601
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Chern CH, Chern TL, Wang LM, Hu SC, Deng JF, Lee CH. Continuous flumazenil infusion in preventing complications arising from severe benzodiazepine intoxication. Am J Emerg Med 1998; 16:238-41. [PMID: 9596422 DOI: 10.1016/s0735-6757(98)90091-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
A prospective, randomly controlled study was conducted to test the effect of continuous flumazenil infusion in preventing complications arising from severe benzodiazepine (BZ) intoxication. Patients who were believed to be suffering benzodiazepine intoxication and whose Glasgow Coma Scale (GCS) score was below 10 were enrolled after showing a clear-cut response to flumazenil 0.5 or 1 mg (an improvement by 4 or more on the GCS). The patients were consecutively enrolled and randomized into two groups: a continuous infusion group (CI, n = 50) who were immediately given flumazenil 0.5 mg/h for 5 hours, and a control group (CIN, n = 50). Age, sex, incidence of underlying disease, GCS score at several time points, and complication rate were compared in the two groups. Although the CI group had a higher GCS score at most time points, the complication rate did not significantly differ between the two groups (14 of 36 in the CI group v 12 of 38 in the CIN group, P = .684). A greater incidence of underlying disease and an older age seemed to contribute to the higher complication rates in both groups. Several patients (in both groups) resedated into deeper coma after showing an initial response to flumazenil or after the cessation of flumazenil infusion. For severe BZ intoxication, treatment with flumazenil infusion should still be considered skeptically and should not be recommended as routine management BZ-intoxicated patients with an underlying disease, an older age, and resedation into a deep comatose state after showing an initial response to flumazenil should be treated in an intensive care unit.
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602
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Park YB, Lee SK, Kim DS, Lee J, Lee CH, Song CH. Elevated interleukin-10 levels correlated with disease activity in systemic lupus erythematosus. Clin Exp Rheumatol 1998; 16:283-8. [PMID: 9631750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To determine serum interleukin-10 (IL-10) levels in systemic lupus erythematosus (SLE) patients and to assess their relationship with disease activity. METHODS Forty-one SLE patients and 35 controls were studied. Paired serum samples were collected from all SLE patients at the time of their presentation with active disease and at 4 weeks after the institution of treatment. IL-10 levels were determined in the sera and were compared with disease activity, measured using the SLE Disease Activity Index (SLEDAI) and laboratory parameters such as the circulating immune complexes (CIC), C3, C4, anti-DNA antibody, IgG, IgM, and IgA. RESULTS The IL-10 levels in SLE patients were significantly higher than those of controls (mean +/- SE, 29.2 +/- 6.8 vs. 3.5 +/- 0.6 pg/ml, p < 0.01). Elevated IL-10 levels correlated well with the SLEDAI in SLE patients (r = 0.46, p < 0.01), but did not correlate with other laboratory activity indices. The changes in serum IL-10 levels also correlated with the changes in the SLEDAI score during the patients' disease course (r = 0.51, p < 0.01). CONCLUSION Serum levels of IL-10 are elevated in SLE patients and increased IL-10 correlates well with SLE disease activity.
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603
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Kim SH, Lee KS, Son JK, Je GH, Lee JS, Lee CH, Cheong CJ. Cytotoxic compounds from the roots of Juglans mandshurica. JOURNAL OF NATURAL PRODUCTS 1998; 61:643-645. [PMID: 9599266 DOI: 10.1021/np970413m] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Three new compounds, a diarylheptanone glucoside (1), 4,5, 8-trihydroxy-alpha-tetralone 5-O-beta-d-[6'-O-(3", 5"-dimethoxy-4"-hydroxybenzoyl)]glucopyranoside (2), and 1,4, 8-trihydroxy-3-naphthalenecarboxylic acid 1-O-beta-d-glucopyranoside methyl ester (3), were isolated from the roots of Juglans mandshurica, and their structures were elucidated on the basis of spectroscopic studies including 2D-NMR.
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604
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Schwemmle M, Salvatore M, Shi L, Richt J, Lee CH, Lipkin WI. Interactions of the borna disease virus P, N, and X proteins and their functional implications. J Biol Chem 1998; 273:9007-12. [PMID: 9535888 DOI: 10.1074/jbc.273.15.9007] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Borna disease virus (BDV) causes persistent central nervous system infection and behavioral disturbances in warm-blooded animals. Protein interaction studies were pursued to gain insight into the functions of the putative nucleoprotein (N), phosphoprotein (P), atypical glycoprotein (gp18), and X protein (X) of BDV. Coimmunoprecipitation experiments indicated that N and P, and P and X, form complexes in infected cells. Two-hybrid analyses confirmed interactions between P and P, P and X, and P and N, but not between P and gp18, N and gp18, X and gp18, or X and N. Analysis of P truncation mutants identified three nonoverlapping regions important for oligomerization (amino acids (aa) 135-172), and binding to X (aa 33-115) or N (aa 197-201). Coexpression of X stimulated oligomerization of P but decreased N-P complex formation. Immunocytochemistry of transfected noninfected CHO cells demonstrated that the distribution of X is dependent upon the presence of P-X expressed alone was found predominantly in the cytoplasm whereas coexpression of X and P resulted in nuclear localization. Immunocytochemistry of infected cells revealed nuclear colocalization of P and X. Interactions of P, N, and X may have implications for regulation of BDV transcription/replication and ribonucleoprotein assembly.
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605
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Kim K, Jung SY, Lee DK, Jung JK, Park JK, Kim DK, Lee CH. Suppression of inflammatory responses by surfactin, a selective inhibitor of platelet cytosolic phospholipase A2. Biochem Pharmacol 1998; 55:975-85. [PMID: 9605421 DOI: 10.1016/s0006-2952(97)00613-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Surfactin inhibits platelet and spleen cytosolic 100 kDa phospholipase A2 (PLA2). In contrast, this same compound enhances rat platelet group II PLA2 activity by approximately 2-fold and slightly increases group I PLA2 activity from porcine pancreas and Naja naja venom in vitro. Surfactin does not affect a Ca2+ -independent PLA2 partially purified from bovine brain. Thus, this compound inhibits selectively the cytosolic form of PLA2. Based on in vitro studies utilizing preincubation of surfactin with the enzyme, dialysis, and increased concentrations of substrates, the inhibitory effect of surfactin appears to be due to a direct interaction with the enzyme. Linear regression analysis of the linear portion of a concentration-response curve reveals an IC50 of 8.5 microM. To further determine the inhibitory pattern, a Dixon plot was constructed to show that the inhibition by surfactin is competitive, but not uncompetitive, with an inhibition constant of Ki = 4.7 microM in 50 mM Tris-HCl buffer, pH 8.0, at 37 degrees. Surfactin blocked non-stimulated and calcium ionophore A23187-stimulated release of arachidonic acid from monkey kidney CV-1 cells, which contain a cytosolic 100 kDa PLA2 as the major activity, as shown in an anionic exchange DEAE-5PW high performance liquid chromatography profile and western blotting analysis. Surfactin ameliorated inflammation induced by several chemicals. That is, it exhibited in vivo anti-inflammatory activity in several tested inflammatory reactions including 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced mouse ear edema, carrageenan-induced rat paw edema, and acetic acid-induced mouse writhing. These results demonstrate that surfactin is a selective inhibitor for cytosolic PLA2 and a putative anti-inflammatory agent through the inhibitory effect produced by direct interaction with cytosolic PLA2, and that inhibition of cytosolic PLA2 activity may suppress inflammatory responses.
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606
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Liu HS, Lee CH, Lee CF, Su IJ, Chang TY. Lac/Tet dual-inducible system functions in mammalian cell lines. Biotechniques 1998; 24:624-8, 630-2. [PMID: 9564536 DOI: 10.2144/98244st03] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The Escherichia coli Lac repressor (Lac system) and tetracycline responsive promoter (Tet system) systems have been used individually to regulate gene expression at the cellular as well as the organismal levels. In this study, these two systems were combined (designated Lac/Tet dual-inducible system) to regulate two inducible genes simultaneously in a single cell. The isopropyl-beta-D-thiogalactopyranoside (IPTG) and tetracycline (used for the operation of the Lac and the Tet systems) were non-cytotoxic to the cells when added together into the cells at around the optimal concentrations (IPTG: < or = 5 mM; tetracycline: < 1.5 micrograms). The rate and efficiency of induction and repression of two inducible genes regulated by the Lac/Tet dual-inducible system were similar to the results obtained when one inducible gene is regulated by one inducible system in a single cell. The Lac/Tet dual-inducible system could function in many cell lines, which was demonstrated by regulating the expression of beta-galactosidase and luciferase reporter genes in five tumor cell lines by transient transfection analysis. The feasibility of introducing a second inducible system into an already established inducible cell line was confirmed. Finally, we showed that the Lac/Tet dual-inducible system functions at translational and at functional levels in a stable cell line named 7-4-b, which contains the Ha-ras and bc1-2 inducible genes. In conclusion, this study extends the application of prokaryotic inducible systems from the regulation of a single gene to two genes and helps clarify the relationship between two genes and the effects of two genes on the cells.
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607
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Chen CW, Lee CH, Chang HY, Hsiue TR, Sung JM, Huang JJ. Respiratory mechanics before and after hemodialysis in mechanically ventilated patients. J Formos Med Assoc 1998; 97:271-7. [PMID: 9585679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Hemodialysis, which leads to negative fluid balance, is often required in mechanically ventilated patients with renal failure. We conducted a prospective study on the influence of hemodialysis on the respiratory mechanics in 14 mechanically ventilated patients (10 men, 4 women, mean age 70.1 +/- 8.1 yr) with various causes of renal failure requiring hemodialysis in an intensive care unit. Respiratory mechanics were measured before and after hemodialysis using the interrupter technique under constant flow and constant volume. The values of several parameters of respiratory mechanics were significantly lower after hemodialysis: peak airway pressure (26.97 +/- 4.62 vs 23.45 +/- 4.13 cmH2O), airway pressure at zero flow (23.81 +/- 4.18 vs 21.50 +/- 3.79 cmH2O), airway plateau pressure (18.56 +/- 3.70 vs 16.48 +/- 3.07 cmH2O), and intrinsic positive end-expiratory pressure (4.03 +/- 2.90 vs 2.65 +/- 1.84 cmH2O). Minimal respiratory resistance and maximal respiratory resistance were significantly decreased after hemodialysis (4.38 +/- 1.26 vs 2.99 +/- 1.00 cmH2O/L/s and 9.93 +/- 2.50 vs 8.39 +/- 2.43 cmH2O/L/s, respectively), but effective additional respiratory resistance and static respiratory compliance were not. Significant correlations were found between body weight reduction by hemodialysis and changes in minimal respiratory resistance (r = 0.758, p < 0.01), maximal respiratory resistance (r = 0.544, p < 0.05), and static respiratory compliance (r = 0.703, p < 0.01). We conclude that hemodialysis significantly alters the respiratory mechanics in mechanically ventilated renal failure patients and that the alteration may be related to the negative fluid balance caused by hemodialysis.
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608
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Sohn J, Lee CH, Chung DJ, Park SH, Kim I, Hwang WI. Effect of petroleum ether extract of Panax ginseng roots on proliferation and cell cycle progression of human renal cell carcinoma cells. Exp Mol Med 1998; 30:47-51. [PMID: 9873822 DOI: 10.1038/emm.1998.7] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Panax ginseng roots have long been used as a medicinal herb in oriental countries. We have investigated anti-proliferative effects of lipid soluble Panax ginseng components on human renal cancer cell lines. Petroleum ether extract of Panax ginseng roots (GX-PE) or its partially purified preparation (7:3 GX) was added to cultures of three human renal cell carcinoma (RCC) cell lines, A498, Caki-1, and CURC II. Proliferation of RCC cells was estimated by a [3H]thymidine incorporation assay and cell cycle distribution was analyzed by flow cytometry. GX-PE, 7:3 GX, panaxydol and panaxynol inhibited proliferation of all three RCC cell lines in a dose dependent manner in vitro with an order of potency, 7:3 GX > panaxydol > panaxynol = GX-PE. Additive effect of interleukin 4 was also demonstrated, most prominently in Caki-1 which responded poorly to GX-PE alone. Analysis of cell cycle in CURC II and Caki-1 treated with GX-PE demonstrated increase in G1 phase population and corresponding decrease in S phase population. The present study demonstrated that proliferation of human RCC cell lines were inhibited by lipid soluble components of Panax ginseng roots by blocking cell cycle progression at G1 to S phase transition.
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609
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Lee CH, Chang SC, Chen CJ, Chang MF. The nucleolin binding activity of hepatitis delta antigen is associated with nucleolus targeting. J Biol Chem 1998; 273:7650-6. [PMID: 9516470 DOI: 10.1074/jbc.273.13.7650] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Hepatitis delta antigens (HDAgs) are important for the replication and assembly of hepatitis delta virus (HDV). To understand the association between HDAgs and cellular proteins and the mechanism of viral multiplication, we have studied the interaction between HDAgs and nucleolin, a major nucleolar phosphoprotein. The interaction between HDAgs and nucleolin was first demonstrated by immunofluorescence staining studies. HDAgs and endogenous nucleolin were colocalized in the nucleoli of cultured cells transfected with plasmids encoding the small and large HDAg. Coimmunoprecipitation results indicated that the NH2-terminal domain of HDAg was essential for its binding to nucleolin. In vitro ligand binding assays revealed two nucleolin binding sites, NBS1 and NBS2. Each spanned amino acid residues 35-50 and 51-65, respectively, with a conserved core sequence K(K/R)XK. HDV replication was modulated by exogenous human nucleolin. In addition, a small HDAg mutant S-d65/75, which possesses both NBS1 and NBS2, was capable of transactivating HDV replication, whereas the small HDAg mutant S-d50/75, which retained NBS1 but not NBS2, was unable to support the replication of HDV. Thus, the nucleolin binding activity of HDAg is critical for its nucleolar targeting and is involved in the modulation of HDV replication.
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610
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Oh YS, Yun M, Hwang SY, Hong S, Shin Y, Lee K, Yoon KH, Yoo YJ, Kim DS, Lee SH, Lee YH, Park HD, Lee CH, Lee SK, Kim S. Discovery of LB30057, a benzamidrazone-based selective oral thrombin inhibitor. Bioorg Med Chem Lett 1998; 8:631-4. [PMID: 9871573 DOI: 10.1016/s0960-894x(98)00079-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Systematic variation of the so-called P-pocket moiety of benzamidrazone-based selective thrombin inhibitors led to the discovery of LB30057. It is potent (Ki = 0.38 nM for human thrombin), selective (Ki = 3290 nM for bovine trypsin), and orally bioavailable (58% oral bioavailability in dogs). LB30057 was efficacious in thrombosis animal models.
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611
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Lee CH, Helweg-Larsen J, Tang X, Jin S, Li B, Bartlett MS, Lu JJ, Lundgren B, Lundgren JD, Olsson M, Lucas SB, Roux P, Cargnel A, Atzori C, Matos O, Smith JW. Update on Pneumocystis carinii f. sp. hominis typing based on nucleotide sequence variations in internal transcribed spacer regions of rRNA genes. J Clin Microbiol 1998; 36:734-41. [PMID: 9508304 PMCID: PMC104617 DOI: 10.1128/jcm.36.3.734-741.1998] [Citation(s) in RCA: 116] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pneumocystis carinii f. sp. hominis isolates from 207 clinical specimens from nine countries were typed based on nucleotide sequence variations in the internal transcribed spacer regions I and II (ITS1 and ITS2, respectively) of rRNA genes. The number of ITS1 nucleotides has been revised from the previously reported 157 bp to 161 bp. Likewise, the number of ITS2 nucleotides has been changed from 177 to 192 bp. The number of ITS1 sequence types has increased from 2 to 15, and that of ITS2 has increased from 3 to 14. The 15 ITS1 sequence types are designated types A through O, and the 14 ITS2 types are named types a through n. A total of 59 types of P. carinii f. sp. hominis were found in this study.
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612
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Koh HC, Shin IC, Hwang SJ, Kang JS, Lee CH, Ha JH, Paik DJ. Mediation of the cardiovascular response of adenosine A1 receptor through a GABA(B) receptor in the spinal cord of the rat. Neurosci Lett 1998; 243:81-4. [PMID: 9535118 DOI: 10.1016/s0304-3940(98)00089-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular inhibitory effects induced by intrathecal (i.t.) administration of adenosine A1 receptor agonist and its modulation by cyclic AMP was suggested by our previous report. In this experiment, we examined the mediation of cardiovascular effects of adenosine A1 receptor by gamma-aminobutyric acid receptors A and B [GABA(A) and GABA(B)] in the spinal cord. I.t. administration of 10 nmol of N6-cyclohexyladenosine (CHA), an adenosine A1 receptor agonist, and pretreatment with bicuculline (10 nmol, i.t), a GABA(A) receptor antagonist, and 5-aminovaleric acid (50 nmol, i.t.), a GABA(B) receptor antagonist, prior to injection of CHA were performed in anesthetized, artificially ventilated Sprague-Dawley rats. I.t. injection of 50 nmol of 5-aminovaleric acid significantly attenuated the inhibitory cardiovascular effects of CHA but 10 nmol of bicuculline did not alter CHA-induced cardiovascular actions. It is suggested that cardiovascular responses of adenosine A1 receptor is mediated by GABA(B) receptor in the spinal cord.
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613
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Lee CH, Guo CL, Wang J. Optical measurement of the viscoelastic and biochemical responses of living cells to mechanical perturbation. OPTICS LETTERS 1998; 23:307-309. [PMID: 18084494 DOI: 10.1364/ol.23.000307] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
We have developed an optical method for real-time monitoring of cellular motion in a natural environment with nanometer resolution. From the motion driven by small optical forces, we measured dynamic viscoelastic responses of living cells in the linear reversible region. Cytoplasmic gel-to-sol transition that was due to the disruption of the actin-filament framework was detected, and a linear release of Ca(2+) from intracellular storage that was related to submicrometer cell deformation was observed. The method was shown to be a powerful tool for studying the natural response of cells to mechanical perturbation.
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614
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Lee JS, Lee CH, Chung JH. Studying the recruitment of Sp1 to the beta-globin promoter with an in vivo method: protein position identification with nuclease tail (PIN*POINT). Proc Natl Acad Sci U S A 1998; 95:969-74. [PMID: 9448269 PMCID: PMC18641 DOI: 10.1073/pnas.95.3.969] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Transcription is thought to be regulated by recruitment of transcription factors, adaptors, and certain enzymes to cis-acting elements through protein-DNA interactions and protein-protein interactions. To better understand transcription, a method with the capability to detect in vivo recruitment of these individual proteins will be essential. Toward this end, we use a previously undescribed in vivo method that we term protein position identification with nuclease tail (PIN*POINT). In this method, a fusion protein composed of a chosen protein linked to a nonsequence-specific nuclease is expressed in vivo, and the binding of the protein to DNA is made detectable by the nuclease-induced cleavage near the binding site. In this article, we used the technique protein position identification with nuclease tail to study the effect of the beta-globin locus control region (LCR) and promoter elements on the recruitment of transcription factor Sp1 to the beta-globin promoter. We present evidence that the hypersensitive sites of the LCR synergistically enhance the recruitment of a multimeric Sp1 complex to the beta-globin promoter and that this may be accomplished by protein-protein interactions with proteins bound to the LCR, the upstream activator region, and, possibly, general transcription factors bound near the "TATA" box.
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615
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Lee J, Chang KH, Park CS, Lee CH, Song CH, Park YN, Park C, Lee SK. A case of autoimmune cholangitis associated with Sjögren's syndrome and arthropathy. J Korean Med Sci 1998; 13:85-8. [PMID: 9539326 PMCID: PMC3054343 DOI: 10.3346/jkms.1998.13.1.85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Autoimmune cholangitis (AC) is a recently proposed entity that describes a specific group of patients presenting overlapping features of primary biliary cirrhosis (PBC) and autoimmune hepatitis. The disease is characterized by dinical cholestasis, high titer antinuclear antibody, negative antimitochondrial antibody, and histologically, findings of PBC coexisting with varying degrees of parenchymal inflammation. In this report, we describe a patient with Sjögren's syndrome who fulfilled the diagnostic criteria of AC associated with unique arthropathy compatible with arthritis of PBC. This case illustrates the unusual coexistence of two diseases that may share similar pathogenic processes.
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616
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Tsai YH, Huang CC, Lin MC, Chen NH, Chang YJ, Lee CH. Arterial oxygenation is unchanged during hemodialysis in patients mechanically ventilated in assist-control mode. J Formos Med Assoc 1998; 97:90-6. [PMID: 9509842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Dialysis-induced hypoxemia can occur in spontaneously breathing renal failure patients but whether it occurs during bicarbonate hemodialysis in critically ill patients receiving mechanical ventilation in assist-control mode is not clear. Twenty-one patients admitted to the medical intensive care unit who required mechanical ventilation and hemodialysis with the use of a cuprammonium dialyzer were enrolled and 25 sessions of hemodialysis were performed. Arterial blood gas, white blood cell count, minute ventilation, respiratory rate, and blood pressure were measured before dialysis (time 0) and at 15, 30, 60, 120, 180, and 240 minutes thereafter. The white blood cell count dropped immediately and reached the nadir 15 minutes after hemodialysis began. Thereafter, it recovered and overshot the predialysis value at the end of dialysis. The serum HCO3- concentration increased progressively after dialysis began and resulted in significant metabolic alkalosis. The P (A-a)O2 was not aggravated and minute ventilation was not depressed by rapid metabolic alkalosis under mechanical ventilatory support. The PaO2 remained stable throughout hemodialysis. No significant hypoxemia occurred in groups of varying predialysis cardiopulmonary dysfunction. These findings suggest that in renal failure patients ventilated in assist-control mode, l) hypoventilation and accompanying hypoxemia did not occur during bicarbonate (35 mEq/L) dialysis, despite significant metabolic alkalosis; and 2) patients with higher Acute Physiologic and Chronic Health Evaluation (APACHE) III scores and P(A-a)O2 levels were not more prone to dialysis-induced hypoxemia.
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617
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Lee CH, Lee C, Trabulsy PP, Alexander JT, Lee K. A cadaveric and clinical evaluation of endoscopically assisted zygomatic fracture repair. Plast Reconstr Surg 1998; 101:333-45; discussion 346-7. [PMID: 9462764 DOI: 10.1097/00006534-199802000-00010] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
An endoscopic method of malar arch repair without a bicoronal incision has been recently described. To determine the effectiveness of this new technique, a cadaver study was performed to evaluate the capacity of this technique to (1) restore the anatomic position of a fractured malar arch, (2) rigidly fixate the arch, and (3) avoid injury to the frontal branch of the facial nerve. The technique of endoscopically assisted fracture repair was then applied to a clinical series of consecutive patients presenting with displaced zygomatic fractures with comminution at the malar arch. All cadaveric specimens repaired with this endoscopic technique demonstrated anatomic reduction and rigid fixation of the arch without disruption of the frontal branch of the facial nerve. In all clinical cases, four-point rigid plate fixation (zygomaticofrontal, infraorbital, malar arch, and zygomaticomaxillary buttress) was achieved endoscopically with limited access incisions. All clinical cases demonstrated excellent skeletal restoration of the zygoma on postoperative computed tomography scans. On clinical examination, facial symmetry and normal facial nerve function were observed in all patients after operation.
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618
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Abstract
Inflammatory bowel disease (IBD) is commonly associated with arthritic manifestations. They are divided into three clinical categories; peripheral arthritis, spondylitis, and sacroiliitis. To evaluate the incidence of arthritis associated with IBD in Korea, we retrospectively reviewed one hundred and twenty-nine patients with IBD, 77 with ulcerative colitis (UC) and 52 with Crohn's disease (CD). Arthritis occurred in twenty-two patients (17.1%); 15 with UC(19.6%), 7 with CD (13.5%). Patients with arthritis had more active inflammations and all were seronegative except one patient. Peripheral arthritis was found in twenty patients (15.5%) and more common in UC (19.6%) than in CD (9.6%). Joint involvements tended to be monoarticular or pauciarticular, and most frequently developed in the knee and ankle. Spondylitis was diagnosed in one patient (1.6%) who showed HLA B27 positivity. Radiographic sacroiliitis was observed in eight patients (6.2%) who revealed HLA B27 negativity. Both peripheral arthritis and sacroiliitis were found in six patients (4.6%). In CD, arthritis occurred in 20% of the patients with colonic involvement but in none of the patients without colonic involvement. In conclusion, arthritis was frequent in patients with IBD. Peripheral arthritis was more common in patients with UC than CD. All the patients with CD and arthritis had colonic involvement.
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619
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Cho WL, Liu HS, Lee CH, Kuo CC, Chang TY, Liu CT, Chen CC. Molecular cloning, characterization and tissue expression of prophenoloxidase cDNA from the mosquito Armigeres subalbatus inoculated with Dirofilaria immitis microfilariae. INSECT MOLECULAR BIOLOGY 1998; 7:31-40. [PMID: 9459427 DOI: 10.1046/j.1365-2583.1998.71049.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A cDNA encoding mosquito Armigeres subalbatus prophenol oxidase (As-pro-PO) was obtained by rapid amplification of cDNA ends-polymerase chain reaction (RACE-PCR) after Dirofilaria immitis inoculation. The 2205 bp As-pro-PO cDNA contains a 32 bp 5'-noncoding region, a 2055 bp open reading frame (685 amino acids), and a 118 bp 3'-noncoding region. Hydrophobic signal peptide for the endoplasmic reticulum targeting is not found in the NH2-terminal region. Two potential copper-binding domains, amino acids 197-245 and 345-412, are highly homologous to those of the other insect pro-POs. A 2.2 kb As-pro-PO transcript was identified by Northern blot analysis using D. immitis microfilariae-inoculated A. subalbatus. Both in situ hybridization and Northern blot analysis demonstrated that As-pro-PO mRNA was synthesized in mosquito haemocytes but not in other tissues, i.e. fat bodies, midguts and ovaries, etc.
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620
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Shih HC, Su CH, Lee CH. Alternations of surface antigens on leukocytes after severe injury: correlation with infectious complications. Intensive Care Med 1998; 24:152-6. [PMID: 9539073 DOI: 10.1007/s001340050537] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the alternations of surface antigens of leukocytes after severe injury and the correlation with clinical outcome. SETTING Emergency Department and Intensive Care Unit of a university hospital. PATIENTS Patients with severe trauma (injury severity score > 16) were enrolled. Those who were transferred or had critical injuries were excluded. MEASUREMENTS AND RESULTS Polymorphonuclear cells (PMN) and mononuclear cells (MN) were isolated from patients on the 1st, 3rd and 7th day following injury. The mean fluorescent expressions of CD11b and CD16 of PMN, and CD25 of MN were measured and compared with those obtained from paralleled controls. Sixteen injured patients were included. The CD11b expressions of PMN increased on the 1st day and were still high on the 7th day. The CD16 expressions decreased on the 1st day and CD25 decreased on the 3rd day; both were still low on the 7th day. Six patients developed infectious complications. CD11b expression remained high and CD16 expression remained low on three measurements of the infectious patients, whereas both expressions recovered on the last measurement of non-infectious patients. CD25 expression remained low in both groups. Three infectious patients with pneumonia died from multiple organ failure. CONCLUSIONS Phenotypic alternations of leukocytes develop early after severe injury. The alternations may represent a state of activation of PMN and subsequent suppression of IL-2 related immunity. Persistent activation of PMN with enhanced CD11b and attenuated CD16 expression indicates the development of infectious complications and a poor prognosis can be anticipated if the infectious sites can not be controlled early.
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Lee SY, Kim SJ, Lee JI, Kim ES, Lee CH, Kim JH, Jeong HJ, Ha SK. Fabry's disease--a case report and review of literatures reported in Korea. Yonsei Med J 1998; 39:67-72. [PMID: 9529988 DOI: 10.3349/ymj.1998.39.1.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Fabry's disease is a rare, X-linked disorder of the glycosphingolipid metabolism, in which a partial or total deficiency of a lysosomal alpha(alpha)-galactosidase results in the progressive accumulation of neutral glycosphingolipids with terminal alpha galactose moieties (i.e., cerebroside di- and trihexoside) in most body fluids and tissues. Accumulation of neutral glycosphingolipids occurs within the lysosomes of endothelial, perithelial, and smooth muscle cells of the myocardial and renal systems; to a lesser extent in reticuloendothelial and connective cells of the cornea; and in ganglion and perineural cells of the autonomic nervous system. In Korea, 7 cases of Fabry's disease have been reported. A 29-year-old man with fever and headache had typical skin findings and a family history of Fabry's disease, and it was confirmed through renal biopsy and enzyme assay for alpha-galactosidase. We report a case of Fabry's disease with a review of the literatures reported in Korea.
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622
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Lee YH, Ji JD, Kim JS, Bak YT, Lee CH, Kim CH, Chae YS, Song GG. Ileocolonoscopic and histologic studies of Korean patients with ankylosing spondylitis. Scand J Rheumatol 1998; 26:473-6. [PMID: 9433410 DOI: 10.3109/03009749709065722] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We investigated the frequency of gut inflammation and the role of gut lesion in the pathogenesis of the ankylosing spondylitis (AS) in Korean patients. Ileocolonoscopy and biopsy of the colon and terminal ileum were performed on 24 Korean patients with AS. Endoscopic lesions were observed in 7 patients (29.2%). The lesions were found more often in the terminal ileum (6/7) than in the colon (1/7). Histologic signs of gut inflammation were detected in 14 patients (58.3%), acute lesions in 2 patients (8.3%) and chronic lesions in 12 patients (50%). Gut inflammation were as frequently found in Korean patients with AS as in Western patients. These findings suggest that gut inflammation may play a role in the pathogenesis of AS in Korean patients as it does in Western patients.
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Cho SH, Na JU, Youn H, Hwang CS, Lee CH, Kang SO. Tepidopterin, 1-O-(L-threo-biopterin-2'-yl)-beta-N-acetylglucosamine from Chlorobium tepidum. BIOCHIMICA ET BIOPHYSICA ACTA 1998; 1379:53-60. [PMID: 9468332 DOI: 10.1016/s0304-4165(97)00081-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A novel pterin compound, designated as tepidopterin, was detected from a thermophilic photosynthetic green sulphur bacterium, Chlorobium tepidum. The amount of tepidopterin inside the cell was estimated to be 2-5 micromol g(-1) dry weight of cell. This compound was purified through a high performance liquid chromatography using preparative DeltaPak C18 column. This compound was characterized by chromatographic behavior and by absorption and fluorescence properties. Its structure was determined to be 1-O-(L-threo-biopterin-2'-yl)-beta-N-acetylglucosamine by 1D- and 2D-NMR spectroscopy, mass spectrometry and CD. The relative amount of tetrahydrotepidopterin was estimated to be 96.7% inside the cell, that of dihydrotepidopterin 2.9%, and that of fully oxidized tepidopterin 0.4%. The amount of tepidopterin within the cell increased continuously until the beginning of the stationary phase of the cell growth.
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624
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Ramos Vara JA, Lu JJ, da Silva AJ, Montone KT, Pieniazek NJ, Lee CH, Pérez L, Steficek BA, Dunstan RW, Craft D, Watson GL. Characterization of natural occurring Pneumocystis carinii pneumonia in pigs by histopathology, electron microscopy, in situ hybridization and PCR amplification. Histol Histopathol 1998; 13:129-36. [PMID: 9476643 DOI: 10.14670/hh-13.129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Macroscopic, histologic, ultrastructural, microbiologic, in situ hybridization (ISH) and PCR detection results in three 8-week-old pigs naturally infected with Pneumocystis carinii (PC) are described. All animals had a nonsuppurative interstitial pneumonia and intra-alveolar Pneumocystis organisms with foamy eosinophilic and PAS positive appearance. Ultrastructurally, PC trophozoites and cysts were observed in pigs No. 2 and No. 3, with the former being much more numerous. PC organisms were located on the alveolar surface or within the alveolar septa. Trophozoites had numerous filopodia and were thick-walled. Cysts had no or few filopodia, were thick-walled and contained intracystic bodies. Using non-isotopic ISH on formalin-fixed, paraffin-embedded lung tissue sections, PC DNA from pigs No. 2 and No. 3 hybridized with a probe specific for PC ribosomal RNA (rRNA). Using primers specific for mitochondrial rRNA gene (pAZ102-E/pAZ102-H), and for the internal transcriber spacers of ribosomal gene of PC, PCR methods amplified a product in the lung of pigs No. 2 and No. 3 using either frozen or formalin-fixed and paraffin-embedded lung tissue. DNA from Pig No. 1 samples did not amplify with any primer. This is the first time that molecular biology techniques (in situ hybridization and PCR) have been applied to the study of porcine pneumocystosis.
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625
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Kim KB, Lee CH, Kim CH, Cha YJ. Effect of the Cox maze procedure on the secretion of atrial natriuretic peptide. J Thorac Cardiovasc Surg 1998; 115:139-46; discussion 146-7. [PMID: 9451057 DOI: 10.1016/s0022-5223(98)70452-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The Cox maze procedure has been confirmed to be effective in curing atrial fibrillation. Some authors have reported severe fluid retention after the Cox maze procedure and have suggested decreased secretion of atrial natriuretic peptide as a possible mechanism. This study was designed (1) to examine the serial changes in atrial natriuretic peptide after the Cox maze procedure as compared with changes occurring after coronary artery bypass grafting and (2) to elucidate any differences in atrial natriuretic peptide levels between patients with transient recurrence of atrial fibrillation after the Cox maze procedure and those without recurrence of atrial fibrillation. METHODS Blood samples were drawn from the right and left atria in patients undergoing the Cox maze procedure (n = 19) and from the right atrium in patients undergoing coronary artery bypass grafting (n = 6) before and 1, 2, and 3 days after the operation. In six patients undergoing the Cox maze procedure, samples were also drawn from the radial artery before and 1, 2, 3, 5, and 7 days after the operation. The plasma samples were prepared by refrigerated centrifugation and stored until radioimmunoassay. In the Cox maze procedure group, atrial natriuretic peptide levels in the right atrium were 629 +/- 366, 154 +/- 112, 162 +/- 112, and 183 +/- 97 pg/ml and those in the left atrium were 276 +/- 168, 152 +/- 91, 162 +/- 111, and 145 +/- 80 pg/ml before and 1, 2, and 3 days after the operation, respectively. A marked decrease in atrial natriuretic peptide levels was evident after the Cox maze procedure (p < 0.001). There was no significant correlation between atrial natriuretic peptide levels and atrial pressures after the Cox maze procedure, which suggests that secretion of atrial natriuretic peptide by the atria was impaired. There was a significant correlation between the atrial natriuretic peptide levels in the left atrium and those in the peripheral radial artery, and the decreased levels of atrial natriuretic peptide in the radial artery continued for 7 days after the Cox maze procedure. There were no differences in the atrial natriuretic peptide levels between the patients with transient recurrence of atrial fibrillation (n = 6) and those without recurrence (n = 13) after the Cox maze procedure. In the coronary artery bypass grafting group, the atrial natriuretic peptide levels in the right atrium were 115 +/- 37, 124 +/- 48, 154 +/- 54, and 156 +/- 36 pg/ml before and 1, 2, and 3 days after the operation, respectively. No change was seen after the operation. CONCLUSIONS We observed a significant decrease in atrial natriuretic peptide levels after the Cox maze procedure. This may be one of the possible causes of fluid retention after this procedure. These decreased atrial natriuretic peptide levels after the Cox maze procedure may result from the multiple atriotomy incisions and excision of both atrial auricles performed during the procedure, rather than from the conversion of atrial fibrillation to normal sinus rhythm.
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