Showing papers by "Taipei Veterans General Hospital published in 1999"

Insulin-like growth factor I improves cardiovascular function and suppresses apoptosis of cardiomyocytes in dilated cardiomyopathy.

Abstract: To investigate how insulin-like growth factor I (IGF-I) modulates cardiovascular function and myocardial apoptosis in heart failure, the therapeutic effects of IGF-I were determined in a canine model of dilated cardiomyopathy. The animals were paced at 220 beats/min, and the left ventricular (LV) chamber became dilated after 2 weeks. A subset of paced dogs was treated with sc injections of IGF-I from week 3 to week 4. After 4 weeks of pacing, untreated paced dogs developed significant ventricular dysfunction. IGF-I-treated paced dogs showed better cardiac output, stroke volume, LV end-systolic pressure, and LV end-diastolic pressure. Moreover, pulmonary wedge pressure and systemic vascular resistance were increased in the untreated group and decreased in the IGF-I-treated group. IGF-I treatment was associated with less thinning of the ventricular wall. Compared with the controls, untreated paced dogs showed increased apoptosis of cardiac muscle cells, which was partially suppressed by IGF-I treatment. The...

Red Wine Inhibits Monocyte Chemotactic Protein-1 Expression and Modestly Reduces Neointimal Hyperplasia After Balloon Injury in Cholesterol-Fed Rabbits

Abstract: Background—Wine consumption decreases the risk of myocardial infarction. Intimal hyperplasia contributes to restenosis after angioplasty. Local ethanol delivery inhibits intimal hyperplasia after balloon injury in rabbit iliac and pig coronary arteries. The effects of wine consumption on intimal response and monocyte chemotactic protein-1 (MCP-1) expression were studied in cholesterol-fed rabbits. Methods and Results—Male rabbits were fed a 2% cholesterol diet together with red wine (12.5% vol, 5 mL/kg body wt per day; n=7), white wine (13.3% vol, 5 mL/kg body wt per day; n=7), or no wine as a control (n=8) for 6 weeks. A balloon injury of the abdominal aorta was performed at the end of the third week. Abdominal aortas were harvested at the end of 6 weeks. Neointimal hyperplasia was measured morphometrically. MCP-1 expression was determined by Northern blot, in situ hybridization, and immunohistochemistry. Rabbits fed red wine had significantly less neointimal hyperplasia than did control rabbits (intima/...

The importance of serine proteinases as aeroallergens associated with asthma.

Abstract: Penicillium and Aspergillus species have been identified as prevalent indoor airborne fungi that are associated with extrinsic bronchial asthma. We have recently

Up‐regulation of multidrug resistance transporter expression by berberine in human and murine hepatoma cells

Abstract: BACKGROUND Berberine, one of the major constitutents of alkaloids of Coptis chinensis is frequently utilized in the treatment of inflammation and liver-related diseases. In Chinese herbal medicine, Coptis chinensis is used as a prophylactic drug to treat gastrointestinal disorders. In a previous study, the authors found that berberine reduced cell proliferation and α-fetoprotein expression in human hepatoma HepG2 cells. Multidrug resistance transporter (pgp-170) is known to be overexpressed in HepG2 cells. Whether berberine regulates the expression of pgp-170 in HepG2 and other hepatoma cell lines is unknown and worthy of investigation. METHODS Human and murine hepatoma cells were treated with berberine (0.32, 3.2, 32, and 320 μM), tamoxifen (1 μM), or verapamil (10 μM) for 24 hours. Flow cytometry was used to measure retention of a fluorescence dye, rhodamine 123, and the level of immunoreactive pgp-170 in berberine-treated hepatoma cells. RESULTS Berberine up-regulated the expression of pgp-170 in three human hepatoma cell lines. The function of pgp-170 was blocked by tamoxifen and verapamil, resulting in increased retention of rhodamine 123. Retention of rhodamine 123 was significantly reduced in berberine-treated hepatoma cells. CONCLUSIONS Berberine modulates the expression and function of pgp-170 in hepatoma cells. These results suggest that treatment of tumor cells with berberine may result in reduced retention of chemotherapeutic agents. Cancer 1999;85:1937–42. © 1999 American Cancer Society.

Elderly use of the ED in an asian metropolis

Abstract: To compare emergency department (ED) use by elderly patients (age 65 yrs or older) with that by younger adult patients (age 15-64 yrs), a prospective consecutive chart review study was conducted from August 1, 1995 through May 31, 1996 in eight designated hospitals in Taipei city (which has 2.6 million residents, 8.4% of whom are 65 yrs or older). Patient age, sex, mode of arrival, living status, triage category, advanced life support (ALS) eligibility, referral, confinement to bed, intensive care unit (ICU) admission, impression, trauma mechanism, and disposition were recorded and compared between the two groups. Of 27,765 adult emergency patients studied during the 10 months, 24% were elderly. The elderly were more likely to be ambulance cases, of high acuity and ALS eligibility, living alone, bed-ridden, and ICU cases (19.4% v 10.5%, 14.8% v 5.5%, 14.7% v 4.3%, 9.7% v 4.1%, 16% v 1.1%, and 4.0 v 1.1%, respectively). The three leading illnesses in the elderly were cerebral vascular accident (6.6%), cancer (5.6%), and cardiovascular disease (5.6%), and the two most common trauma mechanisms were trip (fall from the same level surface) (57.2%) and traffic accident (20.7%). Twenty-seven percent and 22.7% of elderly were disposed to admission and observation, respectively, compared with the 10.9% and 11.4% of the younger patients. Elderly patients have significantly different and more severe presentations to the ED compared with younger adults.

Effect of transcutaneous electrical nerve stimulation for pain relief on patients undergoing hemorrhoidectomy: Prospective, randomized, controlled trial

Abstract: PURPOSE: Posthemorrhoidectomy pain control remains a challenging problem. Transcutaneous electrical nerve stimulation is known to be effective in the treatment of many diseases. Our aim was to investigate the effect of transcutaneous electrical nerve stimulation on pain relief in patients undergoing hemorrhoidectomy. METHODS: Sixty patients with symptomatic hemorrhoids were randomly allocated into two groups, the acupoint group (n=30) and the nonpoint control group (n=30). Transcutaneous electrical nerve stimulation was applied to those patients who received hemorrhoidectomy, and patient-controlled analgesia was achieved by injection of morphine through ambulatory infusion pumps. The dependent measures in this study were pain score from 0 (no pain) to 10 (agonizing pain), analgesic doses administrated through patient-controlled analgesia, and postoperative complications. RESULTS: The subjective pain scores evaluated 8, 12, 16, and 24 hours after hemorrhoidectomy in the control group and the acupoint group were 5.9±0.5 and 4.1±0.5, 5.7±0.5 and 3.5±0.4, 4.1±0.4 and 2.3±0.3, and 3.2±0.4 and 1.9±0.2, respectively (two-way analysis of variance;P<0.05). There was a significant difference between treatment groups in morphine use, with 11.6±2.2 mg in the control group and 6.2±1.3 mg in the acupoint group (P<0.05). The acupoint group tended to have less postoperative acute urinary retention (Fisher's exact probability test;P=0.145) and less need for analgesics than the control group (P=0.112, Fisher's exact test). CONCLUSION: Transcutaneous electrical nerve stimulation is effective for pain relief in patients receiving hemorrhoidectomy. Its efficacy and safety could assist outpatient pain management after hemorrhoidectomy.

Alkaline Serine Proteinase Is a Major Allergen of Aspergillus flavus, a Prevalent Airborne Aspergillus Species in the Taipei Area

Abstract: Background: Aspergillus species are prevalent indoor airborne fungi and have been identified to be a causative agent of human allergic disorders. In the present s

Prevalence of factor V Leiden in the Chinese population

Abstract: Background Thromboembolic diseases remain a major cause of morbidity and mortality in most countries. Factor V Leiden was found to be a major cause of thromboembolic disease in Western countries. Chinese have proved to be less prone to thromboembolic diseases, therefore investigation of the prevalence of factor V Leiden is necessary among a Chinese population. Methods From May, 1997, to April, 1998, a total of 1,261 subjects, including 420 healthy subjects, 719 patients with nonthrombotic hematologic disorders, 77 patients with diabetes mellitus and 45 patients with deep vein thrombosis, different in age and sex, were consecutively entered into our study to determine the prevalence of factor V Leiden in the Chinese population (mean age, 50.1 +/- 18.3 years; range, 1-99 years). Of this population, 873 were male and 388 were female. Results None of the subjects was found to have factor V Leiden mutation (Arg 506-Gln mutation). Activated protein C resistance was also measured in 827 patients; none of them had an activated protein C ratio of less than 2.0. Conclusions We suggest that factor V Leiden mutation is rare among the Chinese.

Direct effects of prolactin on corticosterone release by zona fasciculata-reticularis cells from male rats.

Abstract: The role of prolactin (PRL) in the male is not fully defined. The aim of this study was to investigate the function and mechanism of PRL on the production of corticosterone by zona fasciculata-reticularis (ZFR) cells in vitro. The ZFR cells were obtained from male rats under normal, hyperprolactinemic, or hypoprolactinemic situation. PRL stimulated the corticosterone release in a dose-dependent pattern in the ZFR cells from normal male rats. The cellular adenosine 3'-5'-cyclic monophosphate (cAMP) concentration positively correlated with PRL concentration in the presence of forskolin or 3-isobutyl-1-methylxanthine (IBMX). PRL enhanced the stimulatory effects of cAMP mimetic reagents, i.e., forskolin, 8-bromo-adenosine 3',5'-cyclic monophosphate (8-Br-cAMP), and IBMX on the release of corticosterone. The adenylate cyclase inhibitor (SQ22536) inhibited the corticosterone release in spite of presence of PRL. Nifedipine (L-type calcium channel blocker) did not inhibit corticosterone release. The hyperprolactinemic condition was actualized by transplantation of donor rat anterior pituitary glands (APs) under kidney capsule. By comparison with the cerebral cortex (CX)-grafted group, AP-graft resulted in an increased release of corticosterone, 3beta-hydroxysteriod dehydrogenase (HSD) activity and cAMP production by ZFR cells. Acute hypoprolactinemic status was induced by bromocriptine for 2 days. The results showed the productions of corticosterone were lower in hypoprolactinemic group than in control group, which were persistent along with different ACTH concentrations. These results suggest that PRL increase the release of corticosterone by ZFR cells via cAMP cascades and 3beta-HSD activity.

11C-acetate clearance in nasopharyngeal carcinoma.

Abstract: This study assessed 11 C-acetate turnover (clearance) in nasopharyngeal carcinoma (NPC). Data were acquired by dynamic PET after the intravenous injection of 4.625 MBq.kg -1 body weight of 11 C-acetate for 30 min. Tomograms were reconstructed and evaluated visually. A time-activity curve of the nasopharynx and neck was generated and the clearance rate of 11 C-acetate from the nasopharynx in the slow phase and from NPC was calculated using 0.693/T 1 /2. Ten patients with nasopharyngeal carcinoma and nine normal subjects were studied. The clearance of 11 C-acetate from the normal nasopharynx was rapid and biexponential, in contrast to the rapid uptake followed by extremely slow clearance in patients with NPC. The clearance rate (mean ± S.D.) was 0.0074 ± 0.0042 in NPC and 0.0263 ± 0.0152 in controls in the slow phase, being significantly different between the two groups with no overlap. All nasopharyngeal carcinomas were clearly visualized, in contrast to no obvious retention in the normal nasopharynx. Our initial results indicate that 11 C-acetate clearance can be used to differentiate nasopharyngeal carcinoma from a normal nasopharynx. This finding may lead to new applications of 11 C-acetate in oncology.

Sequence polymorphism of the group 1 allergen of Bermuda grass pollen

Abstract: Background Cyn d 1, the major allergen of Bermuda grass pollen, consists of a number of isoforms. Objective To examine the extent of sequence variation of Cyn d 1 isoforms at the molecular level. Methods A Bermuda grass pollen λZAP II cDNA expression library was immunoscreened with anti-Cyn d 1 monoclonal antibodies. The reactive clones were isolated, subcloned into Escherichia coli, and sequenced. Some of them were expressed in the yeast Pichia pastoris to obtain recombinant Cyn d 1 proteins. Results Ten cDNA clones were obtained, all these clones encode the full length of Cyn d 1 protein. Their deduced mature proteins can be grouped into: the long ones with 246 amino acids, and the short ones with 244 amino acids. The last two amino acids (AG) of the long Cyn d 1 are deleted in the short Cyn d 1. The remaining amino acid sequences share more than 98% identity; a total of nine amino acid variations were observed. Two recombinant Cyn d 1 proteins (rCyn d 3–2 and rCyn d 5–4) with three amino acid substitutions showed differential IgE-binding profiles. Conclusion The present study extended our understanding of the primary structure of isoforms of Cyn d 1.

Evidence that mutational activation of the ras genes may not be involved in aflatoxin B1-induced human hepatocarcinogenesis, based on sequence analysis of the ras and p53 genes

Abstract: Exposure to aflatoxin B(1) (AFB(1)) is one of the risk factors for developing hepatoma. In rats, activation of the ras gene is a prevalent event in AFB(1)-induced hepatocarcinogenesis. It is not clear whether a similar event occurs in humans. By analysis of codon 249 of the p53 gene, six of 36 human hepatoma samples were found to show a G-->T transversion, suggesting that AFB(1) may be a risk factor for hepatocarcinogenesis. However, analysis at codons 12, 13, and 61 in the ras family genes revealed a A-->T transversion at codon 61 of the N-ras gene in a single tumor. Apparently, ras activation is rare in human hepatoma, and the mutation detected might not be induced by AFB(1). This suggests that activation of the ras gene may not be a major event in AFB(1)-related human hepatocarcinogenesis.

Pediatric intracranial germinoma treated with chemotherapy alone.

Abstract: BACKGROUND Pediatric intracranial germinoma treated with radiotherapy is considered a standard treatment, but may cause significant delayed damage to the central nervous system. Chemotherapy has been shown to be effective for the treatment of an intracranial germinoma. In the past 10 years, we treated 11 cases of primary intracranial germinoma with chemotherapy alone. The purpose of this retrospective study is to review the clinical outcome of these patients. METHODS Eleven children with newly diagnosed, previously untreated primary intracranial germinomas were treated with six courses of chemotherapy (vinblastine bleomycin, cisplatin and etoposide, VBPE). The response to chemotherapy, relapses and outcomes are reviewed and evaluated. RESULTS All 11 assessable children achieved a complete response and are alive, with a median follow-up of 61 months. Five patients with tumors located in the midline position of the brain, including pineal, sellar, suprasellar and hypothalamic areas, had no relapse. Six patients had relapses, and all of them achieved a second complete remission after salvage focal radiotherapy. The time of onset of relapse was from nine to 24 months after chemotherapy, with an average of 16.8 months. CONCLUSIONS VBPE chemotherapy was effective for treating newly diagnosed intracranial germinomas. Although a high rate of relapse (6/11) was observed, all of these patients survived with first or second complete remissions. It was beneficial for five children that focal radiation was eliminated and delayed post-irradiation neurologic sequelae were avoided.

Effect of protective colloids on the induction of polymorphic changes in indomethacin agglomerates after solvent evaporation from o/w emulsions

Abstract: Indomethacin (IMC) agglomerates were prepared by the solvent evaporation process from o/w emulsions containing different protective colloids in the external aqueous solution. The types of protective colloids inducing the polymorphic transformation of IMC in the agglomerates without wall material were investigated. The composition and its polymorphs were evaluated from the X-ray diffraction patterns, IR spectra and DSC thermograms. The results indicate that when pectin, beta-cyclodextrin, sodium alginate or sodium dodecyl supphase acted as a protective colloid, the respective IMC agglomerates consisted only of the alpha form of IMC. When gelatin or hydroxypropyl methylcellulose was used as a protective colloid, the amorphous, alpha and gamma forms as well as methylene chloride solvates of IMC were found in the IMC agglomerates. There was only methylene chloride solvate of IMC with a small amount of amorphous form in the IMC agglomerates prepared from albumin as a protective colloid, while IMC agglomerates ...

Solar retinopathy: a case report.

Abstract: Sun-gazing is the main cause of solar retinopathy. A 20-year-old inebriated man lying in a park gazed at the sun for approximately three hours at noon. Forty-eight hours after sun-gazing, the patient experienced the symptoms of blurred vision, erythropsia, and central scotoma in the left eye. Visual acuity decreased from 6/6 to 6/60 in the left eye and fundi examinations showed a round, yellowish-white discoid lesion on the left fovea and a smaller one on the right fovea. Fluorescein angiography showed early dye leakage in the fovea of the left eye, that increased gradually in size and became fuzzy at the foveal border in the late phase. A small, central scotoma of the left eye was also found in the visual field test. One month later, the lesion in the fovea of the left eye became smaller and was surrounded by a coarse pigmented halo. Fluorescein angiography showed a window defect in the retinal pigment epithelium. Visual field testing disclosed that the central scotoma persisted, but became smaller. Six months after sun-gazing, a lamellar hole in the fovea of the left eye was detected by optical coherence tomography. The visual acuity was 6/6 in the right eye and 6/60 in the left eye, and was unchanged at the end of the six-month follow-up period.

Hemodialysis as adjunctive therapy for severe acetaminophen poisoning: a case report.

Abstract: Acetaminophen overdose is a common intoxication in daily practice the standard treatment is N-acetylcysteine (NAC) antidotal therapy for possible poisoning. However, dialysis procedures can remove the drug from the body effectively. We describe a case of acetaminophen overdose that was treated with both hemodialysis (HD) and NAC due to severe intoxication and slow drug clearance. A 37-year-old woman attempted suicide by ingestion of 100 tablets (500 mg each) of acetaminophen, and presented with vomiting, hematemesis and abdominal pain. The patient had elevated liver enzymes, coagulation defects, thrombocytopenia a high serum acetaminophen level (201 mg/l at 12 hours post-ingestion) with a prolonged half-life. Oral NAC was given; however, it was ineffective due to severe vomiting and hematemesis. HD as adjunctive therapy was initiated at 19 hours post-ingestion. HD reduced the serum acetaminophen level from 102.77 to 35.77 mg/l. Severe hepatic injury, bacteremia and pancytopenia were noted in the following days. The patient later recovered after treatment with NAC, HD and intensive supportive care. HD removed 66% of the total acetaminophen body burden during a single four-hour session, increased the clearance by 2.75-fold and shortened the half-life from 7.2 hours to 2.6 hours during HD. Through NAC therapy is the standard regimen for acetaminophen poisoning, in the severely poisoned patient who cannot tolerate NAC therapy, HD may be used as adjunctive therapy to enhance the elimination of acetaminophen.

Coronary flow reserve and ischemic-like electrocardiogram in patients with symptomatic mitral valve prolapse.

Abstract: The purpose of the present study was to determine whether coronary microvascular function is impaired in patients with symptomatic mitral valve prolapse (MVP) and whether ischemia-like ECG, if present, is related to coronary microvascular dysfunction. Twenty chest pain patients with normal coronary angiograms and MVP proven by echocardiogram were included. Both treadmill exercise test (TET) and coronary hemodynamic study were done in each patient. Coronary flow reserve (CFR) was determined by measuring coronary sinus flow (CSF) or great cardiac venous flow (GCVF) both at baseline and after dipyridamole 0.56 mg/kg IV for 4 minutes (maximum). All patients were divided into 2 groups with either negative (TET-) or positive results of TET (TET+). Another 10 subjects with atypical chest pain, normal coronary angiograms, echocardiogram and TET were used as controls. There were no differences in GCVF, either at baseline or after dipyridamole infusion, among the 3 groups. Calculated CFR using GCVF was similar among the 3 groups. However, baseline CSF was higher in the TET+ group (TET- vs TET+ vs control: 77 ± 24 vs 96 ± 31 vs 75 ± 12 ml/min, p < 0.05) and maximum CSF was lower in the TET- group (TET- vs TET+ vs control: 167 ± 25 vs 219 ± 85 vs 238 ± 80 ml/min, p < 0.05). Calculated CFR using CSF was significantly reduced in both the TET- (2.26 ± 0.4) and TET+ groups (2.31 ± 0.7) as compared with the control subjects (3.18 ± 0.95, p < 0.01). There were no differences in any of the hemodynamic parameters between the TET- and TET+ groups. Coronary microvascular function could be impaired in patients with symptomatic MVP. Such impairment, when presented, was probably regional and outside the territory of the left anterior descending coronary artery. However, it was irrelevant to the presence of ischemic-like ECG during exercise.