1
|
Go DE, Gulati M, Kulkarni S, Ryoo JJ, Attaluri V, Ko HC. Anal Canal Adenocarcinomas: Prognostic Factors and Outcomes at a Single Institution. Int J Radiat Oncol Biol Phys 2023; 117:e297-e298. [PMID: 37785088 DOI: 10.1016/j.ijrobp.2023.06.2309] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Adenocarcinomas of the anal canal (AAC) represent a rarity among cancers of the digestive tract. Data guiding management is limited to retrospective studies and optimal treatment paradigms of AAC are still evolving. Here, we aim to investigate their prognostic factors and outcomes. MATERIALS/METHODS We reviewed anorectal adenocarcinoma patients who underwent curative-intent neo/adjuvant therapy +/- surgery at a single institution from 2015-2019. AAC were defined as tumor epicenters ≤ 2 cm from the dentate line. Our primary outcome was 5-year overall survival (OS). We also analyzed 5-year local recurrence, distant metastasis, and disease-free survival (DFS), defined as the interval after treatment completion to the first occurrence of local, regional, distant recurrence, or death. All tumors were staged according to the Rectal Cancer paradigm per AJCC 7th Staging. Kaplan-Meier and Cox-Proportional Hazards Model were used for survival analyses. RESULTS In our cohort, 57 patients met inclusion criteria. Median follow-up time was 54 months. The median age was 64 years; 35% of the cohort was female. The majority of tumors were adenocarcinomas (77%), with a minority of mucinous (12%) and signet ring cell (11%) histologies. The median tumor size was 4 cm, located 1 cm from the anal verge. Most tumors (63%) were grade 2, 77% had T3 disease, and 53% had clinical nodal involvement. Most patients completed neoadjuvant chemoradiation, total mesorectal excision, and adjuvant chemotherapy (54%). Fifty-four percent underwent abdominopelvic resection. Of those who received neoadjuvant therapy, 11% achieved a pathologic complete response. Seventy percent of patients completed chemotherapy, either in the neoadjuvant or adjuvant setting. At 5 years, local recurrence was 9%, regional pelvic recurrence was 12%, inguinal nodal recurrence was 2%, and distant recurrence was 25%. Five-year DFS was 63% and 5-year OS was 70%. Multivariate analysis demonstrated age, female gender, CEA, grade 3 disease, mucinous histology, and nodal involvement to be prognostic of lower OS. Receipt of neo/adjuvant chemotherapy was found to be prognostic of higher OS (HR 0.13, p<0.05). CONCLUSION In this cohort, the majority of whom received surgical management, we show numerically similar or higher overall survival in comparison with prior studies. This study is limited by its retrospective nature and sample sizes of an exceedingly rare entity. Receipt of neo/adjuvant chemotherapy appears to have an impact on survival. Further investigation is needed to explore the role of total neoadjuvant therapy in improving outcomes in this patient population.
Collapse
Affiliation(s)
- D E Go
- Department of Radiation Oncology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - M Gulati
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - S Kulkarni
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - J J Ryoo
- Southern California Permanente Medical Group, Los Angeles, CA
| | - V Attaluri
- Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| | - H C Ko
- Department of Radiation Oncology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
| |
Collapse
|
2
|
Chang TC, Huang SH, Chao HY, Chen BL, Chen C, Chen CH, Chen TR, Chin CY, Chiu CP, Chiu FP, Chou J, Chyr CY, Chu SY, Hsiao SM, Hsieh YM, Huang A, Huang WI, Hung SS, Ko HC, Lin LP, Lin PY, Liu CB, Liu FC, Sheu YI, Shie JS, Tai TF, Tsai SJ, Wang SJ, Wen SC, Wong HC, Yan LP, Yeh T. Efficacy of a Latex Agglutination Test for Rapid Identification of Staphylococcus aureus: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/79.3.661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Fifteen laboratories completed a collaborative study comparing the efficacy of a latex agglutination kit (Aureus Test) with that of AOAC Official Method 987.09 (coagulase test for identification of Staphylococcus aureus). Each laboratory analyzed 240 strains of bacteria, including 160 isolates of S. aureus and 80 isolates of other bacteria. Upon receipt of cultures, collaborators subcultured each isolate on both tryptic soy agar (TSA) and Baird-Parker agar medium (BPA) to determine whether the growth medium has any effect on either method. For cultures grown on TSA, the latex test had sensitivity and specificity rates of 99.2 and 97.1 %, respectively, whereas the coagulase test had respective rates of 98.4 and 92.5%. For cultures able to grow on BPA, the latex test had sensitivity and specificity rates of 99.2 and 96.6%, respectively, while the coagulase test had respective rates of 98.3 and 91.3%. By using the McNemar pairwise comparison test of the 2 methods, the falsepositive and false-negative rates of the latex test were significantly lower (p < 0.01) than those of the coagulase test for strains grown either on TSA or BPA. The latex agglutination test for identification of S. aureus isolated from foods has been adopted by AOAC INTERNATIONAL.
Collapse
Affiliation(s)
- Tsung C Chang
- Food Industry Research and Development Institute, PO Box 246, Hsinchu 300, Taiwan, Republic of China
| | - Su H Huang
- Food Industry Research and Development Institute, PO Box 246, Hsinchu 300, Taiwan, Republic of China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Park MY, Lee JS, Jin HJ, You HS, Kim GW, Ko HC, Kim BS, Kim MB, Kim HS. Localized argyria: troublesome side-effect of acupuncture. J Eur Acad Dermatol Venereol 2017; 32:e62-e65. [PMID: 28833654 DOI: 10.1111/jdv.14526] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Y Park
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - J S Lee
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Gyeongbuk, Korea
| | - H J Jin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H S You
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - G W Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H C Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - B S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - M B Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - H S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
4
|
Sung JS, Jeong YJ, Kim DJ, Lee YY, Jeon YA, Ko HC, Hur OS, Ro NY, Rhee JH, Lee MC, Baek HJ. Comparison of Fatty Acid Compositions and Tocopherols in Perilla germplasm of South Korea. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- JS Sung
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - YJ Jeong
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - DJ Kim
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - YY Lee
- National Institute of Crop Science, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - YA Jeon
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - HC Ko
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - OS Hur
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - NY Ro
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - JH Rhee
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - MC Lee
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| | - HJ Baek
- National Institute of Agricultural Sciences, Rural Development Administration, Jeonju, Korea, Republic of (South)
| |
Collapse
|
5
|
Yang MY, Kim JM, Kim GW, Mun JH, Song M, Ko HC, Kim BS, Kim HS, Kim MB. The clinical and histopathological characteristics of early-onset basal cell carcinoma in Asians. J Eur Acad Dermatol Venereol 2016; 31:75-80. [PMID: 27357061 DOI: 10.1111/jdv.13793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 05/02/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is by far the most common cancer in white populations. In addition, recent reports have demonstrated an increasing incidence of BCC in Korea. We have observed a significant number of early-onset BCC cases in which the disease occurred in patients younger than 50 years. OBJECTIVE To investigate the clinicopathological characteristics of early-onset BCC in an Asian population, specifically in Koreans. METHODS One hundred and five patients with early-onset BCC were enrolled from a total of 1047 BCC patients who underwent surgery between January 1997 and December 2014 (942 patients over the age of 50 years were designated as the control group). RESULTS Early-onset BCC accounted for 10.03% of all 1047 cases and the incidence over time displayed an incremental trend. The early-onset group displayed similar results as the control group, with a predominance of female BCC patients and the majority of tumours displaying the following characteristics: small in size, occurring in sun-exposed areas and belonging to the noduloulcerative clinical subtype and nodular histopathological subtype. In comparison with a previous study in a Western population, the incidence of the disease in non-exposed areas of the body, as well as the proportion of tumours of the superficial histological subtype, were lower in Asian patients. CONCLUSION Although the clinicopathological characteristics of BCC are well-known, these characteristics have not been determined for early-onset BCC in an Asian population. Therefore, this study is the first report on early-onset BCC in Asians, specifically in a Korean patient group.
Collapse
Affiliation(s)
- M Y Yang
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - J M Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - G W Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - J H Mun
- Department of Dermatology, School of Medicine, Seoul National University, Seoul, Korea
| | - M Song
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H C Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - B S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - H S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - M B Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
6
|
Kim WI, Kim JM, Kim GW, Mun JH, Song M, Kim HS, Kim BS, Kim MB, Ko HC. Subacute cutaneous lupus erythematosus induced by capecitabine: 5-FU was innocent. J Eur Acad Dermatol Venereol 2015; 30:e163-e164. [PMID: 26551520 DOI: 10.1111/jdv.13468] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- W I Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - J M Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - G W Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - J H Mun
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - M Song
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - B S Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - M B Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H C Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea. .,Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea. .,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
| |
Collapse
|
7
|
Park SM, Ko HC, Kim BS, Kim MB, Mun JH. Large protruding telangiectatic nodule on the nose. Clin Exp Dermatol 2014; 40:460-2. [PMID: 25476592 DOI: 10.1111/ced.12511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2014] [Indexed: 11/28/2022]
Affiliation(s)
- S M Park
- Department of Dermatology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Republic of Korea
| | - H C Ko
- Department of Dermatology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Republic of Korea
| | - B S Kim
- Department of Dermatology, Pusan National University Hospital, Busan, Republic of Korea
| | - M B Kim
- Department of Dermatology, Pusan National University Hospital, Busan, Republic of Korea
| | - J H Mun
- Department of Dermatology, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Republic of Korea
| |
Collapse
|
8
|
Affiliation(s)
- J M Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - H H Cho
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - H C Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| |
Collapse
|
9
|
|
10
|
Ko HC, Yuan CT, Lin SH, Tang J. Blocked Electron Transfer and Suppressed Blinking of Single CdSe/ZnS Quantum Dots in Agarose Gel. J CHIN CHEM SOC-TAIP 2010. [DOI: 10.1002/jccs.201000075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
11
|
Yuan CT, Yu P, Ko HC, Huang J, Tang J. Antibunching single-photon emission and blinking suppression of CdSe/ZnS quantum dots. ACS Nano 2009; 3:3051-3056. [PMID: 19856980 DOI: 10.1021/nn900760u] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We demonstrated that by properly coupling to silver nanoprisms, single CdSe/ZnS semiconductor quantum dots (QDs) exhibited suppressed blinking behavior, an enhanced fluorescence intensity ( approximately 2.5 fold), increased radiative decay rates ( approximately 12.5 fold), and antibunching single-photon emission. All these modifications significantly promote the overall performance of the proposed single-photon sources based on colloidal semiconductor QDs.
Collapse
Affiliation(s)
- C T Yuan
- Research Center for Applied Sciences, Academia Sinica, Taipei, Taiwan
| | | | | | | | | |
Collapse
|
12
|
|
13
|
Arnett EM, Ko HC, Minasz RJ. Solvent effects in organic chemistry. XIV. Solvation of sodium salts in glycerol acetate binaries by sodium-23 nuclear magnetic resonance spectroscopy and thermodynamics. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100661a025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
14
|
Lu RB, Lee JF, Ko HC, Lin WW. Dopamine D2 receptor gene (DRD2) is associated with alcoholism with conduct disorder. Alcohol Clin Exp Res 2001; 25:177-84. [PMID: 11236830] [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: 02/19/2023]
Abstract
This study examined whether there is evidence for an association between alcoholism with conduct disorder and alleles of the TaqI A and TaqI B polymorphisms, both individually and as haplotypes, at the dopamine D2 receptor gene (DRD2). We studied 182 Han Chinese subjects, including 34 alcoholics with conduct disorder, 63 alcoholics without conduct disorder, and 85 nonalcoholics. Alcohol dependence and conduct disorder were defined according to DSM-III-R criteria. Significant associations were observed between TaqI A and TaqI B at the DRD2 locus, tested individually and as haplotypes, and alcoholism with conduct disorder. Our results suggested that DRD2 might be associated with conduct disorder or a predisposition to both conduct disorder and alcoholism. However, this needs to be further investigated by examining the differences among conduct disorder with alcoholism, conduct disorder only, and controls for the TaqI A and B system at DRD2.
Collapse
Affiliation(s)
- R B Lu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
| | | | | | | |
Collapse
|
15
|
Abstract
The purposes of this study were to assess the fetal cerebellar volume during normal gestation using three-dimensional (3-D) ultrasound (US) and to establish a normal chart of fetal cerebellar volume using Altman's model of statistics. In total, 231 healthy fetuses were studied for assessment of cerebellar volume using a 3-D US volume scanner. The fetuses to be studied were selected to give a cross-sectional series (i.e., each fetus was examined only once). Polynomial regression analysis was calculated to find the best-fit model using gestational age as the independent variable and cerebellar volume as the dependent variable. Altman's model was used to calculate the age-related reference centiles for the variance of cerebellar volume. In addition, common fetal growth indices, such as biparietal diameter, occipitofrontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight, were also measured for the correlation between cerebellar volume and these indices. Our results indicated that the fetal cerebellar volume was highly correlated with gestational age in normal pregnancies with the best-fit polynomial regression equation of a second-order (r = 0.91, p < 0.0001). In addition, fetal cerebellar volume in normal gestation is also highly correlated with common fetal growth indices, such as biparietal diameter, occipitofrontal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight (all p < 0.0001). Following the Altman's model, a normal growth chart of fetal cerebellar volume was established for clinical reference. In conclusion, with 3-D US, the assessment of fetal cerebellar volume becomes feasible. We believe that fetal cerebellar volume assessed by 3-D US may be useful in detecting cerebellar hypoplasia and relevant syndromes prenatally.
Collapse
Affiliation(s)
- C H Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan
| | | | | | | | | |
Collapse
|
16
|
Abstract
The aim of our study was to investigate the parameters of fetal circulation of normal pregnancies and their relationship to fetal cardiac output. We performed a cross-sectional study of 315 normal singleton pregnancies between 20 and 40 weeks' gestation without fetal chromosomal or structural malformations. After follow-up to delivery, 212 patients who fit all the criteria were enrolled for final analysis. Blood flow velocity waveforms were obtained from the tricuspid and mitral ventricular inflow, ascending aorta (AAO), pulmonary artery (PA), middle cerebral artery (MCA), renal artery (RA), umbilical artery (UA), descending aorta (DAO), inferior vena cava (IVC) and ductus venosus (DV) using duplex (real-time Doppler) ultrasound (US) scanner. The peak velocity of DV, AAO, PA and MCA were also obtained. At the intracardiac level, the ratio of peak flow velocity of E wave to peak flow velocity of A wave (E:A ratio) of mitral valve (MV) increased more rapidly than tricuspid valve (TV) E:A ratio. For the great vessels, aortic peak velocity remained higher than the pulmonary peak velocity with advancing gestation. The cardiac output closely correlated to the cardiac compliance and flow resistance indices at arterial and venous level. The acceleration time in the fetal arteries increased with advancing gestation in AAO, PA, MCA and DAO, but it decreased in RA and kept constant in UA. In addition, the acceleration time of UA was unrelated to cardiac output. The changes of the fetal intracardiac, arterial and venous impedances were remarkable through the gestation and related to cardiac output. Fetal cardiac output correlated well with the changes of arterial resistance, except with the DAO. The ventricular compliance increased with advancing gestation, especially in the left side, and was highly related to the change of cardiac output. The acceleration time in major arteries positively correlated with the gestational age and cardiac output, except in UA and RA; this indicates the difference of the changes of mean arterial pressure in uteroplacental circulation, fetal organs and great vessels. In conclusion, the fetal cardiac output correlated well with the ventricular compliance and was influenced by both hemodynamic changes in peripheral resistance and mean arterial pressure.
Collapse
Affiliation(s)
- C H Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan
| | | | | | | | | | | |
Collapse
|
17
|
Chang CH, Chang FM, Yu CH, Liang RI, Ko HC, Chen HY. Fetal ear assessment and prenatal detection of aneuploidy by the quantitative three-dimensional ultrasonography. Ultrasound Med Biol 2000; 26:743-749. [PMID: 10942821 DOI: 10.1016/s0301-5629(00)00206-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [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 purposes of this study were to use quantitative three-dimensional (3-D) ultrasonography to establish the normal charts of three fetal ear-growth indexes, (ear length, ear width and ear area), and to validate their efficacy in the prenatal diagnosis of fetal trisomies, either separately or as a combination. Using quantitative 3-D ultrasonography, we performed a prospective study to measure the three fetal ear growth indexes (i.e., ear length, ear width and ear area) in 129 singleton pregnancies, including 122 normal fetuses and 7 trisomies. The ear shape was also evaluated in these fetuses using both 2-D and 3-D ultrasonography. Our results showed that: First, 3-D ultrasonography offers better visualization and easier evaluation of fetal ears than 2-D ultrasonography. Second, when using the quantitative assessment of 3-D ultrasonography, the measurements of ear length, ear width and ear area were all correlated significantly with gestational age in normal pregnancies (r = 0.881, 0.848, and 0.890, respectively). In addition, 3 of 7 fetal trisomies had ear length below the tenth percentile, 1 had ear width below the tenth percentile, and 2 had ear area below the tenth percentile. Furthermore, with the combination of these three measurements, (including ear length, ear width and ear area), the sensitivity in detecting fetal trisomies was elevated to 57.1% and the specificity was 83.2%. In conclusion, 3-D ultrasonography reduces the limitations of 2-D ultrasonography in the evaluation of fetal ears. However, fetal ear measurement may not be used as a single ultrasonographic parameter in identifying aneuploid fetuses. We recommend using the combination of these three ear growth indexes to enhance the detection rate of aneuploidy.
Collapse
Affiliation(s)
- C H Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan
| | | | | | | | | | | |
Collapse
|
18
|
Chang CH, Chang FM, Yu CH, Ko HC, Chen HY. Three-dimensional ultrasound in the assessment of fetal cerebellar transverse and antero-posterior diameters. Ultrasound Med Biol 2000; 26:175-182. [PMID: 10722905 DOI: 10.1016/s0301-5629(99)00123-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [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
Fetal cerebellum scanning by prenatal ultrasound (US) is very important for early detection of fetal central-nervous-system anomaly, as well as for the determination of gestational age (GA). Due to the small organ size and the unique shape of the fetal cerebellum (CL), accurate measurement of the dimensions of CL by two-dimensional (2-D) US is not easy if the appropriate plane cannot be reached. With the advent of three-dimensional (3-D) US, the disadvantages of 2-D US in assessing the fetal CL dimensions can be avoided. The purpose of this study was to assess the fetal cerebellar transverse diameter (CTD) and cerebellar antero-posterior diameter (CAD) using 3-D US. First, we compared the reproducibility of 2-D and 3-D US on the assessment of fetal cerebellar dimensions. Second, we prospectively measured CTD and CAD in 223 healthy fetuses using a cross-sectional design with an attempt to establish the normal growth charts of fetal CL. Our results showed 3-D US is superior to 2-D US in the reproducibility test of fetal cerebellar dimensions. In addition, with GA as the dependent variable, polynomial regression analysis showed that the best-fit equations for both CTD vs. GA and CAD vs. GA were the first-order. The best-fit predictive equation of GA by CTD was GA (week) = 9.0281 + 0. 58533 x CTD (mm) (r = 0.95, n = 223, SE = 1.82 weeks, p < 0.0001), and the best-fit predictive equation of GA by CAD was GA (week) = 10. 855 + 1.1672 x CAD (mm) (r = 0.82, n = 223, SE = 3.41 weeks, p < 0. 0001). Furthermore, all the correlation coefficients of CTD or CAD vs. the common fetal growth indexes were also highly significant (all p < 0.0001). In conclusion, our data of fetal CL dimensions assessed by 3-D US may serve as a useful reference in assessing fetal CL growth, dating GA or detecting fetal CL anomalies.
Collapse
Affiliation(s)
- C H Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan
| | | | | | | | | |
Collapse
|
19
|
Chen YC, Lu RB, Peng GS, Wang MF, Wang HK, Ko HC, Chang YC, Lu JJ, Li TK, Yin SJ. Alcohol metabolism and cardiovascular response in an alcoholic patient homozygous for the ALDH2*2 variant gene allele. Alcohol Clin Exp Res 1999; 23:1853-60. [PMID: 10630602] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Alcohol metabolism is one of the biological determinants that can influence drinking behavior. Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are the principal enzymes involved in ethanol metabolism. Allelic variation of the ADH and ALDH genes can significantly affect vulnerability for the development of alcoholism. Homozygosity of the variant ALDH2*2 allele previously was believed to fully protect East Asian populations against the development of alcoholism. METHODS Eighty Han Chinese alcoholics who met DSM-III-R criteria for alcohol dependence and 144 nonalcohol-dependent subjects were recruited and their data combined with data from 340 alcohol-dependent and 545 nonalcohol-dependent subjects described in an earlier report (Chen et al., 1999) to assess risk for alcoholism by logistic regression analysis. Genotypes of ADH2, ADH3, and ALDH2 were determined by polymerase chain reaction and restriction fragment length polymorphism. The ALDH2 genotype was confirmed by direct nucleotide sequencing. Blood ethanol concentration was determined by headspace gas chromatography and acetaldehyde concentration by high-performance liquid chromatography with fluorescence detection of the derivatized product. Cardiovascular hemodynamic parameters were measured by two-dimensional Doppler echocardiography and sphygmomanometry. Extracranial arterial blood flow was measured by Doppler ultrasonography. RESULTS An alcohol-dependent patient was identified to be ALDH2*2/*2, ADH2*2/*2, and ADH3*1/*2. Following challenge with a moderate oral dose of ethanol (0.5 g/kg of body weight), the patient exhibited peak concentrations for ethanol (55.7 mg/dl) and acetaldehyde (125 microM). During 130 min postingestion, the patient generally displayed similar or even less intense cardiovascular hemodynamic alterations when compared to a previously published study of nonalcoholic individuals with ALDH2*2/*2 who had received a lower dose of ethanol (0.2 g/kg). Logistic regression analysis of the combinatorial genotypes of ADH2 and ALDH2 in 420 alcohol-dependent and 689 nonalcohol-dependent subjects indicated that risk for alcoholism was 100-fold lower for the ADH2*2/*2-ALDH2*2/*2 individuals than the ADH2*1/*1-ALDH2*1/*1 individuals. CONCLUSIONS The gene status of ALDH2*2/*2 alone can tremendously but not completely (as thought previously) protect against development of alcohol dependence. Individuals carrying the combinatorial genotype of ADH2*2/*2-ALDH2*2/*2 are at the least risk for the disease in East Asians. Physiological tolerance or innate insensitivity to the accumulation of blood acetaldehyde following alcohol ingestion may be crucial for the development of alcoholism in individuals homozygous for ALDH2*2.
Collapse
Affiliation(s)
- Y C Chen
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Abstract
Two new flavonoid glycosides, (2S)-5-hydroxy-7, 3'-dimethoxyflavanone-4'-O-beta-[apiosyl (1 --> 2)]glucoside (1) and rhamnazin-4'-O-beta-[apiosyl (1 --> 2)]glucoside (2) were isolated from Viscum alniformosanae. Structures were elucidated by NMR and mass spectroscopic analysis.
Collapse
Affiliation(s)
- CJ Chou
- National Research Institute of Chinese Medicine, 155-1, Sec. 2, Li-Nung St., Taipei (11221), Taiwan, Republic of China
| | | | | |
Collapse
|
21
|
Lee JF, Lu RB, Ko HC, Chang FM, Yin SJ, Pakstis AJ, Kidd KK. No association between DRD2 locus and alcoholism after controlling the ADH and ALDH genotypes in Chinese Han population. Alcohol Clin Exp Res 1999; 23:592-9. [PMID: 10235293] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Recent studies on the genetics of alcoholism have examined the association between alcoholism and the dopamine D2 receptor locus (DRD2); our study of Chinese Han gave negative results (Lu et al., 1996). The different genotypes at the genes encoding the enzymes involved in alcohol metabolism, class one alcohol dehydrogenase (ADH2 and ADH3) and mitochondrial aldehyde dehydrogenase (ALDH2), have previously been shown to confer different predispositions to the development of alcoholism in Chinese Han males (Thomasson et al., 1991; Chen WJ et al., 1996; Chen CC et al., unpublished data). Therefore, association studies of alcoholism in Chinese Han might be more sensitive if controlled for the genotypes of ADH2,ADH3, and ALDH2, when other loci, such as DRD2, are examined. This study employs such controls to evaluate the evidence for an association between alcoholism and TaqI-A and TaqI-B genotypes and haplotypes at DRD2 in the Chinese Han population. METHODS We studied 213 Chinese Han subjects (128 alcoholics and 85 nonalcoholics) with alcohol dependence defined according to DSM-III-R criteria. RESULTS Significant linkage disequilibrium was observed between the TaqI-A and TaqI-B sites at the DRD2 locus, as previously seen in smaller samples, but no significant association was observed between these genetic variants at the DRD2 locus and alcoholism in Chinese Han. Several different stratifications by ADH and ALDH2 genotypes were examined; no genotypes or haplotypes at DRD2 differ between alcoholics and nonalcoholics except for a small number of nominally significant p-values which do not constitute significant results given the many tests done, some of which are not independent of one another due to linkage disequilibrium. These tests included considering the high risk (ADH2*1/*1; *1/*2; ADH3*1/*2; *2/*2; and ALDH2*1/*1) and the low risk (ADH2*2/*2; ADH3*1/*1; and ALDH2*1/*2; *2/*2) groups of alcoholics, as well as nonalcoholic controls. CONCLUSIONS After stratification by the relevant genotypes of ADH2, ADH3, and ALDH2 no significant association exists between the genetic variants at the DRD2 locus and alcoholism in the Chinese Han population.
Collapse
Affiliation(s)
- J F Lee
- Graduate Institute of Medical Sciences, National Defense Medical Center, Armed Forces Pei-Tou Hospital, Taipei, Taiwan, Republic of China
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
AIMS Oligodendroglial tumours follow genetic pathways different from but overlapping with those of astrocytic tumours. The aim of this study was to examine whether major genetic events such as loss of chromosome 10 and p53 mutation found in astrocytic gliomas are also involved in the development and anaplastic transformation of non-astrocytic gliomas and to correlate the findings with histopathological subtypes of these tumours. METHODS AND RESULTS Sixty-one formalin-fixed, paraffin-embedded oligodendroglial and ependymal tumours (16 oligodendrogliomas, 12 anaplastic oligodendrogliomas, seven oligoastrocytomas, 24 ependymomas and two anaplastic ependymomas) were examined for allelic deletions on chromosome 10q23 and 10q25-26 regions, mutations of PTEN/MMAC1 and p53, MDM2 gene amplification and apoptosis. The frequencies of allelic deletions at marker D10S2491 (which mapped within PTEN/MMAC1) and between markers D10S209 and D10S587 (where DMBT1 was located) were found to be < 30% in both types of non-astrocytic gliomas. High frequency of allelic deletions was detected at marker D10S215 (80%) at the proximal 10q23 region in both oligodendroglial and ependymal tumours and between markers D10S216 (42%) and D10S169 (67%) at distal 10q25-26 region in oligodendroglial tumours. No mutations of PTEN/MMAC1 were found. p53 mutations were detected in three oligoastrocytomas and one ependymoma; three out of five mutations were found in exon 4. MDM2 gene amplification was found in one ependymoma harbouring wild-type p53. The apoptotic index was lower in p53-mutated tumours than in tumours with wild-type p53. CONCLUSION The telomeric end of chromosome 10q could be involved in the development and anaplastic transformation of oligodendroglial tumours. Mutations of PTEN/MMAC1 and p53, amplification of the MDM2 gene and allelic loss on chromosome 10q do not play a major part in the pathogenesis or anaplastic transformation of oligodendrogliomas and ependymal tumours.
Collapse
Affiliation(s)
- C Y Tong
- Department of Anatomical & Cellular Pathology, The Chinese University of Hong Kong, Hong Kong
| | | | | | | | | | | |
Collapse
|
23
|
Osier M, Pakstis AJ, Kidd JR, Lee JF, Yin SJ, Ko HC, Edenberg HJ, Lu RB, Kidd KK. Linkage disequilibrium at the ADH2 and ADH3 loci and risk of alcoholism. Am J Hum Genet 1999; 64:1147-57. [PMID: 10090900 PMCID: PMC1377839 DOI: 10.1086/302317] [Citation(s) in RCA: 199] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Two of the three class I alcohol dehydrogenase (ADH) genes (ADH2 and ADH3) encode known functional variants that act on alcohol with different efficiencies. Variants at both these genes have been implicated in alcoholism in some populations because allele frequencies differ between alcoholics and controls. Specifically, controls have higher frequencies of the variants with higher Vmax (ADH2*2 and ADH3*1). In samples both of alcoholics and of controls from three Taiwanese populations (Chinese, Ami, and Atayal) we found significant pairwise disequilibrium for all comparisons of the two functional polymorphisms and a third, presumably neutral, intronic polymorphism in ADH2. The class I ADH genes all lie within 80 kb on chromosome 4; thus, variants are not inherited independently, and haplotypes must be analyzed when evaluating the risk of alcoholism. In the Taiwanese Chinese we found that, only among those chromosomes containing the ADH3*1 variant (high Vmax), the proportions of chromosomes with ADH2*1 (low Vmax) and those with ADH2*2 (high Vmax) are significantly different between alcoholics and controls (P<10-5). The proportions of chromosomes with ADH3*1 and those with ADH3*2 are not significantly different between alcoholics and controls, on a constant ADH2 background (with ADH2*1, P=.83; with ADH2*2, P=.53). Thus, the observed differences in the frequency of the functional polymorphism at ADH3, between alcoholics and controls, can be accounted for by the disequilibrium with ADH2 in this population.
Collapse
Affiliation(s)
- M Osier
- Department of Human Genetics, Yale University, New Haven, CT 06520-8005, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Abstract
BACKGROUND It has been suggested that platelet serotonin (5-HT) content may reflect aspects of the presynaptic reuptake of 5-HT, while plasma 3-methoxy-4-hydroxy-phenylglycol (MHPG) levels may provide an index of central noradrenergic function. METHODS In order to determine if there is a biological distinction in 5-HT or noradrenergic function within bipolar I and bipolar II depressions, we measured levels of platelet 5-HT and plasma MHPG in 12 patients with bipolar I depression, 12 patients with bipolar II depression, and 20 normal healthy controls. All subjects were medication free for at least 4 weeks prior to the study. RESULTS There was a trend towards higher platelet 5-HT in bipolar I or II depressions when compared to normal controls, whereas there was no difference in platelet 5-HT levels between bipolar I and II depressed patients. When bipolar I and II patients were pooled, there was a significant increase in platelet 5-HT levels in bipolar depressives compared to normal controls, and there was a trend towards a weak positive correlation between platelet 5-HT and 21-item HAMD scores in the patient group. In contrast, there was no difference in plasma MHPG levels between the three groups. LIMITATIONS This study was limited to a small sample size, single point sampling and did not match seasons. CONCLUSIONS Our findings did not provide supportive evidence for a distinctive 5-HT or noradrenergic function within bipolar I and bipolar II depressions. However, the finding of increased platelet 5-HT levels in bipolar depressed patients compared to normal controls is consistent with the results of previous studies, and may suggest an increase in presynaptic 5-HT reuptake, presumably resulting from diminished synaptic 5-HT availability in this condition.
Collapse
Affiliation(s)
- I S Shiah
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
| | | | | | | |
Collapse
|
25
|
Flores-Murrieta FJ, Ko HC, Flores-Acevedo DM, López-Muñoz FJ, Jusko WJ, Sale ME, Castañeda-Hernández G. Pharmacokinetic-pharmacodynamic modeling of tolmetin antinociceptive effect in the rat using an indirect response model: a population approach. J Pharmacokinet Biopharm 1998; 26:547-57. [PMID: 10205770 DOI: 10.1023/a:1023273100270] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The relationship between the pharmacokinetics and the antinociceptive effect of tolmetin was characterized by an indirect model using a population approach. Animals received an intra-articular injection of uric acid in the right hindlimb to induce its dysfunction. Once dysfunction was complete, rats received an oral tolmetin dose of 1, 3.2, 10, 31.6, 56.2 or 100 mg/kg and antinociceptive effect and blood tolmetin concentration were simultaneously evaluated. Tolmetin produced a dose-dependent recovery of functionality, which was not directly related to blood concentration. An inhibitory indirect response model was used based on these response patterns and the fact that tolmetin reduced nociception by inhibiting prostaglandin synthesis. Pharmacokinetic (PK) and pharmacodynamic (PD) data were simultaneously fitted using nonlinear mixed effects modeling (NONMEM) to the one-compartment model and indirect response model. The individual time courses of the response were described using Bayesian analysis with population parameters as a priori estimates. There was good agreement between the predicted and observed data. Population analysis yielded a maximal inhibition of the nociceptive response of 76% and an IC50 of 9.22 micrograms/ml. This IC50 is similar to that for tolmetin-induced prostaglandin synthesis inhibition in vitro (3.0 micrograms/ml). The present results demonstrate that mechanism-based PK-PD analysis using a population approach is useful for quantitating individual responses as well as reflecting the actual mechanism of action of a given drug in vivo.
Collapse
Affiliation(s)
- F J Flores-Murrieta
- Departamento de Farmacología y Toxiçología, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, México, D.F., Mexico
| | | | | | | | | | | | | |
Collapse
|
26
|
Abstract
BACKGROUND Previous studies have shown wide variation in plasma dexamethasone (DEX) concentrations following a standard 1-mg dexamethasone suppression test (DST), and significantly lower DEX concentrations in DST nonsuppressors compared with suppressors, suggesting that DEX pharmacokinetics/bioavailability is an important variable associated with DST nonsuppression. METHODS To determine the effect of plasma DEX levels on the DST in Chinese depressives, we measured plasma DEX and post-DEX cortisol levels at 4:00 PM in a group of 50 depressed outpatients, 28 anxiety outpatients, and 33 normal subjects during the course of 1-mg oral overnight DST. RESULTS We found a significant difference in the plasma DEX levels between DST nonsuppressors and suppressors in the depression group and overall subject population, and a significant negative correlation between the plasma DEX and cortisol levels in the depression, anxiety, and total groups. Within a DEX "window", the DST performance was enhanced, whereas the relationships between plasma DEX and post-DEX cortisol levels remained equally strong. CONCLUSIONS Our findings support a relationship between plasma DEX and post-DEX cortisol levels, a relationship that might be superimposed on the hypothalamic-pituitary-adrenal axis. Comparing our "window" range with those of previous studies, we suggest that Chinese depressives may have lower limits of plasma DEX window, and that ethnicity may be an intervening variable in both DST response and pharmacokinetics of DEX.
Collapse
Affiliation(s)
- I S Shiah
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | | | | |
Collapse
|
27
|
Abstract
Currently available software for nonlinear regression does not account for errors in both the independent and the dependent variables. In pharmacodynamics, measurement errors are involved in the drug concentrations as well as in the effects. Instead of minimizing the sum of squared vertical errors (OLS), a Fortran program was written to find the closest distance from a measured data point to the tangent line of an estimated nonlinear curve and to minimize the sum of squared perpendicular distances (PLS). A Monte Carlo simulation was conducted with the sigmoidal Emax model to compare the OLS and PLS methods. The area between the true pharmacodynamic relationship and the fitted curve was compared as a measure of goodness of fit. The PLS demonstrated an improvement over the OLS by 20.8% with small differences in the parameter estimates when the random noise level had a standard deviation of five for both concentration and effect. Consideration of errors in both concentrations and effects with the PLS could lead to a more rational estimation of pharmacodynamic parameters.
Collapse
Affiliation(s)
- H C Ko
- Department of Pharmaceutics, School of Pharmacy, State University of New York at Buffalo, NY 14260, USA
| | | | | |
Collapse
|
28
|
Abstract
OBJECTIVE To compare the accuracy of three-dimensional ultrasound-assessed fetal thigh volumetry in predicting birth weight with that of other commonly used formulas composed of biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL) by two-dimensional ultrasound. METHODS We assessed the thigh volume of 100 fetuses using three-dimensional ultrasound. Meanwhile, their BPD, AC, and FL were measured by two-dimensional ultrasound. All infants were delivered within 48 hours after the ultrasound examinations. From polynomial regression analysis, we generated a best-fit formula for the thigh volume to predict birth weight. The accuracy of this thigh-volume formula was compared with those of three formulas commonly used in the United States. In addition, another group of 50 fetuses was measured for prospective validation. RESULTS The high volume assessed by three-dimensional ultrasound was highly correlated with birth weight (r = 0.89, n = 100, P < .0001). The best-fit formula for thigh volume to predict birth weight was linear, and it was superior to the other commonly used two-dimensional formulas in predicting birth weight. The predicting error (0 g), percent error (0.7%), absolute error (176.1 g), and absolute percent error (5.8%) of the thigh-volume formula were all smaller than those of the other formulas (n = 100, all P < .05). In addition, the thigh-volume formula predicted birth weight more accurately than the other two-dimensional formulas in the prospective-validation group. The three-dimensional formula had smaller mean values of predicting error (38.6 g), percent error (1.5%), absolute error (160.0 g), and absolute percent error (5.1%) than the two-dimensional formulas (n = 50, all P < or = .001), as well as the smallest variances of the above errors (178.1 g, 5.6%, 84.3 g, and 2.9%, respectively). CONCLUSION The three-dimensional ultrasound-assessed thigh volume has better accuracy in predicting birth weight than the commonly used formulas by two-dimensional ultrasound, and it may improve fetal weight prediction in clinical practice. However, a large-scale prospective validation study may be needed to confirm our conclusions.
Collapse
Affiliation(s)
- F M Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
| | | | | | | | | | | |
Collapse
|
29
|
Abstract
OBJECTIVE Our purpose was to determine the usefulness and accuracy of the three-dimensional ultrasonography assessed fetal upper-arm volume in predicting birth weight. STUDY DESIGN From June 1996 to October 1996, we performed a prospective study of ultrasonography on 105 pregnant women without fetal structural anomaly or aneuploidy. Both the traditional two-dimensional ultrasonographic parameters and three-dimensional ultrasonography for fetal upper arm volume were measured within 48 hours of delivery. RESULTS The upper arm volume correlated well with birth weight (r = 0.92, n = 105, p < 0.0001). With use of linear and polynomial regression, we obtained a best-fit new formula, Birth weight = 1088.60 + 36.024 x Upper-arm volume. The accuracy of this new formula is compared with that of two Chinese equations predicting fetal weight reported before and other formulas commonly used in the world as well. Our formula is more accurate in predicting birth weight than all the other formulas by traditional two-dimensional ultrasonography, either in error, percentage error, or absolute error. Another group by prospective validation further proved this finding. CONCLUSION The upper-arm volume assessed by three-dimensional ultrasonography can accurately predict birth weight, and its accuracy is superior to the previous, formulas. Our study has at least validated the application of upper-arm volume by three-dimensional ultrasonography in estimating fetal weight. Further larger series are needed to confirm our findings.
Collapse
Affiliation(s)
- R I Liang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan
| | | | | | | | | | | |
Collapse
|
30
|
Abstract
This study was designed to investigate the relationship between platelet serotonin (5-HT) and plasma free 3-methoxy-4-hydroxyphenylglycol (MHPG) measures in depressed outpatients obtained from the same patient with unipolar depression during the pretreatment period and subsequent response to 6 weeks of treatment with either fluoxetine or maprotiline. Compared to the nonresponder group, the fluoxetine responders showed significantly higher pretreatment levels of MHPG, but no difference in pretreatment 5-HT levels. There were no significant differences in either 5-HT or MHPG levels between maprotiline responders and nonresponders. As to posttreatment levels, there were no between-group differences in 5-HT or MHPG between responders and nonresponders to either fluoxetine or maprotiline. When the relationships between changes in 5-HT or MHPG levels and treatment response were examined, 5-HT values showed a marked decrease in both fluoxetine responders and nonresponders, but no significant changes were found in the maprotiline treatment groups. On the other hand, MHPG levels in the fluoxetine nonresponders tended to increase (borderline significance), whereas the MHPG levels for fluoxetine responders and maprotiline responders and nonresponders were unaffected from pre- to posttreatment. Pretreatment levels of plasma free MHPG appear to predict response to fluoxetine.
Collapse
Affiliation(s)
- H C Ko
- Department of Public Health, and Psychiatry, Medical College, National Cheng-Kung University, Tainan, Taiwan, Republic of China
| | | | | | | |
Collapse
|
31
|
Yu CH, Yao BL, Chang CH, Ko HC, Lin YS, Chang FM. Refined fetal abdominal growth assessment in normal pregnancy: Part I. Abdominal anteroposterior diameter. Zhonghua Yi Xue Za Zhi (Taipei) 1997; 59:164-70. [PMID: 9198291] [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: 02/04/2023]
Abstract
BACKGROUND The assessment of the adequacy of fetal growth by parameters other than the abdominal anteroposterior diameter (AAPD) of the fetus has been studied extensively. However the designs of these studies and the statistical methods used appears to deserve some criticism, based on present knowledge. Noncross-sectional cases selection, uncertainty of the fetal normality and inadequacy in statistical method, mostly ignored the changing property of each standard deviation (SD) of each gestational age (GA) which was proposed by Altman et. al. in 1993, are the three most common flaws in previous publishes. We tried to use AAPD with a strict study design as well as a reasonable statistical method to evaluate the fetal growth. METHODS This study was performed in the Division of Maternal Fetal Medicine, National Cheng Kung University Hospital, Taiwan. The prenatal sonographic data of the fetuses were collected prospectively based on the following criteria: (1) accurate dating by knowing the maternal last menstration period (LMP) and early ultrasonography of the fetuses, (2) singleton pregnancy, (3) no fetal structural or chromosomal abnormality confirmed by prenatal ultrasonography and postnatal examination, (4) GA at birth was between 37 and 41 weeks' gestation, (5) no birth asphyxia, (6) appropriate birth body weight, and (7) no maternal medical disease or obstetrical complication which might predictably interfere with fetal growth. The collected data were analyzed by polynomial regression test and the best-fit equation for prediction of fetal growth was selected. The standard deviation (SD) of each GA was modeled before constructing the fetal growth centile charts by Altman's method. RESULTS A total of 2077 cross-sectional sonographic data meeting the above criteria were collected for statistical analysis. The best-fit equation for the prediction of fetal GA by AAPD is GA = 20.8539 - 3.36743 x AAPD + 0.86927 x (AAPD)2 - 0.03789 x (AAPD)3 +/- k x [1.2533 x (0.36772 + 0.10938 x AAPD)], (r = 0.97287, p < 0.0001). The best-fit equation for prediction of fetal AAPD by GA is AAPD = -2.49495 + 0.38247 x GA - 1.07071 x 0.001 x (GA)2 +/- k x [1.2533 x (0.01760 + 0.01372 x GA)], r = 0.97122, p < 0.0001. The SD of AAPD for each complete GA was not the same. The fetal growth centile charts in the study are presented in this article. CONCLUSIONS The SD of each complete GA changed with each specific GA. The GA of the fetus can be assessed accurately by measuring the AAPD alone. The utilization of these growth centile charts for evaluation of fetal growth is recommended.
Collapse
Affiliation(s)
- C H Yu
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan, R.O.C
| | | | | | | | | | | |
Collapse
|
32
|
Chang FM, Ko HC, Lu RB, Pakstis AJ, Kidd KK. The dopamine D4 receptor gene (DRD4) is not associated with alcoholism in three Taiwanese populations: six polymorphisms tested separately and as haplotypes. Biol Psychiatry 1997; 41:394-405. [PMID: 9034534 DOI: 10.1016/s0006-3223(96)00248-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The dopaminergic system has been implicated in alcoholism but studies at the dopamine D2 receptor gene (DRD2), one of the five dopamine receptors, have not given a consistent picture of an association with alcoholism. We have now studied the dopamine D4 receptor gene (DRD4) using six polymorphisms, both separately and as haplotypes. Three groups of alcoholics from Taiwan (Atayal, Ami, and Han) diagnosed as having severe alcohol dependence using DSM-III-R criteria, together with nonalcoholics matched for gender, ethnic group, and geographic origin, were typed by polymerase chain reaction (PCR) and/or PCR-restriction fragment length polymorphism (RFLP) for all six polymorphisms. Three out of six markers are polymorphic in all three Taiwanese populations. Although the prevalence rates of alcoholism are remarkably different, no highly significant association of this locus with alcoholism was observed in any of the three groups whether the analysis considered genotype distributions or allele frequencies at the three polymorphic markers considered individually and as haplotypes. Neither is there any obvious pattern in the data that covaries with or hints at a relationship with the very different prevalences of alcoholism in the groups studied. Especially because the powerful, multi-site haplotype analysis was not statistically significant in any of the population samples, we conclude that there is no association of the DRD4 locus with alcoholism in Taiwanese populations.
Collapse
Affiliation(s)
- F M Chang
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut 06520-8005, USA
| | | | | | | | | |
Collapse
|
33
|
Chang FM, Hsu KF, Ko HC, Yao BL, Chang CH, Yu CH, Liang RI, Chen HY. Fetal heart volume assessment by three-dimensional ultrasound. Ultrasound Obstet Gynecol 1997; 9:42-48. [PMID: 9060130 DOI: 10.1046/j.1469-0705.1997.09010042.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Heart volume may provide important information on the status of fetal hemodynamics. However, traditionally fetal heart volume has been assessed with the erroneous assumption that the fetal heart is spherical or elliptical. With the advent of three-dimensional ultrasound, accurate assessment of organ volume has become feasible. The objectives of this study were to compare the reproducibility of two-dimensional ultrasound and three-dimensional ultrasound in the assessment of heart volume, and to test whether heart volume assessed by the traditional method of two-dimensional ultrasound equates to that assessed by three-dimensional ultrasound. If it proved to be significantly different, we aimed to find a new constant which, if incorporated into the traditional formula used to determine heart volume, would enable us to achieve more accurate volumes with two-dimensional ultrasound. In total, 50 normal singleton fetuses ranging from 20 to 30 weeks' gestation were included in the study. Both the traditional two-dimensional and the new three-dimensional volume measurements were compared. The results showed that three-dimensional ultrasound has a better reproducibility than two-dimensional ultrasound in heart volume assessment and that heart volume assessed by the traditional formula of two-dimensional ultrasound is significantly larger than that measured by three-dimensional ultrasound (p < 0.001). We therefore propose that, if the traditional two-dimensional equation is to be used, the constant for heart volume could be modified to 0.4563 (SE = 0.0153, n = 50) to achieve more accurate results. With this new constant, the heart volume derived by two-dimensional ultrasound was not found to differ from that measured by three-dimensional ultrasound. From our series, we conclude that three-dimensional ultrasound is theoretically the best method for the assessment of heart volume. However, because of the limitations of three-dimensional ultrasound (i.e. it is not routinely available, it is more expensive and more time-consuming) two-dimensional ultrasound in practical terms should be the method of choice. Although we were able to improve the accuracy of the heart volume measurements using a new constant in the traditional two-dimensional formula, the new constant will not improve variability, which can only be reduced by three-dimensional ultrasound.
Collapse
Affiliation(s)
- F M Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Ko HC, Lu RB, Shen JJ, Shyu LY. Construction of a screening inventory for major mental disorder in the Army. Ann Acad Med Singap 1997; 26:8-12. [PMID: 9140570] [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: 02/04/2023]
Abstract
The development of a 29-item self-report inventory to screen for non-adaptiveness with an episode or a history of major mental disorder in the army is described. Initially, a 58-item inventory was constructed. However, through a pilot study 46 items remained. The reliability and validity test of the 46-item inventory was then carried out on 357 patients and 126 controls. Firstly, item analyses were performed which showed 12 items that distinguished between schizophrenic patients and controls, 9 items that distinguished between depressive patients and controls and 8 items that distinguished between manic patients and controls. A final 29-item inventory was found to have satisfactory reliability, sensitivity and specificity. The analyses of the best cut-off scores using the receiver-operating-characteristic curve suggested a score of 3 for the Schizophrenia Scale, 2 for the Depression Scale, and 3 for the Mania Scale. The inventory can be completed in about 5 to 10 minutes and has a simple method of scoring. The use of this screening inventory in the army is discussed.
Collapse
Affiliation(s)
- H C Ko
- Department of Public Health, Psychiatry Medical College, National Cheng Kung University, Taiwan ROC
| | | | | | | |
Collapse
|
35
|
Chang FM, Hsu KF, Ko HC, Yao BL, Chang CH, Yu CH, Chen HY. Three-dimensional ultrasound assessment of fetal liver volume in normal pregnancy: a comparison of reproducibility with two-dimensional ultrasound and a search for a volume constant. Ultrasound Med Biol 1997; 23:381-389. [PMID: 9160906 DOI: 10.1016/s0301-5629(96)00218-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The purposes of this study are to compare the reproducibility of two-dimensional ultrasound (2DUS) and three-dimensional ultrasound (3DUS) in the assessment of fetal liver volume (LV), and to test whether the fetal LV assessed by the traditional method with 2DUS is equal to that with 3DUS in normal pregnancy. If significantly different, we then try to calculate a new constant of fetal LV for the traditional equation from the LV values obtained with 3DUS. In total, 30 normal singleton fetuses with gestational ages ranging from 20 to 30 weeks were included for the reproducibility test and 55 cases ranging from 20 to 31 weeks gestation were enrolled for finding a new volume constant of LV. The results showed that 3DUS is superior to 2DUS in the reproducibility test of fetal LV assessment. Moreover, the LV assessed with the traditional 2DUS method (identified as LV_42) was significantly smaller than that measured with 3DUS (P < 0.001). If the traditional 2DUS equation is to be used, the multiplying factor in the equation for the calculation of LV should be modified to 0.55 (SE = 0.017, N = 55). With the new volume constant, the new derived LV with 2DUS (identified as LV 55) was not different from that with 3DUS (identified as LV_3D). In conclusion, we recommend that 3DUS, instead of 2DUS, should be used for reaching an accurate assessment of fetal LV. Otherwise, applying our new volume constant may be of help in detecting abnormal fetal liver growth when only 2DUS is available.
Collapse
Affiliation(s)
- F M Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
| | | | | | | | | | | | | |
Collapse
|
36
|
Lu RB, Ko HC, Chang FM, Castiglione CM, Schoolfield G, Pakstis AJ, Kidd JR, Kidd KK. No association between alcoholism and multiple polymorphisms at the dopamine D2 receptor gene (DRD2) in three distinct Taiwanese populations. Biol Psychiatry 1996; 39:419-29. [PMID: 8679787 DOI: 10.1016/0006-3223(95)00182-4] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study examined whether there is evidence for an association between alcoholism and the alleles of the TaqI A, TaqI B, and short tandem repeat polymorphisms (STRP), both individually and as haplotypes, at the dopamine D2 receptor gene (DRD2) in males of three populations from Taiwan. We studied 46 Chinese Han (21 alcoholics and 25 nonalcoholics), 42 Atayal (21 alcoholics and 21 nonalcoholics), and 40 Ami (20 alcoholics and 20 nonalcoholics). Alcoholism was diagnosed according to DSM-III-R criteria and all individuals in the alcoholic groups were severely affected. Significant linkage disequilibrium occurs for the three polymorphic sites in all three populations. No significant association was observed between any of the three polymorphisms at the DRD2 locus, tested individually and as haplotypes, and alcoholism in the three subject groups. We conclude that no association exists between genetic variation at the DRD2 locus and alcoholism in Chinese Han, Atayal, and Ami males.
Collapse
Affiliation(s)
- R B Lu
- Department of Psychiatry, Tri-Service General Hospital, National Defence Medical Center, Taipei, Taiwan, Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Ko HC, Jusko WJ. Pharmacodynamic modeling of finasteride, a 5 alpha-reductase inhibitor. Pharmacotherapy 1995; 15:509-11. [PMID: 7479205] [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: 01/25/2023]
Abstract
Finasteride is a 4-azasteroid inhibitor of one isoenzyme of 5 alpha-reductases that converts testosterone to dihydrotestosterone (DHT). We characterized the time course of DHT concentrations. The following model was used to assess DHT pharmacodynamics: [formula: see text] where joint fitting of three dose levels yielded kin0 = 28% change/hour, kout = 0.28 hour-1, IC50 = 0.012 ng/ml, and Emax = 0.7. The modification of a previous model with the maximum partial effect factor, Emax, may be useful in characterizing the pharmacodynamics of drugs with similar indirect mechanisms.
Collapse
Affiliation(s)
- H C Ko
- Department of Pharmaceutics, School of Pharmacy, State University of New York at Buffalo 14260, USA
| | | |
Collapse
|
38
|
Abstract
PURPOSE The effect of exogenous corticosteroid binding globulin (CBG) on the pharmacokinetics of intravenous prednisolone was determined in rats to test the "free hormone hypothesis." METHODS A dose of CBG to yield 95% binding with 1000 ng/ml of prednisolone in vitro in rat plasma or saline was administered before dosing 2 mg/kg of prednisolone hemisuccinate or methylprednisolone intravenously. Drug concentrations in plasma samples were assayed by HPLC. RESULTS Single administration of CBG decreased apparent prednisolone clearance by 56% (155 to 66 ml/min/kg) and reduced apparent VSS by 35% (4.1 to 2.7 L/kg) (p < 0.001). Methylprednisolone pharmacokinetics, studied as a negative control because the drug does not bind to CBG, did not change. CONCLUSIONS The corticosteroid bound to CBG does not appear to be available for removal by clearance organs.
Collapse
Affiliation(s)
- H C Ko
- Department of Pharmaceutics, School of Pharmacy, State University of New York at Buffalo, New York 14260, USA
| | | | | |
Collapse
|
39
|
Jusko WJ, Ko HC, Ebling WF. Convergence of direct and indirect pharmacodynamic response models. J Pharmacokinet Biopharm 1995; 23:5-8; discussion 9-10. [PMID: 8576844 DOI: 10.1007/bf02353781] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- W J Jusko
- Department of Pharmaceutics, School of Pharmacy, State University of New York at Buffalo 14260-1200, USA
| | | | | |
Collapse
|
40
|
Chang FM, Yao BL, Yu CH, Huang SC, Lin YS, Ko HC. Acceleration time in normal fetal umbilical artery at term and its relationship to the cord blood hematocrit. J Clin Ultrasound 1995; 23:33-37. [PMID: 7699091 DOI: 10.1002/jcu.1870230107] [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: 05/21/2023]
Abstract
The purpose of this study was to test the hypothesis that the acceleration time (AT) of the fetal umbilical artery remains constant at term for normal pregnancies. In addition, we also examined whether the AT has any correlation with umbilical cord blood hematocrit (Hct). In total, 539 normal-term fetuses with menstrual ages (MA) ranging from 37 weeks to 42 weeks were enrolled in a cross-sectional design. The AT of the fetal umbilical artery was measured prior to delivery using a high-resolution, real-time Doppler scanner. All were delivered within 2 days of the ultrasound examination. At parturition, blood from the umbilical vein was collected and the red cell indices, including the Hct, were determined. The results indicated that the mean values of AT of the umbilical artery remained constant during normal-term pregnancies from 37 weeks to 42 weeks, menstrual age (mean: 0.104 sec, SE: 0.001 sec, n = 539). Although the AT was thought to be affected by the Hct, the AT had no correlation with umbilical venous Hct (n = 539, r = 0.002, p > 0.05). This constant value of the AT may be used as a reference for fetal physiology and perinatal medicine.
Collapse
Affiliation(s)
- F M Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan, Republic of China
| | | | | | | | | | | |
Collapse
|
41
|
Abstract
We have been following up the biological and mental development of children exposed prenatally to polychlorinated biphenyls and their contaminants (Yucheng children). When we started this 12-year follow-up study in August 1985, 118 Yucheng children we assigned a non-exposed child matched by sex, age, locality of residence, mother's age, socio-economic status of the family. This article reports the cognitive aspect of the development of Yucheng children as compared to their matched controls. A consistent tendency which indicates that Yucheng children score lower in each kind of measurement tool at each age level has been observed. This seems to imply that congenitally exposure to PCBs and their contaminants has long-term adverse effects on the cognitive development of human being.
Collapse
Affiliation(s)
- T J Lai
- Department of Psychiatry, National Cheng-Kung University Medical College, Tainan, Taiwan, R.O.C
| | | | | | | | | |
Collapse
|
42
|
Abstract
A family of four basic physiologic indirect response models has been proposed to account for the pharmacodynamics of drugs that act by way of inhibition or stimulation of the production or loss of endogenous substances or mediators. Such models were applied previously to account for the anticoagulant effects of warfarin, adrenal suppression by corticosteroids, cell trafficking effects of corticosteroids, antipyretic effects of ibuprofen, and aldose reductase inhibition. Additional responses that can be readily characterized with such models include muscular contraction from pyridostigmine, diuresis from furosemide, bronchodilation from terbutaline, prolactin secretion after cimetidine, and potassium suppression by terbutaline. This report shows that indirect response models, rather than "link" or "hypothetical effect compartment" models, may be more appropriate for diverse drugs when time lags exist between plasma or biophase drug concentrations and the time course of pharmacodynamic responses.
Collapse
Affiliation(s)
- W J Jusko
- Department of Pharmaceutics, School of Pharmacy, State University of New York at Buffalo 14260
| | | |
Collapse
|
43
|
Ko HC, Tsai TH, Chou CJ, Hsu SY, Li SY, Chen CF. High-performance liquid chromatographic determination of rutaecarpine in rat plasma: application to a pharmacokinetic study. J Chromatogr B Biomed Appl 1994; 655:27-31. [PMID: 8061830 DOI: 10.1016/s0378-4347(94)80128-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A simple and sensitive high-performance liquid chromatographic method for determination and identification of rutaecarpine in rat plasma has been developed. Up to 0.1 ml of plasma containing rutaecarpine was deproteinized by acetonitrile, which contained an internal standard (paeonol). The supernatant was injected onto a reversed-phase column using a acetonitrile-water-orthophosphoric acid (85%) (60:40:0.1, v/v/v, pH 2.5-2.8) as the mobile phase and ultraviolet detection at 344 nm. It was applied to the pharmacokinetic study of rutaecarpine in rat after a 2 mg/kg intravenous administration. A biphasic process with a rapid distribution followed by a slower elimination phase was observed from the plasma concentration-time curve. Compartmental analysis yielded a two-compartment model.
Collapse
Affiliation(s)
- H C Ko
- National Research Institute of Chinese Medicine, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
44
|
Chen CP, Chang FM, Chang CH, Lin YS, Chou CY, Ko HC. Prediction of fetal macrosomia by single ultrasonic fetal biometry. J Formos Med Assoc 1993; 92:24-8. [PMID: 8099822] [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: 01/28/2023] Open
Abstract
A total of 1,056 fetuses underwent single ultrasonographic measurement of fetal biparietal diameter (BPD), abdominal circumference (AC), femur length (FL), and estimated body weight within five days of delivery. The accuracy of these parameters and estimated body weight equations in the prediction of macrosomia (birth weight > or = 4,000 g) was evaluated. With the use of receiver operator characteristic curves, the optimal cutoff value for each parameter with the best sensitivity, specificity and accuracy was selected. BPDs > or = 9.4 cm had the best sensitivity (68.8%), specificity (74.3%), and accuracy (74.1%). ACs > or = 35 cm had the best sensitivity (81.3%), specificity (81.5%), and accuracy (81.5%). FLs > or = 7.0 cm had the best sensitivity (68.8%), specificity (74.5%), and accuracy (74.3%). The estimated body weight equations did not increase the prediction values whether or not FL was included. Both had the same prediction values at > or = 3,700 g, ie, sensitivity (71.9% vs 71.9%), specificity (92.1% vs 93.8%), and accuracy (91.5% vs 93.2%). The results showed AC to be the best single parameter for predicting macrosomia. Combinations of these parameters were better than a single parameter in the prediction of macrosomia.
Collapse
Affiliation(s)
- C P Chen
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, Tainan, Taiwan, R.O.C
| | | | | | | | | | | |
Collapse
|
45
|
Chang FM, Ko HC, Lin YS, Yao BL, Wu CH, Kuo PL, Liu CH. Clinical validation of two equations in antenatal prediction of Chinese fetal weight by ultrasonography. J Formos Med Assoc 1991; 90:1086-92. [PMID: 1687056] [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: 12/28/2022] Open
Abstract
The purpose of this series is to prospectively validate the Chinese equations for predicting fetal weight developed in a previous study. A total of 640 Chinese fetuses were examined antenatally for biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) by real-time ultrasonography within two days of delivery. The results showed the actual birth weight (BW) to be highly correlated with the estimated body weight for both the equation using BPD and AC (EBW1) (r = 0.888, p less than 0.0001) and the equation using BPD, AC and FL (EBW2) (r = 0.890, p less than 0.0001). Our results demonstrate that the Chinese equations developed by Hsieh et al are a better fit for Chinese fetuses than the foreign equations are. Also, the two Chinese equations predict fetal weight well between 2,000 g and 4,000 g, but further modification is needed in cases where the BW is less than 2,000 g or greater than 4,000 g.
Collapse
Affiliation(s)
- F M Chang
- Department of Obstetrics and Gynecology, National Cheng Kung University Medical College, Tainan, Taiwan, R.O.C
| | | | | | | | | | | | | |
Collapse
|
46
|
Hsieh FJ, Chang FM, Yao BL, Ko HC, Chen HY. Cranial and orbital growth in Chinese fetuses. Taiwan Yi Xue Hui Za Zhi 1989; 88:1147-51. [PMID: 2699889] [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
We assess Chinese fetal orbital growth by biparietal diameter (BPD) in normal pregnancies. One hundred and ninety-six normal fetuses, whose gestational periods ranged from 14 weeks to term, were measured by prenatal ultrasonography. Orbital parameters measured included orbital diameter (OD), biorbital distance (BOD), and interorbital distance (IOD). At the same time, fetal BPD was measured. The results show that orbital growth correlates well with BPD; OD versus BPD (r = 0.94, p less than 0.001), BOD versus BPD (r = 0.96, p less than 0.001), and IOD versus BPD (r = 0.83, p less than 0.001). Polynomial regression analysis demonstrates that the best-fit model for orbital parameters versus BPD was the first-order linear regression. From the above analysis, the 5th, 50th and 95th confidence limits of OD, BOD, and IOD were computed for specific growth values of BPD, and these can serve as a reference for prenatal diagnosis of fetal orbital malformations when menstrual age is not defined.
Collapse
|
47
|
Kaarsholm NC, Ko HC, Dunn MF. Comparison of solution structural flexibility and zinc binding domains for insulin, proinsulin, and miniproinsulin. Biochemistry 1989; 28:4427-35. [PMID: 2669954 DOI: 10.1021/bi00436a046] [Citation(s) in RCA: 122] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The chromophoric divalent metal ion chelators 4-(2-pyridylazo)resorcinol (PAR) and 2,2',2"-terpyridine (terpy) are used as kinetic and spectroscopic probes to investigate in solution the SCN- -induced conformational transformations of the insulin, proinsulin, and miniproinsulin hexamers (miniproinsulin is a proinsulin analogue wherein the C-chain is replaced by a dipeptide cross-link between Gly-A1 and Ala-B30). Herein we designate the 2Zn and 4Zn crystal forms of the hexamer as the T6 and T3R3 conformations, respectively. For all three proteins, addition of SCN- reduces the rate of sequestering and removal of zinc ion by chelator. The effect of SCN- on the rate of this process saturates at the same concentration (30 mM) known to induce the T6 to T3R3 transformation in the insulin crystal. Under both T6 and T3R3 conditions, the critical stoichiometry for high-affinity interaction between Zn2+ and each of the three proteins is shown to be 2 mol of Zn2+/mol of protein hexamer. Consequently, we confirm the finding that off-axial coordination of Zn2+ via His-B10 and His-B5 residues is of minor importance for the SCN- -induced conformation change in solution [Renscheidt, H., Strassburger, W., Glatter, U., Wollmer, A., Dodson, G. G., & Mercola, D. A. (1984) Eur. J. Biochem. 142, 7-14]. Under T6 conditions, the kinetics of the reactions between insulin, proinsulin, and miniproinsulin and a variable excess of terpy are similar and biphasic.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- N C Kaarsholm
- Department of Biochemistry, University of California, Riverside 92521
| | | | | |
Collapse
|
48
|
Abstract
Twenty-three inpatients who met DSM-III criteria for schizophrenia were selected for cerebrospinal fluid (CSF) neurochemical study of tardive dyskinesia (TD). Ten inpatients had tardive dyskinesia, and the remaining 13 patients without TD served as controls. There were no intergroup differences in sex, age, duration of neuroleptic treatment, or in total amount of neuroleptics received between the TD and the control groups. Cerebrospinal fluid was collected by lumbar puncture, and concentrations of homovanillic acid (HVA), MHPG, 5-hydroxyindoleacetic acid (5-HIAA), and acetylcholinesterase (AChE) activity were measured. The concentrations of MHPG (TD 11.56 +/- 3.48 ng/ml versus control 14.20 +/- 3.86 ng/ml), 5-HIAA (45.27 +/- 9.77 ng/ml versus 40.34 +/- 13.77 ng/ml), and HVA (38.26 +/- 18.31 ng/ml versus 31.40 +/- 7.83 ng/ml), and the activity of AChE (TD 7.95 +/- 5.21 mmol/g.hr versus control 12.89 +/- 8.04 mmol/g.hr) showed no significant differences between the two groups, but the ratios of HVA/AChE (t = 2.21, p = 0.05), 5-HIAA/AChE (t = 2.62, p = 0.02), MHPG/HVA (t = -2.16, p = 0.04), and MHPG/5-HIAA (t = -2.48, p = 0.02) were statistically different. The results indicated that TD might involve an imbalance of dopamine-acetylcholine, noradrenalin-dopamine, noradrenalin-serotonin, and serotonin-acetylcholine.
Collapse
Affiliation(s)
- R B Lu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | | | | | | | | |
Collapse
|
49
|
Abstract
During the period of 1979-1982, 10 cases of cholangiocarcinoma associated with hepatolithiasis were seen. We report the clinical features of 10 cases of cholangiocarcinoma in association with hepatolithiasis, along with detailed histopathology from the four resected specimens. Our observations suggest that whenever intrahepatic stones are encountered in patients over 50 years of age with a long history of recurrent cholangitis and intractable pain, further examination including echo-guided aspiration cytology, liver scanning, and peritoneoscopy should be performed to rule out a coexisting cholangiocarcinoma.
Collapse
|
50
|
Tsai GL, Siauw CP, Chen PH, Lee MD, Ko HC, Chen TY. Pulmonary aspergillosis complicating bronchogenic carcinoma--a report of 2 cases. Taiwan Yi Xue Hui Za Zhi 1984; 83:862-868. [PMID: 6596394] [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: 05/21/2023]
|