991; 11:374-9. [PMID: 1809034 DOI: 10.1159/000168341] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
From January 1987 to July 1988, 30 patients suffering from end-stage renal disease were treated with continuous ambulatory peritonitis dialysis (CAPD) therapy. Serial cell number, size and cycle of the peritoneal macrophage (PM) in these patients were measured before and during episodes of peritonitis from the time they started CAPD therapy. Patients with peritonitis were divided into high peritonitis occurrence (HPOG) and low peritonitis occurrence (LPOG) groups. Both before and during occurrence of peritonitis, there were no significant differences in the number of PM cells in the dialysate taken from patients in the HPOG and LPOG. When peritonitis occurred, the size and cell cycle S/Go-G1 ratio decreased about 3 days after the onset of peritonitis. It progressed to the lowest level 7-10 days later, then progressively recovered. However, the dialysate PM cells from the HPOG took a much longer time to recover to the preperitonitis size. When dialysate PM cells from patients without peritonitis were put into the dialysate of HPOG patients on day 10 of peritonitis and incubated for 24 h, an obvious decrease in cell size could be identified. On the other hand, when the PM cells from HPOG patients with peritonitis on day 10 were incubated 24 h with the dialysate from patients without peritonitis, there were obvious increases in cell size. These results suggest there may be a substance (or substances) in the peritonitis dialysate, which contribute(s) to the shrinkage of PM cell size.
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Affiliation(s)
- W T Chen
- Department of Pediatrics, Osaka University, School of Medicine, Japan
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47
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Yu CL, Tsai CY, Hong SY, Lue CS, Chiu CC, Chiang BN, Han SH, Wang SR. Immunoregulatory effects of phospholipase A2 (PLA2) on the proliferation of human lymphocytes. Scand J Rheumatol 1991; 20:8-15. [PMID: 2011718 DOI: 10.3109/03009749109165916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 12/29/2022]
Abstract
Extracellular phospholipase A2 (PLA2) is a proinflammatory enzyme found especially in the inflammatory exudate to modulate blood flow to areas of antigen stimulation. In this study we found that PLA2 exerted a biphasic effect on the proliferation of phytohemagglutinin (PHA)-stimulated human mononuclear cells (PHA MNC). At low concentrations range from 0.001 to 1 U/ml, PLA2 enhanced the proliferation of PHA MNC (maximal increase was 37.0 +/- 5.67%). Conversely, at concentrations over 10 U/ml, PLA2 markedly suppressed the PHA-induced MNC proliferation (maximal decrease was 88.86 +/- 2.89%). PLA2 was non-toxic to lymphocytes after three days culture, unless the concentration was higher than 100 U/ml. The membrane polarization of PHA-stimulated lymphocytes was also increased by PLA2 at a low concentration. In addition, PLA2 displayed a similar effect on the proliferation of streptokinase-streptodornase (SK/SD) or allogeneic cell stimulated lymphocytes. The change of lymphocyte proliferation by PLA2, was parallel to the change of percentage of helper T cells. Furthermore--a CD4-rich population was proved more susceptible to PLA2 effect than a CD8-rich population. Para-bromophenacyl bromide (pBPB), an irreversible inhibitor of PLA2, abrogated the biphasic effect of PLA2 on PHA MNC proliferation. These results suggest that PLA2 plays a regulatory role on immune reactions by modulating the percentage of helper T cells.
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Affiliation(s)
- C L Yu
- Department of Medicine, Veterans General Hospital-Taipei, Taiwan, ROC
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48
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Abstract
During the development of methods to protect the heart from ischaemic injury, attention has been focused on protection of the left ventricle. In an attempt to assess right heart preservation. 55 consecutive patients undergoing open heart surgery were studied. Mean aortic cross-clamp time was 59.3 +/- 29.4 min. Temperature probes were inserted into the right atrium (RA), right ventricle (RV), and left ventricle (LV). During cardioplegia, the mean myocardial temperatures of RA, RV and LV were 19.1 degrees +/- 4.1 degrees C, 12.7 degrees +/- 4.8 degrees C and 7.3 degrees +/- 3.4 degrees C, respectively. Of the LV temperature measurements, 67.2% were 10 degrees C or lower. By contrast, 94.1% of RA measurements and 58.5% of RV measurements were above 10 degrees C. The inhomogeneity of chamber temperatures was observed irrespective of the patient's disease or age and whether the atrium or right ventricle were open or not. Hearts with mitral regurgitation (MR), in contrast to mitral stenosis and stenoinsufficiency, had higher LV temperatures, similar to those in the RV. We conclude that there is uneven hypothermia among the three cardiac chambers during hypothermic cardioplegic arrest, regardless of disease states except MR and regardless of age and procedure performed.
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Affiliation(s)
- Y F Chen
- Department of Surgery, Kaohsiung Medical College, Taiwan
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49
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Chen YF, Chan HM, Chou SH, Chiu CC, Lin YT, Wu JR, Huang TY. A simple and rapid method for obliteration of patent ductus arteriosus in the small infant. Gaoxiong Yi Xue Ke Xue Za Zhi 1989; 5:241-3. [PMID: 2769829] [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: 01/02/2023]
Abstract
There was a 45-day old small baby with 2,650 g of body weight undergoing surgical operation of patent ductus arteriosus because of congestive heart failure and severe pulmonary hypertension. A simple and rapid method as proposed by Traugott et al for obliteration the ductus with two ligaclips (Ethicon LC300) is presented.
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50
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Yu CL, Chang KL, Chiu CC, Chiang BN, Han SH, Wang SR. Defective phagocytosis, decreased tumour necrosis factor-alpha production, and lymphocyte hyporesponsiveness predispose patients with systemic lupus erythematosus to infections. Scand J Rheumatol 1989; 18:97-105. [PMID: 2544025 DOI: 10.3109/03009748909099924] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [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: 01/01/2023]
Abstract
Twenty-three patients with systemic lupus erythematosus (SLE) were studied in order to understand the mechanism of increased susceptibility to infection in SLE patients. We found that phagocytosis by polymorphonuclear leucocytes (PMN) was significantly defective in untreated (24.2 +/- 3.1%) and immunosuppressant-treated SLE patients (30.0 +/- 3.6%) compared with normals (47.9 +/- 0.6%), while the generation of superoxide anion radicals was normal. The defective phagocytosis in SLE could be increased by human recombinant tumour necrosis factor alpha (TNF-alpha). However, the percentages of phagocytosis in SLE before and after TNF-alpha stimulation were 56.6% and 60.7% of the normal values. This indicates that certain populations of PMN in SLE are not only defective as regards phagocytosis but also unresponsive to TNF-alpha stimulation. In an ELISA, TNF-alpha production by phorbol myristate acetate (PMA)-stimulated mononuclear cells from SLE patients was significantly decreased (181.4 +/- 22.7 pg/ml vs. 533.0 +/- 81.9 pg/ml, p = 0.002). In addition, the percentage of phytohaemagglutinin (PHA)-stimulated mononuclear cells in S phase in the cell cycle was deficient in patients with SLE (17.2 +/- 1.8% vs. 29.7 +/- 2.9%, p less than 0.001). These results lead us to propose that defective PMN in spontaneous and TNF-alpha-induced phagocytosis, decreased production of TNF-alpha, and lymphocyte hyporesponsiveness predispose patients with SLE to infections.
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Affiliation(s)
- C L Yu
- Department of Medicine, Taiwan Veterans General Hospital, Taipei, ROC
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