101
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Abstract
A previously healthy 18-year-old boy presented with daily spiking fever, polyarthritis, and evanescent skin rashes, as well as hepatomegaly and Raynaud's phenomena for 2 months. He was initially diagnosed with adult-onset Still's disease (AOSD). During the period of follow-up, intermittent fever and migratory polyarthritis persisted and an insidiously growing mass over the right axillary region was noted 1 year after the diagnosis of AOSD. Excisional biopsy of the mass revealed a group of lymph nodes with histological features of the hyaline vascular type of Castleman's disease. The patient's symptoms disappeared soon after excision of the lymph nodes. evanescent rash, lymphadenopathy, hepatosplenomegaly and serositis [5]. A clinical picture compatible with the diagnosis of AOSD has not been described in the localised hyaline vascular type of Castleman's disease. We report such a case in an 18-year-old male patient who presented prolonged fever and polyarthritis with an initial diagnosis of AOSD. The diagnosis of hyaline vascular type of Castleman's disease was made 1 year later, when the patient developed an insidiously growing mass over the right axilla.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Kweishan, Taoyuan, Taiwan
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102
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Lin SJ, Chao HC, Yan DC, Huang JL. Serum eosinophil cationic protein determination in asthmatic children-effect of different collecting tubes used for blood sampling. Asian Pac J Allergy Immunol 1999; 17:269-73. [PMID: 10698466] [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: 02/15/2023]
Abstract
We compared the effect of using 2 different serum collecting tubes, serum separation tubes (SST, with clot activator and gel barrier) and conventional glass tubes (with no additives), on circulating levels of eosinophil cationic protein (ECP) in asthmatic children and controls. The serum ECP values obtained from both SST and glass tubes were significantly higher in asthmatic children than in corresponding controls. ECP values were higher in serum samples using SST than in those using glass tubes (P<0.01), while no difference was found between the two in controls. ECP levels correlated with peripheral eosinophil counts, for SST samples and glass tube samples alike. The difference in ECP levels between these two tubes also correlated with circulating eosinophil counts (r = 0.62, P = 0.004) After 18-hour storage at room temperature, the ECP values increased significantly in samples obtained from asthmatic children. No difference in ECP values between SST samples and glass tube samples was found for 18 hour samples. Thus, ECP levels obtained from SST samples and glass tube samples, though reliable, should not be directly compared, especially in asthmatic children with eosinophilia.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Taiwan
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103
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Lambert BL, Lin SJ, Chang KY, Gandhi SK. Similarity as a risk factor in drug-name confusion errors: the look-alike (orthographic) and sound-alike (phonetic) model. Med Care 1999; 37:1214-25. [PMID: 10599603 DOI: 10.1097/00005650-199912000-00005] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND One of every four medication errors reported in the United States is a name-confusion error. The rate of name-confusion errors might be reduced if new and confusing names were not allowed on the market and if safeguards could be put in place to avoid confusion between existing names. OBJECTIVES To evaluate several prognostic tests of drug-name confusion, alone and in combination, with respect to their sensitivity, specificity, and overall accuracy. RESEARCH DESIGN Case-control study. Twenty-two different computerized measures of orthographic similarity, orthographic distance, and phonetic similarity were used to compute similarity/distance scores for n = 1,127 cases (ie, pairs of names that appeared in published error reports or national error databases) and n = 1,127 controls. MAIN OUTCOME MEASURES Mean similarity/distance scores were compared across cases and controls. The performance of each measure at distinguishing between cases and controls was evaluated by tenfold crossvalidation. Dose-response relationships were examined. Univariate and multivariate logistic regression models were formed and evaluated by 10 fold crossvalidation. RESULTS Cases had significantly higher similarity scores than controls. Every measure of similarity proved to be a significant risk factor for error. There was a significant increasing trend in the odds-ratio as a function of similarity. A three-predictor logistic regression model had crossvalidated sensitivity of 93.7%, specificity of 95.9% and accuracy of 94.8%. CONCLUSIONS A sensitive and specific test of drug-name confusion potential can be formed using objective measures of orthographic similarity, orthographic distance, and phonetic distance.
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Affiliation(s)
- B L Lambert
- Department of Pharmacy Administration, University of Illinois at Chicago, USA.
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104
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Feng AN, Chen YL, Chen YT, Ding YZ, Lin SJ. Red wine inhibits monocyte chemotactic protein-1 expression and modestly reduces neointimal hyperplasia after balloon injury in cholesterol-Fed rabbits. Circulation 1999; 100:2254-9. [PMID: 10578000 DOI: 10.1161/01.cir.100.22.2254] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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/media area ratio 0.59+/-0.05 [red wine group] versus 0.79+/-0.07 [control group], P<0.05). However, rabbits fed white wine showed a trend (but not significant) toward less intimal response compared with control rabbits (intima/media area ratio 0.65+/-0.04 [white wine group] versus 0.79+/-0.07 [control group], P=0.165). Both red wine and white wine significantly reduced MCP-1 mRNA and protein expression in the aorta. CONCLUSIONS Long-term consumption of red wine and white wine inhibits MCP-1 expression, and in the small number of animals studied, red wine modestly reduces neointimal hyperplasia. Since red wine exhibits higher antioxidant capacity than does white wine, the decreased intimal response might be partly attributed to its antioxidant effects.
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Affiliation(s)
- A N Feng
- Division of Cardiology, Taipei Veterans General Hospital, Taiwan
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105
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Peng CJ, Chang CM, Kuo SE, Liu YJ, Kuo HC, Lin SJ. Analysis of anthropometric growth trends and prevalence of abnormal body status in Tainan elementary-school children. Acta Paediatr Taiwan 1999; 40:406-13. [PMID: 10927954] [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: 02/17/2023]
Abstract
Objectives of this study were to examine the prevalence of over/underweight or obesity in Chinese children and investigate the trend of anthropometric change through the years. Cross-sectional measurements on randomly selected 6,373 Tainan elementary-school children were conducted in 1997. Anthropometric parameters such as height, weight, body mass index (BMI), triceps skinfold thickness (TSF), mid-arm circumference (MAC) and body-fat percentage (%FAT) were measured. Girls and boys had an average of 4.8 cm and 5.1 cm, or 3.7% and 3.9% increase in height, and 5.5 kg, 6.2 kg, or 19.9% and 22.2% increase in weight when compared to data of nationwide survey in 1986-88. If the height and weight were compared to the data of nationwide survey in 1993-1996, Tainan girls and boys would have similar height but have averaged 3.4% and 4.7% heavier weight. Mean BMI reached 19.4 kg/m2 for girls and 19.6 kg/m2 for boys of age 12 to 13. Mean %FAT of girls was 24.3% and of boys was 23.7%. When using weight-for-length index (WLI) larger than 1.2, mean weight exceeding 120% of age-and-sex specific mean weight, %FAT exceeding 30% to evaluate prevalence of obesity, results would be 42.1%, 17% and 22.0% respectively. In conclusion, both sexes had faster growth in weight than in height in recent 10 years. Boys had significantly higher weight, WLI, BMI, MAC than girls, while girls had significantly higher TSF and %FAT than boys. Prevalence of obesity is highly method-dependent. Appropriate index and cutoff values need to be developed.
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Affiliation(s)
- C J Peng
- Department of Nutritional Services, National Cheng-Kung University Hospital, Tainan, Taiwan
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106
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Abstract
We investigated the capability of color Doppler sonography in evaluating acute osteomyelitis in children. Twelve children suspected of having osteomyelitis were evaluated with color Doppler ultrasonography at admission and at regular intervals to observe the inflammatory process of osteomyelitis, determine the response of antibiotic therapy, and predict the need of surgery in these patients. At admission, color Doppler flow within or around the infected periosteum was found in patients with symptoms for 4 days or longer, whereas those with symptoms for less than 4 days showed no color Doppler flow within and around the periosteum. During sonographic follow-up, six cases were found to have increased color Doppler vascular flow within and around the affected periosteum, and two of them had periosteal abscess. They eventually required surgical treatment. Persistent or increased color Doppler flow during follow-up examination correlated with elevated serum levels of C-reactive protein as well. Our study indicated that color Doppler vascular flow within or around the infected periosteum correlated with advanced acute osteomyelitis, and surgery usually was required in these patients. Those with early stage acute osteomyelitis usually showed no vascular flow within or around the infected periosteum. Thus, color Doppler sonography allowed detection of advanced osteomyelitis and revealed the progression of inflammation during antibiotic therapy. Color Doppler ultrasonography might be valuable in determining the efficacy of antibiotic therapy and justifying the need for operation.
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Affiliation(s)
- H C Chao
- Department of Pediatrics, Chang Gung Children's Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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107
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Lee WL, Chen JW, Ting CT, Ishiwata T, Lin SJ, Korc M, Wang PH. Insulin-like growth factor I improves cardiovascular function and suppresses apoptosis of cardiomyocytes in dilated cardiomyopathy. Endocrinology 1999; 140:4831-40. [PMID: 10499543 DOI: 10.1210/endo.140.10.7082] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [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: 11/19/2022]
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 s.c. 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 myocardial apoptotic index was negatively related to the thickness of the ventricular wall and to cardiac output, suggesting that ventricular remodeling/dysfunction involves the occurrence of myocardial apoptosis. Due to the close resemblance between this experimental model of dilated cardiomyopathy and human heart failure, the results of this study provide evidence that IGF-I may be a potential therapeutic agent for the failing human heart.
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Affiliation(s)
- W L Lee
- Department of Medicine, Taichung and Taipei Veterans General Hospital, National Yang-Ming University, Taiwan
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108
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Lin SJ. Cytogenetics: from aneuploidy to polymorphism. Acta Paediatr Taiwan 1999; 40:297. [PMID: 10910535] [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: 04/14/2023]
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109
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Wu TC, Chen JW, Hsu NW, Chen YH, Lin SJ, Wang SP, Ding YA, Chang MS. Coronary flow reserve and ischemic-like electrocardiogram in patients with symptomatic mitral valve prolapse. Jpn Heart J 1999; 40:571-8. [PMID: 10888377 DOI: 10.1536/jhj.40.571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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.
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Affiliation(s)
- T C Wu
- Department of Medicine, Taipei Veterans General Hospital, Taiwan
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110
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Lin SJ, Yoshimura E, Sakai H, Wakagi T, Matsuzawa H. Weakly bound calcium ions involved in the thermostability of aqualysin I, a heat-stable subtilisin-type protease of Thermus aquaticus YT-1. Biochim Biophys Acta 1999; 1433:132-8. [PMID: 10446366 DOI: 10.1016/s0167-4838(99)00140-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Aqualysin I is a heat-stable protease; in the presence of 1 mM Ca(2+), the enzyme is stable at 80 degrees C and shows the highest activity at the same temperature. After gel filtration to remove free Ca(2+) from the purified enzyme sample, the enzyme (holo-aqualysin I) still bound Ca(2+) (1 mol/mol of the enzyme), but was no longer stable at 80 degrees C. On treatment of the holo-enzyme with EDTA, bound Ca(2+) decreased to about 0.3 mol/mol of the enzyme. The thermostability of holo-aqualysin I was dependent on the concentration of added Ca(2+), and 1 mM added Ca(2+) stabilized the enzyme completely, suggesting that aqualysin I has at least two Ca(2+) binding sites, i.e. stronger and weaker binding ones. Titration calorimetry showed single binding of Ca(2+) to the holo-enzyme with an association constant of 3.1 x 10(3) M(-1), and DeltaH and TDeltaS were calculated to be 2.3 and 6.9 kcal/mol, respectively, at 13 degrees C. La(3+), Sr(2+), Nd(3+), and Tb(3+) stabilized the holo-enzyme at 80 degrees C, as Ca(2+) did. These results suggest that the weaker binding site exhibits structural flexibility to bind several metal cations different in size and valency, and that the metal binding to the weaker binding site is essential for the thermostability of aqualysin I.
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Affiliation(s)
- S J Lin
- Department of Biotechnology, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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111
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Chiou KR, Chou CY, Chan WL, Pan JP, Lin SJ, Charng MJ, Chen YH, Hsu NW, Wang SP, Ding PY, Chang MS. Results of coronary stenting after delayed angioplasty of the culprit vessel in patients with recent myocardial infarction. Catheter Cardiovasc Interv 1999; 47:423-9. [PMID: 10470471 DOI: 10.1002/(sici)1522-726x(199908)47:4<423::aid-ccd9>3.0.co;2-k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Little information is available concerning the effect of late coronary stenting in patients with recent myocardial infarction, especially long-term results. We retrospectively reviewed our results of 57 stent placements in 52 consecutive patients who received stents at an infarct-related lesion 24 hr to 30 days after an acute myocardial infarctions (median, 14 days). The average age was 67 years; 90% were male. Two patients who suffered from acute stent thrombosis received revascularization again and two early deaths were due to refractory cardiogenic shock before discharge. Mean patient clinical follow-up was 18.3 +/- 6.5 months. There were 1 subacute stent thrombosis, 1 cardiogenic death, and 10 patients (20.8%) in total suffering from angina class II to IV. Angiographic follow-up was performed in 36 patients (80%) at a mean of 7.5 +/- 3.1 months. Of these 36 patients, only 1 (3% of the total population undergoing follow-up angiography) had reocclusion at follow-up, but restenosis existed in 18 patients (50%). We conclude that there is still relatively high incidence of angiographic recurrence that is often silent in long-term follow-up, though the long-term result of late stenting in recent MI is low incidence of reocclusion.
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Affiliation(s)
- K R Chiou
- Department of Medicine, National Yang-Ming University, School of Medicine, Taiwan
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112
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Wang SM, Liu CC, Tseng HW, Wang JR, Huang CC, Chen YJ, Yang YJ, Lin SJ, Yeh TF. Clinical spectrum of enterovirus 71 infection in children in southern Taiwan, with an emphasis on neurological complications. Clin Infect Dis 1999; 29:184-90. [PMID: 10433583 DOI: 10.1086/520149] [Citation(s) in RCA: 241] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An outbreak of enterovirus 71 (EV71) infection occurred in Taiwan in 1998. The clinical spectrums and laboratory findings for 97 patients with virus culture-proven EV71 infections were analyzed. Eighty-seven percent of the patients were younger than age 5 years. Hand-foot-and-mouth syndrome occurred in 79% of the children and central nervous system (CNS) involvement in 35%, including nine fatal cases. The predominant neurological presentations were myoclonus (68%), vomiting (53%), and ataxia (35%). Brain stem encephalitis was the cardinal feature of EV71 CNS involvement during this outbreak. Magnetic resonance imaging and pathological findings illustrated that the midbrain, pons, and medulla were the target areas. EV71 brain stem encephalitis can present either with cerebellar signs and an initially mild, reversible course or with overwhelming neurogenic shock and neurogenic pulmonary edema (NPE) resulting in a fatal outcome. Brain stem encephalitis that progressed abruptly to neurogenic shock and NPE was indicative of poor prognosis in this epidemic. Early aggressive treatment and close monitoring of the neurological signs are mandatory to improve the chance of survival.
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Affiliation(s)
- S M Wang
- Department of Emergency Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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113
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Liu YC, Lin SJ, Ding PY, Chang MS. Development of a coronary artery aneurysm three months after stent implantation: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 1999; 62:461-6. [PMID: 10418182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Coronary artery stents have been used widely to prevent acute closure as a bailout procedure, or to decrease restenosis after balloon angioplasty. Stent use has increased substantially in recent years due to the ease and simplicity with which stents provide a predictable angiographic result. However, few data exist on the long-term safety of stents. This case report describes a 63-year-old male patient who developed intimal dissection after balloon angioplasty and who underwent coronary stent placement of a sheathed stent (half Palmaz-Schatz stent, 3.5 mm in diameter and 7 mm in length) as a bailout procedure. Postdilatation with a 3.5-mm balloon was performed at the maximum pressure of 14 atmospheres with a satisfactory angiographic result. However, an aneurysmal dilatation at the stent site was noted three months later. High-pressure stent use without immediately visible vascular dissection by angiography may not be effective for prevention of coronary aneurysm development in a case such as this. Aneurysmal dilatation may be a late complication in cases of coronary artery stent placement.
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Affiliation(s)
- Y C Liu
- Department of Medicine, Veterans General Hospital-Taipei, Taiwan, ROC
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114
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Chao HC, Wong KS, Lin SJ, Kong MS, Lin TY. Ultrasonographic diagnosis and color flow Doppler sonography of internal jugular venous ectasia in children. J Ultrasound Med 1999; 18:411-416. [PMID: 10361846 DOI: 10.7863/jum.1999.18.6.411] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We investigated the diagnostic utility of ultrasonography in the diagnosis of internal jugular venous ectasia. Eight children (six boys, two girls) were recruited into this prospective study. Sonography of internal jugular venous ectasia in these patients revealed fusiform dilation of the internal jugular vein, and the possibility of thrombus and external compression could be ruled out. Marked variation in size of ectatic jugular veins during respiration was demonstrated under real-time sonography. The mean anteroposterior diameter of these dilated internal jugular veins was 0.79+/-0.18 mm (mean+/-standard deviation), which increased to 1.58+/-0.27 mm with Valsalva maneuver. Our study showed that the anteroposterior diameters of the internal jugular veins in cases of ectasia were greater than those of contralateral jugular veins in same patients as well as those in normal children, and they showed greater increase after Valsalva maneuver. Under color Doppler flow studies, turbulent vascular flows were demonstrated in these patients with jugular venous ectasia. No progression of venous ectasia was found in any of our patients during a 6 month follow-up period. We conclude that internal jugular venous ectasia in children is a benign condition, which usually does not require surgical intervention. Ultrasonography is a good diagnostic modality for the diagnosis of internal jugular venous ectasia. Color Doppler ultrasonography demonstrate the turbulent flow in jugular venous ectasia.
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Affiliation(s)
- H C Chao
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan, Republic of China
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115
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Chen JW, Ting CT, Chen YH, Wu TC, Hsu NW, Lin SJ, Chang MS. Differential coronary microvascular function in patients with left ventricular dysfunction of unknown cause--implication for possible mechanism of myocardial ischemia in early stage of cardiomyopathy. Int J Cardiol 1999; 69:251-61. [PMID: 10402108 DOI: 10.1016/s0167-5273(99)00042-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To evaluate whether or not coronary microvascular dysfunction is associated with exercise-induced myocardial ischemia in left ventricular dysfunction of unknown cause, both the treadmill exercise test (TET) and coronary hemodynamics were studied in 20 patients with impaired left ventricular ejection fraction (<50% by radionuclide ventriculogram), normal cardiac size, normal coronary angiogram and no evidence of clinical heart failure. Ten subjects with atypical chest pain were studied as the control. Coronary hemodynamics were studied both at baseline and after dipyridamole infusion (0.56mg/kg, i.v. for 4'). There was no difference in age, gender, blood pressure, baseline great cardiac venous flow (GCVF) and coronary vascular resistance between ten patients with a positive TET and the other ten with a negative TET. At baseline, coronary sinus oxygen concentration was increased and myocardial oxygen consumption reduced in patients with a positive TET compared with those with negative a TET. After dipyridamole infusion, maximum GCVF (102+/-47 vs. 144+/-31 ml/min, P=0.027) and coronary flow reserve (2.31+/-0.49 vs. 3.00+/-0.61, P=0.012) were significantly reduced and minimum coronary vascular resistance was higher (1.00+/-0.42 vs. 0.63+/-0.12 mmHg/ml/min, P=0.016) in patients with a positive TET than in those with a negative TET. At follow-up, 40% of patients with a positive TET and 10% of those with a negative TET developed clinical heart failure with a dilated left ventricle during a period of 45 months. Thus, coronary microvascular function is heterogeneous in patients with left ventricular dysfunction of unknown cause. In some of them, coronary microvascular dysfunction could be related to the presence of exercise-induced myocardial ischemia, suggesting that similar pathophysiology underlies the early stage of dilated cardiomyopathy and syndrome X.
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Affiliation(s)
- J W Chen
- Department of Medicine, Veterans General Hospital-Taipei and -Taichung, and National Yang-Ming University School of Medicine, Taiwan, Republic of China
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116
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Chao HC, Chiu CH, Lin SJ, Lin TY. Colour Doppler ultrasonography of retropharyngeal abscess. J Otolaryngol 1999; 28:138-41. [PMID: 10410344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
OBJECTIVE This study was conducted to determine the capability of colour Doppler ultrasonography (CDU) in evaluating retropharyngeal abscess in children. MATERIALS AND METHODS From July 1996 to February 1998, five children with clinical suspicion of retropharyngeal abscess were evaluated by CDU. The distance from internal carotid artery (ICA) to cervical vertebra (CV) (DICA-CV) at the upper cervical level was measured by longitudinal ultrasonography. Fifty healthy children, aged from 1 to 15 years, were recruited in the study to measure DICA-CV as control. Colour Doppler ultrasonography was used to differentiate abscess from other pathology and to detect carotid sheath invasion. Computed tomography was performed to confirm the sonographic diagnosis. Measurements of the DICA-CV at regular intervals were performed to monitor the progression of retropharyngeal abscess. RESULTS Retropharyngeal abscess was highly suspected in all cases under sonographic studies. A patient was found to have carotid sheath invasion. Computed tomography confirmed the diagnosis of retropharyngeal abscess in all cases. Retropharyngeal abscess can be evaluated by the measured DICA-CV. The DICA-CV decreased as the retropharyngeal abscess gradually resolved. CONCLUSION Colour Doppler ultrasonography offers a sensitive method to evaluate retropharyngeal abscess in children. It can also be used to monitor the progression of retropharyngeal abscess and avoid unnecessary radiologic examinations.
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Affiliation(s)
- H C Chao
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan, R.O.C
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117
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Chen LC, Huang JL, Wang CR, Yeh KW, Lin SJ. Use of standard radiography to diagnose paranasal sinus disease of asthmatic children in Taiwan: comparison with computed tomography. Asian Pac J Allergy Immunol 1999; 17:69-76. [PMID: 10466541] [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: 02/13/2023]
Abstract
Paranasal sinus disease and bronchial asthma are frequently associated. Computed tomography imaging is currently the most reliable method for confirming the diagnosis of sinusitis. Due to the cost and amount of radiation during computed tomography, our aim was to analyze whether standard radiography, under computed tomography-control, had a reasonable degree of confidence in the diagnosis of sinusitis. Fifty-three asthmatic patients (42 males and 11 females) with a mean age of 9 years (range 4-14) were enrolled. We evaluated the maxillary sinuses, ethmoidal sinuses, frontal sinuses, and sphenoidal sinuses using standard radiography (Waters' view, Caldwell view, and lateral view) and compared with computed tomography (coronal views), the latter served as a standard. Computed tomography (CT) showed paranasal sinusitis in 58% (31/53) of the asthmatic children. Compared with the results of computed tomography, standard radiography revealed a sensitivity of 81.1% and a specificity of 72.7% for maxillary sinusitis. The sensitivity and specificity for ethmoidal, frontal, and sphenoidal sinusitis were 51.8%, 84.8%; 47.3%, 87.2%; and 40.8%, 93.3%, respectively. In 21 (40%) of the 53 patients, discrepancies were seen between the interpretations of standard radiography c and those of CT scans. In patients with maxillary sinusitis, the correlation between standard radiography and CT was good. However, ethmoidal, frontal, and sphenoidal sinusitis were poorly demonstrated using radiography. Standard radiography can be recommended as a screening method for maxillary sinusitis, but it is not recommended for the diagnosis of other paranasal sinusitis.
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Affiliation(s)
- L C Chen
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan
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118
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Lin SJ, Huang JL, Chao HC, Lee WY, Yang MH. A follow-up study of systemic-onset juvenile rheumatoid arthritis in children. Acta Paediatr Taiwan 1999; 40:176-81. [PMID: 10910610] [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: 02/17/2023]
Abstract
We analyzed the clinical and laboratory features, treatment, and course of twenty-one children with systemic-onset juvenile rheumatoid arthritis (S-JRA) encountered at our institution over the past ten years. There were eleven boys and ten girls. The mean age at onset was 11.6 +/- 4.2 years. The mean duration of symptoms prior to diagnosis was 5.5 +/- 1.7 months, and the mean follow-up period was 45.7 +/- 9.5 months. The clinical and laboratory features at presentation were similar to previous reports, except that peripheral blood smear revealed toxic granulation of neutrophils in 60% of our patients. Although systemic manifestation could be readily controlled by non-steroidal anti-inflammatory drugs (NSAIDs) with or without additional steroids, nine patients suffered from chronic arthritis (duration > 6 months) requiring disease-modifying anti-rheumatic drugs (DMARDs). Of the nine children with chronic arthritis, six (67%) had a monocylic systemic course, and seven (78%) had polyarticular disease (five or more joints affected) at the disease onset. Five patients developed severe destructive polyarthritis, with persistent anemia, thrombocytosis, elevated serum C-reactive protein (CRP) levels, and marked functional limitation during follow-up. One of the five patients with severe arthritis developed systemic lupus erythromatosis after 8-year follow-up, and died of sepsis. Our study indicated significant morbidity in children with S-JRA in Taiwan.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan
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119
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Yang MH, Lee WI, Chen LC, Lin SJ, Huang JL. Intraarticular triamcinolone hexacetonide injection in children with chronic arthritis: a survey of clinical practice. Acta Paediatr Taiwan 1999; 40:182-5. [PMID: 10910611] [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: 02/17/2023]
Abstract
To assess the efficacy of the intraarticular steroid(IAS) injection in the management of arthritis and the possible related complications in children with chronic arthritis. We evaluated 11 children of chronic arthritis (4 girls and 7 boys), age of onset ranged from 2-13.6 years, who had persistent arthritis treated with IAS from November 1994 to June 1997. The results of injections showed that the beneficial effect was noted within one day to 2 weeks without significant adverse reactions, remission exceeding 6 months was seen in 10 of 11 patients (in 14 of 18 joints). According to subgroups of chronic arthritis, the remission rate of IAS injection in children with pauciarticular arthritis reached 100%. A significant fall in C-reactive protein (CRP) between pre- and post-IAS injection (p = 0.03), but there were no differences in hemoglobin (Hb), white blood cells (WBCs), thrombocytes (Plts), erythrocyte sedimentation rate (ESR) and osteocalcin level. No injection-related complications were found. In conclusion, the IAS injection was an effective and safe treatment in children with chronic arthritis with no obvious complications especially in pauciarticular arthritis.
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Affiliation(s)
- M H Yang
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan
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120
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Lee WL, Chen JW, Ting CT, Lin SJ, Wang PH. Changes of the insulin-like growth factor I system during acute myocardial infarction: implications on left ventricular remodeling. J Clin Endocrinol Metab 1999; 84:1575-81. [PMID: 10323383 DOI: 10.1210/jcem.84.5.5676] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In vitro and in vivo experiments have shown important biological actions of insulin-like growth factor I (IGF-I) in heart. The aims of this study were to determine the changes in circulating IGF-I and IGF-binding proteins (IGFBPs) during acute myocardial infarction (AMI) and to explore the relationship between IGF-I levels and myocardial remodeling and function after AMI. Thirty-four patients with acute Q-wave AMI and 17 matched controls were investigated in this study. Compared to normal subjects, free IGF-I and IGFBP-3 were significantly elevated, and IGFBP-1 was decreased upon AMI. Myocardial remodeling occurred after AMI in these patients. The day 2, 3, and 7 total IGF-I levels were inversely related to day 7 left ventricular (LV) end-diastolic, end-systolic diameters (r = -0.395 to -0.516) and LV mass (r = -0.487 to -0.661). Moreover, total IGF-I levels were positively related to LV ejection fraction (r = 0.402-0.453). Compared to the healthy survivors, those patients with poor outcomes had lower total IGF-I levels immediately after AMI. Most healthy survivors had total IGF-I levels greater than 137 ng/mL, but all patients with poor outcome had total IGF-I levels less than 137 ng/mL. Thus, AMI is associated with significant alterations in the IGF-I system. A higher total IGF-I level immediately after the onset of AMI is associated with better myocardial remodeling and ventricular function.
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Affiliation(s)
- W L Lee
- Department of Medicine, Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Veterans General Hospital, Taichung, Taiwan
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121
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Defossez PA, Prusty R, Kaeberlein M, Lin SJ, Ferrigno P, Silver PA, Keil RL, Guarente L. Elimination of replication block protein Fob1 extends the life span of yeast mother cells. Mol Cell 1999; 3:447-55. [PMID: 10230397 DOI: 10.1016/s1097-2765(00)80472-4] [Citation(s) in RCA: 307] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A cause of aging in yeast is the accumulation of circular species of ribosomal DNA (rDNA) arising from the 100-200 tandemly repeated copies in the genome. We show here that mutation of the FOB1 gene slows the generation of these circles and thus extends life span. Fob1p is known to create a unidirectional block to replication forks in the rDNA. We show that Fob1p is a nucleolar protein, suggesting a direct involvement in the replication fork block. We propose that this block can trigger aging by causing chromosomal breaks, the repair of which results in the generation of rDNA circles. These findings may provide a novel link between metabolic rate and aging in yeast and, perhaps, higher organisms.
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Affiliation(s)
- P A Defossez
- Department of Biology Massachusetts Institute of Technology, Cambridge, 02139, USA
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122
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Abstract
In the bakers yeast S. cerevisiae, there at least four intracellular targets requiring copper ions-1) Ccc2p and Fet3p in the secretory pathway (homologues to Menkes/Wilson proteins and ceruloplasmin); 2) cytochrome oxidase in the mitochondria; 3) copper transcription factors in the nucleus; and 4) Cu/Zn superoxide dismutase (SOD1) in the cytosol. We have discovered a small soluble copper carrier that specifically delivers copper ions to the secretory pathway. This 8.2 kDa factor known as Atx1p, exhibits striking homology to the MERp mercury carrier of bacteria and contains a single MTCXXC metal binding site also found in the Menkes/Wilson family of copper transporting ATPases. Our studies show that Atx1p is cytosolic and facilitates the delivery of copper ions from the cell surface copper transporter to Ccc2p and Fet3p in the secretory pathway; furthermore, it is not involved in the delivery of copper ions to the mitochondria, the nucleus or cytosolic SOD1, implicating specific signals directing Atx1p to the secretory pathway. Homologues to Atx1p have been found in invertebrates, plants and humans, and the human gene is abundantly expressed in all tissues. In addition to Atx1p, we have recently uncovered an additional metal trafficking protein that appears to specifically deliver copper ions to SOD1. Mutants in the corresponding gene (lys7) are defective for SOD1 activity, and are unable to incorporate copper into SOD1, while there is no obvious impairment in copper delivery to cytochrome oxidase of Fet3p. The encoded 27 kDa protein contains a single MHCXXC consensus copper binding sequence and close homologues have been identified in a wide array of eukaryotic species including humans.
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Affiliation(s)
- V C Culotta
- Department of Environmental Health Sciences, Johns Hopkins University School of Public Health, Baltimore, Maryland 21205, USA
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123
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Lin WT, Lin SJ, Ni YH, Chen HL, Wang HP, Chu JS, Chang MH. Primary sclerosing cholangitis in a child. J Formos Med Assoc 1999; 98:209-13. [PMID: 10365542] [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: 02/12/2023] Open
Abstract
Primary sclerosing cholangitis (PSC) is a rare disease in Taiwan and has not been described in Taiwanese children previously. We report a 4-year-old girl who presented with prolonged fever, eosinophilia (11%), hepatomegaly, and markedly elevated serum levels of alkaline phosphatase (3,318 IU/L) and gamma-glutamyl transpeptidase (475 IU/L). Subsequent investigations including endoscopic retrograde cholangiopancreatography and liver histology confirmed the diagnosis fo PSC. Treatment with a low dose of prednisolone for 2 months and ursodeoxycholic acid during 32 months of follow-up resulted in clinical remission and halted disease progression. A high index of suspicion is necessary for physicians to diagnose this disorder in children with chronic liver disease. Our experience in this case indicates that therapy with prednisolone and ursodeoxycholic acid may be helpful for the treatment of PSC in children, and suggests the need for more trials of combined therapy.
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Affiliation(s)
- W T Lin
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
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124
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Lin SJ, Chen JB, Hsu KT, Hwang DF. Acute goby poisoning in southern Taiwan. J Nat Toxins 1999; 8:141-7. [PMID: 10091134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Food poisoning due to ingestion of two fishes, Yongeichthys nebulosus and Sillago japonica, occurred in Kaohsiung, Taiwan, in February 1997. Two male persons (48 and 58 years old) were poisoned, with symptoms featured by dizziness, nausea, vomiting, numbness, and difficulty in respiration. All of the specimens of fish retained by the victims were combined and consisted of Yongeichthys nebulosus and Sillago japonica. These retained specimens were assayed for anatomical distribution of toxicity (as tetrodotoxin) and all specimens were found to be toxic. The highest toxicity of specimen was 7,650 mouse units (MU) in Y. nebulosus and 1,460 MU in S. japonica. However, the other specimens re-collected from that fish pier were also found to be highly toxic in Y. nebulosus, but nontoxic in S. japonica. Hence, Y. nebulosus was judged as the real causative fish in this food poisoning. The toxins were partially purified from the methanolic extracts of toxic fishes by ultrafiltration and Bio-Gel P-2 column chromatography. Cellulose acetate membrane electrophoresis and high performance liquid chromatography analyses demonstrated that tetrodotoxin was the causative agent of this food poisoning.
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Affiliation(s)
- S J Lin
- Department of Marine Food Science, National Taiwan Ocean University, Keelung, R.O.C
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125
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Abstract
This study was to evaluate the dynamic changes in cardiac autonomic control preceding electrocardiographic (ECG) myocardial ischemia in patients with syndrome X. Twenty-four-hour ambulatory ECG was obtained in 34 consecutive patients in a drug-free state. Fourteen (41%) of them, aged 58.8+/-13.5 years, presented a total of 19 ischemic episodes, mean duration 12.4+/-19.8 min (ranged 1 to 90 min). Heart rate variability was measured for 24 h; for 3 min and 30 min before, and during the 15 min (in five 3-min intervals) immediately antedating ST segment depression; and for another 3 min after ST segment back to normal. There were significant progressive shortenings in sinus cycle lengths over the 30 min preceding myocardial ischemia (-30 vs -3 minute, 822+/-32 ms vs 637+/-23 ins, P<0.05; a decrement of 22.5%). The sinus cycle lengths lengthened after ischemia ceased. High frequency activity, pNNSO and rMSS.D. were significantly reduced from the -30 min baseline to a nidus in the last 3 min before ischemia (P<0.05), whereas low frequency band and low/high frequency ratio did not present significant change. These findings strongly argue that cardiac autonomic control, especially vagal withdrawal, is involved in the pathogenesis of dynamic myocardial ischemia in syndrome X.
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Affiliation(s)
- W L Lee
- Department of Medicine National Yang-Ming University School of Medicine and Veterans General Hospital-Taichung, Taiwan
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126
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Chen JW, Jen SL, Lee WL, Hsu NW, Lin SJ, Ting CT, Chang MS, Wang PH. Differential glucose tolerance in dipper and nondipper essential hypertension: the implications of circadian blood pressure regulation on glucose tolerance in hypertension. Diabetes Care 1998; 21:1743-8. [PMID: 9773741 DOI: 10.2337/diacare.21.10.1743] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [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
OBJECTIVE The goals of this study were to compare glucose tolerance in dipper and nondipper hypertensive patients and to explore the cause of glucose intolerance in essential hypertension. RESEARCH DESIGN AND METHODS A total of 50 patients <45 years old who had essential hypertension were recruited and studied by 24-h blood pressure monitoring and an oral glucose tolerance test (OGTT). Autonomic function was assessed with spectral analysis of heart rate variability RESULTS Dipper hypertensive patients (n=25) had lower nocturnal blood pressure than nondipper (n=25) patients. During OGTT, postprandial glucose levels were higher in the nondippers at 0, 90, and 120 min (all P < 0.05). Nondippers had a higher fasting insulin/glucose ratio than was apparent in normal control subjects. Despite higher postprandial glucose levels, nondippers had lower postprandial insulin levels. These results suggest that nondippers were insulin resistant and that their pancreatic beta-cell function was impaired. For all patients, nocturnal reduction of blood pressure was inversely related to total glucose levels under the OGTT curve and was positively related to postprandial insulin levels. Daytime heart rate did not differ between the dippers and nondippers, but nocturnal heart rate was higher in the nondippers, suggesting that nocturnal sympathetic activities were higher among the nondippers. Spectral analysis of heart rate variability suggests that the nondippers had lower parasympathetic activities and unbalanced sympathetic/parasympathetic outflow. CONCLUSIONS These findings indicate that nondipper hypertensive patients are more glucose intolerant than are dipper patients. The abnormalities of glucose metabolism in nondippers could be explained by insulin resistance and beta-cell dysfunction. The results of spectral analysis suggest that abnormal autonomic outflow may represent a possible link between hypertension and associated metabolic dysfunction.
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Affiliation(s)
- J W Chen
- Department of Medicine, Veterans General Hospital, Taipei, Taiwan
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127
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Lin SJ, Huang JL, Yan DC, Hsieh KH. Orthopedic manifestation in a child with hyperimmunoglobulin E syndrome. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1998; 39:330-2. [PMID: 9823680] [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: 02/09/2023]
Abstract
We report a 12-year-old girl with hyperimmunoglobulin E (HIE) syndrome who presented with genu vulgus of left knee, joint deformities involving both hands, and frequent fractures. She had had chronic eczema and recurrent skin and soft tissue infections since infancy, and was found to have a pneumatocele during admission. Immunologic abnormalities included extremely elevated serum IgE levels (18989 IU/ml) and cutaneous anergy to candida, purified protein derivative, and tetanus toxoid. The results of polymorphonuclear leukocyte function tests including the nitroblue tetrazolium test and chemotaxis were normal. A high index of suspicion for HIE syndrome should be given in patients with recurrent skin infections and orthopedic complaints. The physician should anticipate orthopedic problems in caring for patients with HIE syndrome, and optimal antibiotics prophylaxis should be used.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan
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128
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Abstract
A 10-year-old boy with hyperimmunoglobulin E (HIE) syndrome was admitted to the hospital due to intermittent fever and a growing neck mass noted for 3 months. He had had chronic eczema and recurrent skin infections since infancy. At age 8, the diagnosis of HIE was established when a pneumatocele was found in the presence of extremely elevated serum IgE levels (7842 IU/mL). He also had defective T-lymphocyte function, manifested by cutaneus anergy, as well as abnormal proliferative response to mitogenic stimuli. Chemotactic function of neutrophils was normal. Pathological examination of the lymph node disclosed Hodgkin's disease (nodular sclerosis). A high index of suspicion for lymphoma should be given in patients with HIE syndrome who present with lymph node enlargement.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Taiwan, Republic of China
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129
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Lin SJ, Roberts RL, Ank BJ, Nguyen QH, Thomas EK, Stiehm ER. Effect of interleukin (IL)-12 and IL-15 on activated natural killer (ANK) and antibody-dependent cellular cytotoxicity (ADCC) in HIV infection. J Clin Immunol 1998; 18:335-45. [PMID: 9793826 DOI: 10.1023/a:1023290932154] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [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: 11/12/2022]
Abstract
The ability of IL-12 and IL-15 to enhance natural killer (NK) activity and antibody-dependent cellular cytotoxicity (ADCC) of mononuclear cells (MNCs) from HIV+ children and their mothers was investigated. MNCs from HIV+ patients were deficient in NK and ADCC activity compared to control MNCs against several target cells. Overnight incubation with IL-15 or IL-12 augmented NK activity of MNCs from both patients and controls, and the combination of IL-12 and IL-15 resulted in the greatest enhancement. ADCC in HIV+ patients against gp120-coated CEM.NKR cells or chicken erythrocytes could also be enhanced by IL-2 or IL-15 in overnight cultures. Culturing MNCs with either IL-2 or IL-15 for 1 week increased the NK activity in patients to levels of controls treated with these cytokines. However, the response to the combination of IL-12 and IL-15 was less than that to IL-15 alone in 1-week cultures. Culturing MNCs with IL-2 and IL-15 for 1 week also increased the percentage of CD16+/CD56+ cells in both patients and controls. Thus, IL-15 can restore the deficient NK activity in patients and may be a candidate for immunomodulative therapy in HIV+ patients.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, UCLA Children's Hospital 90095, USA
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130
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Chen CH, Ting CT, Lin SJ, Hsu TL, Ho SJ, Chou P, Chang MS, O'Connor F, Spurgeon H, Lakatta E, Yin FC. Which arterial and cardiac parameters best predict left ventricular mass? Circulation 1998; 98:422-8. [PMID: 9714092 DOI: 10.1161/01.cir.98.5.422] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.2] [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: 11/16/2022]
Abstract
BACKGROUND Many cardiovascular and noncardiovascular parameters are thought to be determinants of left ventricular mass (LVM). Complicated interactions necessitate the simultaneous measurement and consideration of each to determine their individual and collective impact on LVM. We undertook such a comprehensive study. METHODS AND RESULTS The influence of anthropometry, cardiac size and contractility, arterial structure and function, as well as indices of lifestyle, physical activity, and dietary salt intake on LVM (by two-dimensionally guided M-mode echocardiography) was analyzed in 1315 Chinese subjects who were either normotensive or had untreated hypertension. Effects of many cardiac and arterial factors were assessed. In univariate analysis, almost all measured noncardiovascular, cardiac, and arterial variables were significantly correlated with LVM. In multivariate linear regression analyses, when age, sex, body habitus, fasting serum C-peptide level, dietary salt, physical activity, and lifestyle were accounted for, the optimum multivariate linear regression main effects model had an adjusted model r2 of 0.740, with 98% of the model variance accounted for by the 5 independent determinants of LVM: stroke volume (49.6%), systolic blood pressure (30.7%), contractility (14.7%), body mass index (1.8%), and aortic root diameter (1.6%). Other proposed arterial indices were significant independent determinants of LVM only when blood pressure was removed from the model and, even then, these indices not only resulted in less powerful prediction but also accounted for only a very small percentage of the total variance of LVM. CONCLUSIONS In a large population, we (1) confirmed that age, body habitus, and some indexes of arterial structure and function are independent determinants of LVM; (2) found aortic diameter to be an independent structural determinant of LVM; (3) demonstrated that the effects of the derived measures of arterial function were small and provided no better predictive power than blood pressure alone; and (4) showed that when the best measures of cardiac and vascular load were included, the single most potent predictor was an index of left ventricular size.
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Affiliation(s)
- C H Chen
- Division of Cardiology, Veterans General Hospital, Taipei, Taiwan
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131
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Himelblau E, Mira H, Lin SJ, Culotta VC, Peñarrubia L, Amasino RM. Identification of a functional homolog of the yeast copper homeostasis gene ATX1 from Arabidopsis. Plant Physiol 1998; 117:1227-34. [PMID: 9701579 PMCID: PMC34887 DOI: 10.1104/pp.117.4.1227] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/1997] [Accepted: 04/30/1998] [Indexed: 05/20/2023]
Abstract
A cDNA clone encoding a homolog of the yeast (Saccharomyces cerevisiae) gene Anti-oxidant 1 (ATX1) has been identified from Arabidopsis. This gene, referred to as Copper CHaperone (CCH), encodes a protein that is 36% identical to the amino acid sequence of ATX1 and has a 48-amino acid extension at the C-terminal end, which is absent from ATX1 homologs identified in animals. ATX1-deficient yeast (atx1) displayed a loss of high-affinity iron uptake. Expression of CCH in the atx1 strain restored high-affinity iron uptake, demonstrating that CCH is a functional homolog of ATX1. When overexpressed in yeast lacking the superoxide dismutase gene SOD1, both ATX1 and CCH protected the cell from the reactive oxygen toxicity that results from superoxide dismutase deficiency. CCH was unable to rescue the sod1 phenotype in the absence of copper, indicating that CCH function is copper dependent. In Arabidopsis CCH mRNA is present in the root, leaf, and inflorescence and is up-regulated 7-fold in leaves undergoing senescence. In plants treated with 800 nL/L ozone for 30 min, CCH mRNA levels increased by 30%. In excised leaves and whole plants treated with high levels of exogenous CuSO4, CCH mRNA levels decreased, indicating that CCH is regulated differently than characterized metallothionein proteins in Arabidopsis.
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Affiliation(s)
- E Himelblau
- Department of Biochemistry, University of Wisconsin, 420 Henry Mall, Madison, Wisconsin 53706, USA
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132
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Chu SM, Huang JL, Lin SJ, Hsueh C. Successful treatment of Sjögren's syndrome with cyclophosphamide pulse therapy: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1998; 39:268-70. [PMID: 9775500] [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: 02/09/2023]
Abstract
The treatment of Sjögren's syndrome (SS) is very controversial, though several therapeutic regimens have been proposed. Cyclophosphamide pulse therapy has been widely used in many disease entities. However, reports concerning its clinical application in SS were very rare. We report a 17-year-old girl presenting with lupus nephritis and SS, which was refractory to corticosteroid therapy but successfully treated with cyclophosphamide pulse therapy. The improvement of clinical features was confirmed by Schirmer's test and minor salivary gland biopsy.
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Affiliation(s)
- S M Chu
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan, R.O.C
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133
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Abstract
Microbial transformations of the labdane-diterpene isocupressic acid (1) with different microorganisms yielded several oxygenated metabolites that were isolated and characterized by MS and NMR spectroscopic analyses. Nocardia aurantia (ATCC 12674) catalyzed the cleavage of the 13,14-double bond to yield a new nor-labdane metabolite, 2. Cunninghamella elegans (-) (NRRL 1393) gave 7beta-hydroxyisocupressic acid (3) and labda-7,13(E)-diene-6beta,15, 17-triol-19-oic acid (4), and Mucor mucedo (ATCC 20094) gave 2alpha-hydroxyisocupressic acid (5) and labda-8(17),14-diene-2alpha, 13-diol-19-oic acid (6).
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Affiliation(s)
- S J Lin
- Division of Medicinal and Natural Products Chemistry, and Center for Biocatalysis and Bioprocessing, College of Pharmacy, University of Iowa, Iowa City, Iowa 52242, USA
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134
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Lin SJ, Huang JL. Circulating interleukin (IL)-1 beta, IL-6 and tumor necrosis factor-alpha in children with febrile infection--a comparison with C-reactive protein. Asian Pac J Allergy Immunol 1998; 16:105-9. [PMID: 9876948] [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: 02/09/2023]
Abstract
Circulating interleukin (IL)-1 beta, IL-6, and tumor necrosis factor (TNF)-alpha were examined in 42 febrile children with fever lasting more than 4 days. Their diagnosis were probable viral syndrome in 22, urinary tract infection (UTI) in 10, and probable bacterial pneumonia in 10. None of our study patients had detectable serum IL-1 beta. TNF-alpha levels were significantly higher in children with pneumonia than in those with viral syndrome (p < 0.01). Children with UTI and pneumonia had significantly higher IL-6 and CRP, compared to those with probable viral syndrome (p < 0.01 for both IL-6 and CRP). When appropriate cutoff values are chosen, IL-6 had greatly improved specificity (86.4%, > 20 pg/ml) to demonstrate UTI and pneumonia, as compared to that using CRP (48%, > 40 mg/l). After three days' antibiotic treatment, IL-6 fell to control levels in children with UTI and pneumonia, while CRP remained elevated. There was no difference in TNF-alpha values before and after treatment. Thus, IL-6, rather than IL-1 beta and TNF-alpha, may be a helpful diagnostic tool for evaluation of pediatric febrile infection. Sequential studies involving more patients are needed to determine whether IL-6 is better than CRP in this clinical setting.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan
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135
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Nguyen QH, Roberts RL, Ank BJ, Lin SJ, Thomas EK, Stiehm ER. Interleukin (IL)-15 enhances antibody-dependent cellular cytotoxicity and natural killer activity in neonatal cells. Cell Immunol 1998; 185:83-92. [PMID: 9636686 DOI: 10.1006/cimm.1998.1286] [Citation(s) in RCA: 39] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Interleukin (IL)-15 is a novel cytokine that is very similar to IL-2 in receptor specificity and biological activities. We compared the ability of IL-15 and IL-12 to enhance the cytotoxicity of neonatal (cord blood) and adult mononuclear cells (MNC) in both natural killer (NK) and antibody-dependent cellular cytotoxicity (ADCC) assays. Incubation with IL-15 (10 ng/ml) or IL-12 (1 ng/ml) for 18 h enhanced the NK activity (using K562 target cells) of both cord and adult MNC, increasing cord cell cytotoxicity threefold. Similar enhancement was seen in ADCC assays using erythrocyte targets and NK-resistant CEM cells coated with HIV gp-120 antigen. Incubation of cord cells with IL-15 or IL-12 for 1 week increased both NK and ADCC, although the combination produced less of an effect than either cytokine alone. IL-15 also increased the percentage of CD16+/CD56+ cells after 1 week incubation. This enhancement of NK and ADCC activities and the number of NK cells by IL-15 suggests it may be clinically useful in treating immunodeficient patients.
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MESH Headings
- Adjuvants, Immunologic/pharmacology
- Adult
- Animals
- Antibody-Dependent Cell Cytotoxicity/drug effects
- CD56 Antigen/biosynthesis
- Chickens
- Cytotoxicity Tests, Immunologic
- Erythrocytes/immunology
- Fetal Blood/cytology
- Fetal Blood/immunology
- Fetal Blood/metabolism
- HIV Envelope Protein gp120/immunology
- HIV-1/immunology
- Humans
- Infant, Newborn
- Interleukin-12/pharmacology
- Interleukin-15/pharmacology
- Killer Cells, Natural/drug effects
- Killer Cells, Natural/immunology
- Killer Cells, Natural/metabolism
- Leukemia, Erythroblastic, Acute/immunology
- Leukemia, T-Cell/immunology
- Mice
- Receptors, IgG/biosynthesis
- Tumor Cells, Cultured
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Affiliation(s)
- Q H Nguyen
- Department of Pediatrics, UCLA Children's Hospital, Los Angeles, California 90095, USA
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136
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Lin SJ, Chao HC, Huang JL. Gastrointestinal involvement as the initial manifestation in children with Henoch-Schönlein purpura--clinical analysis of 27 cases. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1998; 39:186-90. [PMID: 9684524] [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: 02/08/2023]
Abstract
A retrospective study was conducted to analyze the clinical and laboratory features, results of imaging studies, and course and treatment in 27 children with Henoch-Schönlein purpura (HSP) who initially presented with only abdominal symptoms. There were 17 boys and 10 girls, aged 6.7 +/- 0.5 years. The abdominal symptoms preceded the purpura for 10.2 +/- 1.9 days, ranging from 3 to 48 days. The main abdominal symptoms were periumbilical pain (77.8%); vomiting (51.9%); diarrhea (29.6%); pain mimicking appendicitis (22.2%) and bloody stool (14.8%). Laboratory findings revealed leukocytosis (88.9%), thrombocytosis (77.8%), positive stool guaiac tests (77.8%), and elevation of serum C-reactive protein (71.4%). Plain film is of limited use, but emergent abdominal sonography can be helpful in patients suspected of appendicitis. Unnecessary laparotomy was performed in three patients, whose pain persisted after the operation. Corticosteroid, given upon the appearance of rash, alleviated the abdominal pain in 2.4 +/- 0.2 days. All patients had recovered completely at six-month follow-up, except that three had persistent microscopic hematuria. A high index of suspicion and early diagnosis of HSP based on clinical features, laboratory data and the findings from diagnostic imaging may avoid unnecessary surgery. Early use of corticosteroid may reduce the suffering in these children.
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Affiliation(s)
- S J Lin
- Division of Allergy, Asthma and Rheumatology, Chang Gung Children's Hospital, Taoyuan, Taiwan, R.O.C
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137
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Abstract
Paralytic toxicity was seasonally detected in every 10 specimens of the starfish Astropecten scoparius from Pingtung in Taiwan from December 1995 to November 1996. The highest toxicity and the average toxicity of total specimens, expressed as tetrodotoxin (TTX), were 5,938 and 1,679 mouse unit (MU), respectively. The highest value of monthly average toxicity in viscera and other parts were 354 and 247 MU/g, respectively. The toxin was partially purified by YM-2 membrane ultrafiltration and Bio-Gel P-2 column chromatography. HPLC and GC-MS analyses showed that the starfish toxin was mainly composed of tetrodotoxin (88%), along with minor gonyautoxin 2-3 and saxitoxin (12%).
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Affiliation(s)
- S J Lin
- Department of Marine Food Science, National Taiwan Ocean University, Keelung, ROC
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138
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Chen SH, Wu HL, Yen CH, Wu SM, Lin SJ, Kou HS. Trace determination of methanol in water-ethanol solution by derivatization and high-performance liquid chromatography. J Chromatogr A 1998; 799:93-9. [PMID: 9550102 DOI: 10.1016/s0021-9673(97)01055-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A simple and sensitive high-performance liquid chromatographic method has been established for the determination of methanol in water-ethanol solution. The method is based on the transfer of the methoxide anion, which is formed from methanol under strong alkaline treatment in aqueous solution, by benzalkonium chloride into the dichloromethane organic phase for derivatization with 3-bromomethyl-7-methoxy-1,4-benzoxazin-2-one. The derivative obtained was separated on a LiChrospher diol column with n-hexane-dichloromethane (9:1, v/v) as the mobile phase. Several parameters affecting the partition/derivatization of methanol were investigated. The linear range for the determination of methanol was 2-20 mumol/ml; the detection limit (signal-to-noise ratio = 5; sample size, 10 microliters) of methanol was about 0.10 mumol/ml (R.S.D. = 16%, n = 3). The method has been satisfactorily applied to the assay of methanol in spiked commercial liquors.
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Affiliation(s)
- S H Chen
- School of Pharmacy, Kaohsiung Medical College, Taiwan
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139
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Su PH, Hwu WL, Chiang SC, Chiu PC, Lin SJ, Shu SG, Wang TR. Mucopolysaccharidosis type II (Hunter's syndrome) in Taiwan. J Formos Med Assoc 1998; 97:186-90. [PMID: 9549269] [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: 02/07/2023]
Abstract
The mucopolysaccharidoses are a group of inherited disorders of lysosomal storage of glycosaminoglycans. Among them, mucopolysaccharidosis (MPS) type II (Hunter's syndrome), caused by a deficiency in iduronate sulfatase, is the only one inherited in an X-linked recessive manner. We describe 12 Hunter's syndrome patients and seven carriers, with precise analysis of glycosaminoglycan content in urine and iduronate sulfatase activity in cultured fibroblasts and plasma. Their ages at the time of diagnosis ranged from 1 year 10 months to 11 years (mean 4.3 yr). The delay in diagnosis was from 1 month to 5 years (mean 2.1 yr) after the initial presentation. The most frequent initial complaints of the patients were delayed developmental milestones (75%) and speech (67%), although all patients were found to have coarsening of facial features at diagnosis. The difficulties in disease recognition allowed disease recurrence in four of the 11 families. Prompt clinical suspicion and referral will be important in genetic counseling for MPS type II and its management, if definitive therapy becomes available.
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Affiliation(s)
- P H Su
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
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140
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Lin SJ, Huang JL. Henoch-Schönlein purpura in Chinese children and adults. Asian Pac J Allergy Immunol 1998; 16:21-5. [PMID: 9681125] [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: 02/08/2023]
Abstract
From 1987 to 1996, we retrospectively analyzed 84 children and 38 adults admitted to Chang Gung Memorial Hospital with the diagnosis of Henoch-Schönlein purpura (HSP). All of the adult patients had skin biopsy finding showing leukocytoclastic vasculitis. Male predominance was noted in children, but not in adults. Preceding infection was noted in 40.5% of children and 31.6% of the adults (P = 0.46). 8.3% of children and 13.2% of adults had medication intake at disease onset (P = 0.62). Children had more frequent abdominal pain than the adults (70.2% vs 28.9%, P < 0.01). Renal involvement was more common and severe in adults, manifested as more frequent hypertension (P < 0.05) and heavy proteinuria (P < 0.01). During acute attack, leukocytosis, thrombocytosis, elevation of serum C-reactive protein levels were more frequently observed in children, while elevated serum IgA and cryoglobulin levels were more common in adults. The overall prognosis was good in both age groups, although two adults developed end stage renal disease. Our study demonstrated the different expression of HSP in Chinese children and adults.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Kweishan, Taoyuan, Taiwan
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141
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Wu YJ, Hong CY, Lin SJ, Wu P, Shiao MS. Increase of vitamin E content in LDL and reduction of atherosclerosis in cholesterol-fed rabbits by a water-soluble antioxidant-rich fraction of Salvia miltiorrhiza. Arterioscler Thromb Vasc Biol 1998; 18:481-6. [PMID: 9514418 DOI: 10.1161/01.atv.18.3.481] [Citation(s) in RCA: 125] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Antioxidants that prevent LDL from oxidation may reduce atherosclerosis. Salvia miltiorrhiza Bunge is a Chinese herb widely used for the treatment of atherosclerosis-related disorders. Salvianolic acid B (Sal B), a water-soluble polyphenolic antioxidant isolated from the roots of this plant, was found to scavenge 1,1-diphenyl-2-picrylhydrazyl radicals and inhibit LDL oxidation more effectively than probucol. In order to evaluate the antiatherogenic potential, New Zealand White rabbits were fed for 12 weeks a normal diet, a high cholesterol diet, a high cholesterol diet containing 1% probucol, or a high cholesterol diet containing a 5% water-soluble extract of S miltiorrhiza (SM). Both SM and probucol feeding reduced plasma cholesterol. LDLs from the SM-treated group were more resistant to Cu2+-induced oxidation and contained more vitamin E (21.7+/-2.1 mmol/micromol LDL cholesterol) than did LDLs from the high cholesterol diet group (9.6+/-1.8 nmnol/micromol LDL cholesterol) (P<.005). Endothelial damage, determined at week 6, was reduced by 53% in the SM group (P<.01). SM treatment reduced the atherosclerotic area in the abdominal aorta by 56% (P<.005) and cholesterol deposition in the thoracic aorta by 50% (P<.005). The severity of atherosclerosis in the SM group was significantly reduced after adjustment by using cholesterol exposure as an index of the cholesterol-lowering effect. This study concludes that the reduction of atherosclerosis by SM relies not only on its cholesterol-lowering effect but more heavily on its antioxidant potential to prevent endothelial damage and inhibit LDL oxidative modification in hypercholesterolemic animals.
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Affiliation(s)
- Y J Wu
- Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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142
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Lin SJ, Huang JL, Hsieh KH. Clinical and laboratory correlation of acute Henoch-Schönlein purpura in children. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1998; 39:94-8. [PMID: 9599897] [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: 02/07/2023]
Abstract
The clinical and laboratory features of 72 children with Henoch-Schönlein purpura (HSP) were examined to determine if there were associations between the laboratory indices--including white blood cell (WBC) counts, serum C-reactive protein (CRP) levels, platelet (PLT) counts--and the clinical manifestations of acute HSP. Marked leukocytosis (WBC > 15,000/mm3), elevation of serum CRP levels (> 10 mg/L) and thrombocytosis (PLT > 400 x 10(3)/mm3) were associated with gastrointestinal (GI) bleeding, but not associated with abdominal pain in the absence of GI bleeding. None of the three parameters was associated with arthritis and nephritis. Elevated serum CRP levels alone was associated with prolonged hospital course, and may serve as an indicator of disease severity in patients with HSP. GI bleeding did not occur in patients with normal WBC counts, serum CRP levels, PLT counts (0/19), but occurred in 21.7% (5/23), 50% (8/16), and 85.7% (12/14) in patients with only one, two of the three and all three laboratory abnormalities, respectively. Patients with GI bleeding had higher mean WBC, PLT counts and serum CRP levels than those with abdominal pain in the absence of GI bleeding, and than those without abdominal pain. Routine measurement of these parameters is warranted to monitor children with acute HSP.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Tao-Yuan, Taiwan, R.O.C.
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143
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Jiang JJ, Yumoto E, Lin SJ, Kadota Y, Kurokawa H, Hanson DG. Quantitative measurement of mucosal wave by high-speed photography in excised larynges. Ann Otol Rhinol Laryngol 1998; 107:98-103. [PMID: 9486902 DOI: 10.1177/000348949810700203] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 02/06/2023]
Abstract
The movement characteristics of mucosal waves of the vocal fold are important components in normal phonation. Quantitative studies of the mucosal wave have used stroboscopic techniques from a supraglottic view. The current study measured displacement of mucosal epithelium during experimental phonation by using high-speed photography from an infraglottic view. Effects of thyroarytenoid contraction, increased mean airflow rate, and variation of vocal fold length were examined in canine larynges. Top and bottom vocal fold "lip" amplitude, fundamental frequency, and phase difference were the dependent variables examined. Thyroarytenoid contraction increased the amplitude of the top and bottom lips, decreased the fundamental frequency, and increased the phase difference. Increase in airflow through the glottis decreased the top lip amplitude and phase difference and appeared to increase the fundamental frequency and to decrease the bottom lip amplitude. Vocal fold lengthening decreased the bottom lip amplitude and increased the fundamental frequency and appeared to decrease the top lip amplitude and phase difference.
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Affiliation(s)
- J J Jiang
- Department of Otolaryngology, Northwestern University Medical School, Chicago, Illinois 60611, USA
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144
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Nguyen QH, Roberts RL, Ank BJ, Lin SJ, Lau CK, Stiehm ER. Enhancement of antibody-dependent cellular cytotoxicity of neonatal cells by interleukin-2 (IL-2) and IL-12. Clin Diagn Lab Immunol 1998; 5:98-104. [PMID: 9455889 PMCID: PMC121400 DOI: 10.1128/cdli.5.1.98-104.1998] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Newborn infants are more susceptible to infections due in part to deficiencies in the cytotoxic functions of their lymphocytes. We investigated the ability of interleukin-2 (IL-2) and IL-12 to enhance the cytotoxicity of neonatal (cord blood) and adult mononuclear cells (MNCs) in both natural killer (NK) cell and antibody-dependent cellular cytotoxicity (ADCC) assays. The cytotoxic activity of cord blood MNCs was less than 50% that of adult MNCs in most assays prior to exposure to cytokines. Incubation with IL-2 (100 U/ml) or IL-12 (1 ng/ml) for 18 h increased the NK cell activity (using K562 target cells) of both cord blood and adult MNCs, and the combination of IL-2 and IL-12 increased cord blood cytotoxicity threefold, making the cytotoxicity of cord blood cells equivalent to that of adult cells treated with the same cytokines. In ADCC assays with chicken erythrocyte targets, the combination of IL-2 and IL-12 increased the cytotoxicities of both cord blood and adult MNCs, with greater enhancement again seen with cord blood cells. In assays with NK cell-resistant CEM cells coated with human immunodeficiency virus (HV) gp120 antigen in the presence of hyperimmune anti-HIV immunoglobulin, ADCC of cord blood MNCs was about 50% that of adult MNCs; ADCC of cord blood MNCs increased two- to threefold with the addition of IL-2 and IL-12, whereas ADCC of adult MNCs did not increase. Incubation of cord blood cells, but not adult cells, with IL-2 or IL-12 for 1 week increased the percentage of CD16+/CD56+ cells two- to fivefold and enhanced ADCC activity. Thus, IL-2 and IL-12 greatly enhance both the NK cell and ADCC activities of neonatal MNCs and increase the number of NK cells in longer-term culture.
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Affiliation(s)
- Q H Nguyen
- Department of Pediatrics, Children's Hospital, University of California at Los Angeles, 90095, USA
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145
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Lin SJ, Short RE, Ford SP, Grings EE, Rosazza JP. In vitro biotransformations of isocupressic acid by cow rumen preparations: formation of agathic and dihydroagathic acids. J Nat Prod 1998; 61:51-56. [PMID: 9461652 DOI: 10.1021/np970372u] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Isocupressic acid [15-hydroxylabda-8(17),13E-dien-19-oic acid] (1) was incubated under anaerobic conditions for 48 h in an in vitro ruminal fluid mixture and was transformed into two metabolites. The two metabolites were identified by GC/MS as agathic acid [labda-8(17),13(E)-diene-15,19-dioic acid] (4E) and dihydroagathic acid [labda-8(17)-ene-15,19-dioic acid] (6). Metabolite identities were confirmed by chemical conversions of isocupressic acid (1) and imbricataloic acid (5) into 4E and 6, respectively. Structures of synthetic metabolites were confirmed by 1H and 13C NMR, specific rotation, GC/MS, and high-resolution mass spectrometry. Plasma obtained from cows that were fed Ponderosa pine needles contained (13R,S)-dihydroagathic acid (6) but not isocupressic acid (1) or 4E. The results suggest that isocupressic acid (1) is metabolically oxidized to agathic acid (4E), subsequently reduced to (13R,S)-dihydroagathic acid (6) in the rumen, and then absorbed into the bloodstream of cattle.
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Affiliation(s)
- S J Lin
- Division of Medicinal and Natural Products Chemistry, College of Pharmacy, University of Iowa, Iowa City 52242, USA
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146
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Hsu NW, Chen JW, Jen SL, Kuo BI, Lee WL, Mar GY, Lin SJ, Wang SP, Chang MS. Differentiating syndrome X from coronary artery disease by treadmill exercise test in patients with chest pain and exercise-induced myocardial ischemia. Angiology 1998; 49:13-24. [PMID: 9456160 DOI: 10.1177/000331979804900102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Even though the underlying mechanisms of myocardial ischemia may be different, it is difficult to differentiate syndrome X from coronary artery disease (CAD) by means of the treadmill exercise test in elderly patients with chest pain and exercise-induced myocardial ischemia. One hundred sex- and age-matched patients-42 with syndrome X and 58 with CAD-were studied. Another 10 subjects with atypical chest pain, negative treadmill exercise test, and normal-appearing coronary angiograms served as controls. We evaluated the difference in exercise performance between patients with syndrome X and CAD, and the treadmill exercise test was undertaken with modified Bruce protocol within 2 weeks before coronary angiography. Parameters including time to 1 mm ST segment depression (STD), exercise duration (ED), heart rate (HR), systolic blood pressure, rate-pressure product (RPP), and percentage of age-predicted maximum HR (% HR) at different stages of the test were measured and then compared among the three groups of patients. Compared with CAD patients, syndrome X patients had significantly higher HR, % HR, and RPP at the time of 1 mm STD and at peak exercise. The time to 1 mm STD and ED were longer in syndrome X than in CAD patients. However, ED was shorter and HR, % HR, and RPP at peak exercise were similar in syndrome X patients as compared with control subjects. The new criterion of combined ED (> or =315 seconds) and RPP at peak exercise (> or =24,000 beats x mmHg/min) was found to be highly specific (86%) and moderately sensitive (64%) in differentiating syndrome X from CAD patients. The positive likelihood ratio for this criterion was 4.57 and negative likelihood ratio was 0.42. In conclusion, syndrome X patients had better exercise performance than CAD patients, but less ED and similar workload when compared with control subjects. The new criterion proposed in this study may provide a quick and simple way to differentiate syndrome X from CAD in a group of aged and predominantly male patients with chest pain and positive treadmill exercise test.
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Affiliation(s)
- N W Hsu
- Department of Medicine, Veterans General Hospital-Taipei, and School of Medicine, National Yang-Ming University, Taiwan, ROC
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147
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Yang BC, Chen RF, Chio CC, Chang WC, Lin MT, Lin SJ. Effects of insulin on protein phosphorylation and protein kinase C activity in human malignant gliomas. Proc Natl Sci Counc Repub China B 1998; 22:22-30. [PMID: 9536517] [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: 02/07/2023]
Abstract
Modulation of protein phosphorylation activities by insulin was investigated in glioma and normal glial cells. Insulin suppressed the in vitro protein phosphorylation of glioma cells in a dose-dependent manner while it stimulated that of meningiomas, neurilemmomas and glial cells. Although gliomas and glial cells contained different species of tyrosyl phosphoproteins before treatment, they expressed similar kinds of tyrosyl phosphoproteins in response to insulin. Insulin increased the activities of casein kinase II and total protein kinase C (PKC) in glioma and normal glial cells. The membrane-bound PKC activity in U373-MG cells was elevated by insulin. The PKC isozymes, including subtypes alpha, beta, delta, epsilon and gamma, were detected in gliomas, but few were found in glial cells. Insulin down regulated the cytosolic PKC-gamma and the membrane-bound PKC-epsilon proteins in gliomas. These results indicate that an altered insulin signaling pathway exists in human gliomas, which might involve differential regulation of PKC isozymes.
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Affiliation(s)
- B C Yang
- Department of Microbiology and Immunology, Medical College, National Cheng Kung University, Tainan, Taiwan, Republic of China
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148
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Lin SJ, Chao HC, Huang JL, Lin TY, Hsieh KH. Acetaminophen overdose in children and adolescents. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1997; 38:448-53. [PMID: 9473817] [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: 02/06/2023]
Abstract
From 1982 to 1997, 12 Chinese children were admitted to Chang Gung Memorial Hospital with acetaminophen overdose. Six subjects (one young child, and five adolescents) developed liver damage which was severe in three cases (AST > 1000 IU/L). Acetaminophen-induced liver function abnormalities were characterized by elevation of transaminase levels with ALT higher than AST(6/6), coagulopathy(5/6), thrombocytopenia (1/6), but absence of jaundice(6/6). Fortunately, none of the six patients with liver damage developed fulminant liver failure, and all recovered completely. Acetaminophen overdose can cause significant morbidity in children and adolescents. Caretakers should be well instructed to give the drug correctly. So far, acetaminophen is still considered as the drug-of-choice for antipyresis in pediatric practice. However, multicentered collaborative study is necessary to determine whether acetaminophen intoxication causes less hepatic failure in Chinese children than in Western children.
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Affiliation(s)
- S J Lin
- Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan, R.O.C
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149
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Pufahl RA, Singer CP, Peariso KL, Lin SJ, Schmidt PJ, Fahrni CJ, Culotta VC, Penner-Hahn JE, O'Halloran TV. Metal ion chaperone function of the soluble Cu(I) receptor Atx1. Science 1997; 278:853-6. [PMID: 9346482 DOI: 10.1126/science.278.5339.853] [Citation(s) in RCA: 502] [Impact Index Per Article: 18.6] [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: 02/05/2023]
Abstract
Reactive and potentially toxic cofactors such as copper ions are imported into eukaryotic cells and incorporated into target proteins by unknown mechanisms. Atx1, a prototypical copper chaperone protein from yeast, has now been shown to act as a soluble cytoplasmic copper(I) receptor that can adopt either a two- or three-coordinate metal center in the active site. Atx1 also associated directly with the Atx1-like cytosolic domains of Ccc2, a vesicular protein defined in genetic studies as a member of the copper-trafficking pathway. The unusual structure and dynamics of Atx1 suggest a copper exchange function for this protein and related domains in the Menkes and Wilson disease proteins.
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Affiliation(s)
- R A Pufahl
- Department of Chemistry, Northwestern University, Evanston, IL 60208, USA
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150
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Chen JW, Lin SJ, Ting CT. Syndrome X: pathophysiology and clinical management. Zhonghua Yi Xue Za Zhi (Taipei) 1997; 60:177-83. [PMID: 9439045] [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: 02/05/2023]
Abstract
The term "syndrome X" is now widely used to specify a group of patients with anginal chest pain, ischemia-like electrocardiogram, normal coronary angiograms, and no evidence of coronary spasm. Though chest pain and exercise-induced myocardial ischemia may both be present in patients with syndrome X and those with coronary artery disease, the underlying pathogenesis of these two disease entities is different. In patients with syndrome X, the causes of angina and myocardial ischemia are multifarious while coronary angiograms are normal. Coronary microvascular function has been shown to be impaired in these patients. However, the presentation of myocardial ischemia may be varied and even subclinical, suggesting dynamic characteristics and regional distribution of coronary microvascular insufficiency in them. Recently, there is increasing evidence that chest pain may develop without detectable myocardial ischemia and has been attributed to abnormal pain perception in at least some of the patients. Thus, there is a heterogeneous group of patients with syndrome X. The rational patient management should be related to individual clinical presentation and depend upon the proper identification of the underlying mechanisms of anginal chest pain or myocardial ischemia or both in these patients.
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Affiliation(s)
- J W Chen
- Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C
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