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Lu CL, Chen CY, Hou MC, Chang FY, Lee SD. The experience of endoscopic tissue glue injection in the treatment of hepatic sarcoidosis related gastric variceal bleeding: report of a case. HEPATO-GASTROENTEROLOGY 1999; 46:2293-5. [PMID: 10521985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
A case of hepatic sarcoidosis complicated with portal hypertension and gastric variceal bleeding is described. A 53 year-old male suffered from persistent fever and massive hematemesis. Acute gastric variceal bleeding was diagnosed. Endoscopic tissue glue injection stopped this acute episode and ablated the varices after another two sessions of endoscopic tissue glue injection treatment. Subsequent administration of corticosteroids improved the symptoms and liver function. This was probably the first case of hepatic sarcoidosis associated with gastric variceal bleeding which was successfully treated by endoscopic tissue glue injection to be reported.
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Chen CY, Lu CL, Chou YH, Chang FY, Lee SD. Abdominal aortic aneurysm compression is probably responsible for the recurrent episodes of acute pancreatitis: case report. HEPATO-GASTROENTEROLOGY 1999; 46:2625-7. [PMID: 10522053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
An aged male with a known history of abdominal aortic aneurysm suffered from epigastralgia, vomiting and cold sweating for one day. According to the physical examination, serum amylase level and computed tomographic examination, acute pancreatitis was diagnosed. Surgical intervention for the abdominal aortic aneurysm was not performed because of his age, and finally this patient died after three recurrent episodes. Acute pancreatitis co-existing with an intact abdominal aortic aneurysm has never been reported before. The possible pathogenesis of this recurrent acute pancreatitis was discussed.
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Chang FY, Yeh CL, Lu CL, Chen CY, Lee SD, Doong ML, Wang PS. Preserved esophagogastric manometric motility in patients after distal gastrectomy. HEPATO-GASTROENTEROLOGY 1999; 46:2387-92. [PMID: 10522003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND/AIMS A prospective study resolved whether commonly employed distal gastrectomies could influence the esophagogastric manometric measurements and the role of vasoactive intestinal polypeptide in mediating motility after surgery. METHODOLOGY Studied groups consisted of 20 patients following radical subtotal gastrectomy for gastric cancer, 20 patients after subtotal gastrectomy for duodenal ulcer and 20 controls. Fasting blood was obtained to measure serum vasoactive intestinal polypeptide levels. A pneumohydraulic infusion system measured esophagogastric motility parameters. RESULTS Measured lower esophageal sphincter pressures in subjects of gastric cancer surgery, duodenal ulcer surgery and controls were 15.3 +/- 4.7, 13.1 +/- 5.3 and 12.6 +/- 5.0 mmHg, respectively (NS), while the sphincter lengths were 3.15 +/- 0.81, 3.22 +/- 0.79 and 2.86 +/- 0.85 cm, respectively (NS). In addition, other parameters including lower esophageal body remained unchanged. The serum vasoactive intestinal polypeptide levels of three groups were 24.1 +/- 10.8, 22.5 +/- 9.5 and 21.3 +/- 7.8 pg/ml, respectively (NS). CONCLUSIONS Neither gastric cancer nor duodenal ulcer in distal stomach removal can alter the lower esophageal body and LES manometric motilities. Unchanged serum VIP levels after gastric surgery are likely one of the mechanisms preserving esophagogastric integrity.
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Chen CY, Lu CL, Chang FY, Lu RH, Ng WW, Lee SD. Endothelin-1 is a candidate mediating intestinal dysmotility in patients with acute pancreatitis. Dig Dis Sci 1999; 44:922-6. [PMID: 10235598 DOI: 10.1023/a:1026696227575] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
We studied whether gastrointestinal transit was disturbed during acute pancreatitis and attempted to identify which mechanisms might be involved in acute pancreatitis. Using a noninvasive hydrogen breath test to determine the orocecal transit time, 24 patients with the clinical diagnosis of acute pancreatitis were enrolled into the intestinal motility study. Orocecal transit time was measured twice in all patients: once at the acute stage and once at recovery. Blood was obtained to study amylase, lipase, C-reactive protein, erythrocyte sedimentation rate, and endothelin-1 and nitrate/nitrite levels. Orocecal transit times measured at the acute stage were significantly delayed compared with those at recovery (mean values +/- SEM, 130.0 +/- 9.0 vs 80.8 +/- 7.4 min, P < 0.001). Plasma endothelin-1 levels exhibited a positive correlation with orocecal transit times in the acute stage (r = 0.509, P = 0.011). The percentages of altered orocecal transit times also correlated with the percentages of altered plasma endothelin-1 levels (r = 0.751, P < 0.001). Plasma nitrate/nitrite levels significantly decreased at the acute stage compared with those at recovery (5.25 +/- 0.82 vs 10.20 +/- 1.24 microM, P < 0.05). We conclude that intestinal transit is delayed in patients with mild to moderate acute pancreatitis. Elevated plasma endothelin-1 levels in the acute stage may be one mechanism mediating intestinal dysmotility.
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Wang YY, Lee CT, Lu CL, Chen CY, Chang FY, Lee SD, Doong ML, Wang PS. Gastric inhibitory polypeptide appears less important in mediating acid secretion. HEPATO-GASTROENTEROLOGY 1999; 46:2105-9. [PMID: 10430406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND/AIMS Gastric inhibitory polypeptide is recognized as an acid inhibitor, while its relationship with Helicobacter pylori colonization is unknown. The present study measured serum gastric inhibitory polypeptide levels in patients after various types of gastric resection and the influence of demographic characteristics including Helicobacter pylori on serum gastric inhibitory polypeptide levels. METHODOLOGY The study included twenty patients who underwent distal gastrectomy for duodenal ulcer, 33 patients who underwent radical subtotal gastrectomy for gastric carcinoma and 7 patients who underwent total gastrectomy. Another 58 healthy subjects served as controls. Their demographic characteristics were recorded, while serum gastric inhibitory polypeptide levels were measured using a homemade radioimmunoassay kit. RESULTS The serum gastric inhibitory polypeptide levels in the three patient groups and the controls were 246.2+/-38.7 pg/ml, 201.7+/-30.9 pg/ml, 183.5+/-34.5 pg/ml and 202.6+/-14.0 pg/ml, respectively. The difference among the four groups was not significant. Neither age, gender, body mass index, smoking, Helicobacter pylori colonization nor type of gastrectomy had an influence on serum gastric inhibitory polypeptide levels in the controls and the three patient groups. However, elapsed time since operation in patients following total gastrectomy exhibited a significant positive correlation with their gastric inhibitory polypeptide levels (r=0.89, p<0.05). CONCLUSIONS Serum gastric inhibitory polypeptide levels remain unchanged in patients undergoing various types of gastrectomy. Colonization of Helicobacter pylori does not influence its level. This peptide is probably less important in mediating gastric acid secretion.
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Chen CY, Lu CL, Lee PC, Wang SS, Chang FY, Lee SD. The risk factors for gallstone disease among senior citizens: an Oriental study. HEPATO-GASTROENTEROLOGY 1999; 46:1607-12. [PMID: 10430304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND/AIMS Few Occidental studies have addressed the risk factors for gallstone disease (GSD), among aged people. It is unknown whether these factors also present in the Orientals. Therefore, we studied the prevalence and risk factors for GSD among aged people in Taiwan. METHODOLOGY 1441 aged subjects (> or = 60 years) who received a paid physical checkup at this hospital were investigated. Their demographic characteristics and biochemical parameters were recorded and compared. Ultrasonographic diagnosis revealed a normal gallbladder in 1092 subjects, gallbladder stones in 171, cholecystectomy for gallstones in 65, gallbladder polyps in 83, mixed gallbladder stones/polyps in 10, and miscellaneous results in 20. We enrolled 236 subjects showing either gallbladder stones or cholecystectomy for gallstones as the GSD group. RESULTS Excluding those subjects with mixed gallbladder stones/polyps, the overall prevalence of GSD in our series was 16.6%. Using multivariate analysis, the encountered factors manifesting risk for the development of GSD were old age (p<0.001), lower serum high-density lipoprotein level (p<0.01), diabetes mellitus (adjusted odds ratio: 2.127; p<0.001) and glucose intolerance (adjusted odds ratio: 1.954; p<0.001), whereas past history of alcohol consumption (adjusted odds ratio: 0.335; p<0.01) exhibited a protective effect against the development of GSD. Other demographic characteristics and biochemical parameters, such as body mass index, ABO blood type, cigarette smoking, blood pressure, serum cholesterol level, hepatitis B virus carrier, liver function, and parity, did not have any correlation to GSD. CONCLUSIONS Among the aged senior citizens in Taiwan, individuals with old age, lower serum high-density lipoprotein level, diabetes and glucose intolerance are at high risk for developing GSD.
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Shi J, Qu S, Lu CL, He XL, Wang CH. [Protection of spinal motorneurons of section sciatic nerve by transplantation of NT-4 genetically expression cells into the side of section]. SHENG LI XUE BAO : [ACTA PHYSIOLOGICA SINICA] 1999; 51:128-32. [PMID: 11499005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The NT-4 genetically engineered cells were made by infecting L-6TG cell (a rat myoblast cell line) in vitro with a retroviral vector pN2A containing the rat NT-4 cDNA. The bioactivities were determined by bioassay of PC12 cell survival rate. The rat with left sciatic nerve transaction was used as a model for treatment by implanting NT-4 genetically modified cell. The condition of motorneurons was assessed by Nissl stain and ChE stain. The results showed that: (1) the percentage of surviving Nissl-stained neurons on the lessened side of NT-4 (+) grafts significantly increased as compared to that with NT-4 (-) grafts 2-3 weeks and 3 months after sciatic nerve transaction, and (2) the grafted cells produced significant increase in the positive ChE stained area after sciatic nerve transaction in 1-3 weeks. Our observations indicate that adult motor neurons are still able to respond to neurotrophic factors and they may require the factors for survival.
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Abstract
The aim of this study was to investigate the sympathovagal balance after meals by measuring the spectral analysis of heart rate variability (HRV). Nine healthy volunteers were enrolled in this study. The electrocardiogram (ECG) was recorded for 30 min in a fasting state and 60 min after a 500-kcal test meal. The HRV was derived from the ECG and was measured by power spectral analysis using fast-Fourier transform algorithm. It reveals two dominant spectral components. The low-frequency (LF) band reflects primarily sympathetic activity with some parasympathetic input. The high-frequency (HF) band is a reflection of parasympathetic (vagal) activity. The LF-to-HF ratio is considered a marker of sympathovagal balance. It was found that the postprandial LF-to-HF ratio, compared with the fasting state, was significantly increased at both the first 30 min (2.50 +/- 0.49 vs 1.78 +/- 0.33, P < 0.05) and the second 30 min (2.68 +/- 0.55 vs 1.78 +/- 0.33, P < 0.05). The postprandial HF diminished significantly at both the first (16.0 +/- 0.5 vs 21.8 +/- 4.2, P < 0.05) and the second (13.8 +/- 9.5 vs 21.8 +/- 4.2, P < 0.05) 30-min period. In conclusion, the postprandial sympathovagal ratio shows a sustained elevation lasting 1 hr, mainly attributed to diminished vagal activity.
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Luo JC, Hwang SJ, Lai CR, Lu CL, Li CP, Tsay SH, Wu JC, Chang FY, Lee SD. Clinical significance of portal lymphoid aggregates/follicles in Chinese patients with chronic hepatitis C. Am J Gastroenterol 1999; 94:1006-11. [PMID: 10201474 DOI: 10.1111/j.1572-0241.1999.01004.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Portal lymphoid aggregates/follicles (lymphoid A/F) is a characteristically histological finding in patients with chronic hepatitis C. We assessed the prevalence of lymphoid A/F in Chinese patients with chronic hepatitis C and evaluated the correlation of this phenomenon with clinical, biochemical, immunological, virological, and other histological features of these patients. METHODS Eighty-nine Chinese patients with chronic hepatitis C were enrolled and portal lymphoid A/F was evaluated in liver biopsy. Clinical, biochemical, immunological, histological, and virological data, including serum HCV RNA titer and HCV genotype and the response to interferon therapy, were compared between patients with and without portal lymphoid A/F. RESULTS Twenty-nine (33%) of 89 patients with chronic hepatitis C had portal lymphoid A/F. Patients with lymphoid A/F had a significantly higher frequency of HCV genotype 1b infection (p = 0.039) and had a significantly higher mean score of bile duct damage, periportal necroinflammation, and portal inflammation in liver histologies when compared with patients without lymphoid A/F. No significant difference in sex distribution, mean age, history of blood transfusion, serum liver biochemistry, presence of serum autoantibodies/cryoglobulinemia, serum viral titer, and response to interferon therapy was noted between the two groups. Multivariate logistic regression analysis showed HCV genotype 1b infection and periportal necroinflammation were significant independent predictors associated with portal lymphoid A/F. CONCLUSIONS The presence of portal lymphoid A/F in Chinese patients with chronic hepatitis C was significantly correlated with HCV genotype 1b infection and periportal necroinflammation.
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Huang YH, Wu JC, Chau GY, Lui WY, King KL, Chiang JH, Yen SH, Sheng WY, Hou MC, Lu CL, Chang FY, Lee SD. Supportive treatment, resection and transcatheter arterial chemoembolization in resectable hepatocellular carcinoma: an analysis of survival in 419 patients. Eur J Gastroenterol Hepatol 1999; 11:315-21. [PMID: 10333206 DOI: 10.1097/00042737-199903000-00017] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE AND DESIGN Both surgical resection and transcatheter arterial chemoembolization (TACE) are effective treatments for hepatocellular carcinoma (HCC). Few reports have compared the different treatment modalities for resectable HCC based on clinically matched groups. The aim of this study was to compare the survival rate after surgery, TACE or supportive treatment in resectable HCC patients, and also in elderly patients (> or = 70 y/o). METHODS From 1984 to 1993, 419 consecutive patients with resectable HCC were included in this study. Of these, 311 (74%) underwent resection of tumours and 46 (11%) refused operation, opting instead for TACE. The remaining 62 (15%) who refused both methods of treatment were given supportive care. Univariate and multivariate analyses for prognostic factors and the 5-year survival rate among the groups were studied. RESULTS Both surgical resection and TACE groups had a better 5-year survival rate than the supportive treatment group (43% and 34% vs. 7%). There was no difference in survival between the surgery and TACE groups. However, the 5-year survival rate was 11% in TACE and 41% in the surgical group when the patients were > or = 70. In multivariate analysis, female sex (P = 0.0466), tumour size < or = 3 cm (P = 0.0001), alpha-fetoprotein (AFP) < 400 U/l (P = 0.0036), single tumour (P = 0.0474), serum creatinine < or = 1.5 mg/dl (P = 0.0006) and alkaline phosphatase (AP) < or = 100 U/l (P = 0.0007) are associated with good prognosis for resectable HCC. CONCLUSION TACE is an alternative for resectable HCC. Tumour size, tumour number, AFP level, renal function, AP level and female sex are prognostic factors. In elderly people, TACE must be used prudently and has a worse prognosis.
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Wong MY, Lu CL, Liu CM, Hou LT, Chang WK. Relationship of the subgingival microbiota to a chairside test for aspartate aminotransferase in gingival crevicular fluid. J Periodontol 1999; 70:57-62. [PMID: 10052771 DOI: 10.1902/jop.1999.70.1.57] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate the association between the occurrence of certain specific periodontal pathogens and aspartate aminotransferase (AST) levels in gingival crevicular fluid (GCF). METHODS Thirty systemically healthy subjects with moderate to advanced periodontitis were selected. Within each subject, the AST contents of GCF from sites with probing depth between 5 mm and 7 mm were measured using a chairside colorimetric test. AST-positive site refers to one that had an AST level > or = 800 microIU. Subgingival plaque samples from one AST-positive and one negative site were collected for microbiological examination. One site with probing depth < or = 3 mm and no gingival inflammation was selected as a healthy control. Clinical parameters of the chosen sites, including the plaque index and gingival index scores, probing depth, and clinical attachment level were measured. Culture and immunofluorescence (IF) were used for detecting common periodontal pathogens, including Actinobacillus actinomycetemcomitans, Peptostreptococcus micros, Campylobacter rectus, Eikenella corrodens, Fusobacterium nucleatum, Capnocytophaga species, Prevotella intermedia, Prevotella melaninogenica, and Porphyromonas gingivalis. Logistic regression was used to analyze the correlation between the AST test and certain specific pathogens. RESULTS The GCF scores and total cultivable bacterial counts were higher in AST-positive sites than either AST-negative or healthy sites. The prevalence and proportions of specific periodontal pathogens such as C rectus, E. corrodens, F. nucleatum, Capnocytophaga species, P. intermedia, and P. gingivalis were significantly higher in positive than in negative sites. In analyzing the correlation of the proportion of 6 pathogens with the AST test by logistic regression, only P. gingivalis showed a significant positive correlation. The odds ratio of having a high proportion of P. gingivalis in the presence of a positive AST test was 1.21. CONCLUSIONS The present study showed that at AST-positive sites, there is a higher prevalence and higher proportion of certain periodontal pathogens. Although only the correlation of P. gingivalis and AST values was statistically significant, the results imply that certain periodontal pathogens may be associated with elevation of AST levels in GCF.
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Cao L, Jiang CL, Lu CL. [The immunoregulatory effects of beta-endorphin]. SHENG LI KE XUE JIN ZHAN [PROGRESS IN PHYSIOLOGY] 1999; 30:38-40. [PMID: 12532847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Lu CL, Montgomery P, Zou X, Orr WC, Chen JD. Gastric myoelectrical activity in patients with cervical spinal cord injury. Am J Gastroenterol 1998; 93:2391-6. [PMID: 9860398 DOI: 10.1111/j.1572-0241.1998.00693.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Dyspeptic symptoms are common in patients with cervical spinal cord injury (SCI). The supraspinal control of sympathetic innervation to the stomach is interrupted in these patients. Gastric emptying has been reported to be delayed in some patients with cervical SCI. Gastric myoelectrical activity is known to regulate gastric motility and is correlated with gastric emptying. The change in gastric myoelectrical activity after cervical SCI is unknown; our aim was to investigate it. METHODS The study was performed in 12 cervical SCI patients and 14 healthy controls. Gastric myoelectrical activity was recorded using surface electrogastrography for 30 min in the fasting state and 1 h after a standard test meal. Spectral analysis was performed to compute the following parameters from the electrogastrogram; investigated were the percentage of 2-4 cycles/min (cpm) slow waves, the instability coefficient (IC) of the dominant frequency, the postprandial increment of dominant frequency (deltaF), and its power (deltaP). RESULTS In both fasting and fed states, regular and stable gastric slow waves were observed in both the control group and patients with cervical SCI. The percentage of normal 2-4 cpm slow waves (preprandial, 80.7+/-3.6% vs 91.5+/-3.7%, p > 0.05; postprandial, 82.0+/-4.4% vs 87.2+/-4.2%, p > 0.05) and IC (preprandial, 0.19+/-0.04% vs 0.28+/-0.05%; postprandial, 0.24+/-0.04% vs 0.27+/-0.02%, p > 0.05) were not significantly different between the two groups. The dominant frequency and its power were also similar between the two groups, no matter whether in the fast (frequency, 2.92+/-0.3 vs 2.93+/-0.06 cpm; power, 30.05+/-1.29 vs 29.08+/-1.23 dB, p > 0.05) or fed (frequency, 3.17+/-0.07 vs 3.02+/-0.06 cpm; power, 32.55+/-0.90 vs 32.07+/-1.18 dB,p > 0.05) state. The postprandial response measured by deltaF (0.25+/-0.09 vs 0.09+/-0.07 cpm, p > 0.05) and deltaP (2.52+/-1.10 vs 2.24+/-1.20 dB, p > 0.05) were also similar between the two groups. CONCLUSION Gastric myoelectrical activity was not altered after cervical SCI.
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Wan XW, Li WH, Huang M, You ZD, Tan YX, Lu CL, Gong ZH. Levels of immunoreactive dynorphin A1-13 during development of morphine dependence in rats. ZHONGGUO YAO LI XUE BAO = ACTA PHARMACOLOGICA SINICA 1998; 19:560-3. [PMID: 10437147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
AIM To study the relationship between the levels of immunoreactive dynorphin A1-13 (ir-dynorphin A1-13) and the degree of morphine dependence. METHODS The levels of ir-dynorphin A1-13 in discrete brain regions, spinal cord, and plasma in rats were determined by radioimmunoassay, and the degree of morphine dependence was assessed by scoring withdrawal signs on d 3, d 6, and d 12. RESULTS Morphine injection s.c. decreased the levels of ir-dynorphin A1-13 in spinal cord, pituitary, and plasma. The levels of ir-dynorphin A1-13 in hippocampus and hypothalamus were increased. No changes in cortex, midbrain, cerebellum, pons, and medulla were observed. With continuous injection of morphine, withdrawal signs scores were increased on d 6, but there was no difference between the scores of d 6 and d 12. CONCLUSION The changes of the levels of endogenous ir-dynorphin A1-13 in pituitary, spinal cord, and plasma were compatible with the degree of morphine dependence.
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Chang FY, Lu CL, Lee SD, Yu GL. An improved electrogastrographic system in measuring myoelectrical parameters. J Gastroenterol Hepatol 1998; 13:1027-32. [PMID: 9835319 DOI: 10.1111/j.1440-1746.1998.tb00565.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This study assessed the reliability of an improved electrogastrographic (EGG) system in recording stomach myoelectrical parameters and tried to establish the normal ranges of myoelectricity using this system. The analytical software of the current system mainly included an autoregressive modelling program to compute myoelectrical frequency and power. Forty healthy subjects were enrolled to receive myoelectrical measurement in two consecutively fasting and one postprandial 30 min sessions. The myoelectrical frequencies in both fasting and postprandial sessions were almost three cycles per min (c.p.m.) and showed little variation. The percentage of dominant frequencies (2.5-3.5 c.p.m.) in three sessions was approximately 80% while the computed myoelectrical powers in the first and second fasting sessions exhibited a significant correlation (r=0.84, P<0.001). Meal ingestion increased the myoelectrical powers by 6.8dB compared with the second fasting recording (P< 0.001). The mean variation in myoelectrical amplitude for the ratio of second: first fasting session was 110.3+/-88.8% (16-478%, median 88%). This new EGG system is, indeed, reliable for measuring myoelectrical frequency and power, whereas the interassay of recorded amplitudes appears markedly variable.
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Jiang CL, Lu CL, Liu XY. The molecular basis for bidirectional communication between the immune and neuroendocrine systems. Domest Anim Endocrinol 1998; 15:363-9. [PMID: 9785040 DOI: 10.1016/s0739-7240(98)00026-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
IL-2 has analgesic effects in both central and peripheral nervous systems. There are two distinct domains in IL-2 molecule mediating immunologic and analgesic activity, respectively. The analgesic domain of IL-2 may be composed of the 44th Phe, 45th Tyr, 107th Tyr, and 117th Phe residues that are located closely in the tertiary structure of IL-2. The analgesic activity may be mediated through the analgesic domain interaction with opioid receptor. In addition to peptides, cytokines may directly bind to peptide receptors, other than their specific cytokine receptors themselves. Conversely, peptides may also interact with cytokine receptors. Thus, peptide neurotransmitters and hormones may serve as endogenous regulators of the immune system, and cytokines may also serve as neurotransmitters. Multiple actions might be mediated by interactions between distinct domains of bioactive molecules with different receptors.
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Lee CT, Chuang TY, Lu CL, Chen CY, Chang FY, Lee SD. Abnormal vagal cholinergic function and psychological behaviors in irritable bowel syndrome patients: a hospital-based Oriental study. Dig Dis Sci 1998; 43:1794-9. [PMID: 9724171 DOI: 10.1023/a:1018848122993] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Irritable bowel syndrome (IBS) patients in Western countries usually manifest autonomic nerve dysfunctions and abnormal psychological behaviors. The purpose of this study was to assess whether Oriental IBS patients with predominant bowel symptoms also exhibited similar abnormalities. We enrolled 40 IBS patients from the outpatient clinic and 20 controls with normal daily bowel habit for study. The IBS patients were further divided according to their predominant bowel habit: 20 were constipation-predominant and 20 were diarrhea-predominant. Sympathetic function was evaluated by sympathetic skin response (SSR) while vagal cholinergic function was determined by measuring R-R interval variation (RRIV) in electrocardiography during rest and deep breathing. Psychological parameters were assessed by scales of the Minnesota Multiphasic Personality Inventory (MMPI) and the Hopkins Symptom Checklist (HSCL-90). IBS patients, despite their bowel habit, showed normal SSR response. RRIV during deep breathing was significantly lower in constipation-predominant IBS patients than in controls or diarrhea-predominant IBS patients (16.5+/-3.1% vs 20.5+/-4.8% and 21.5+/-4.6%, P < 0.001). IBS patients also exhibited abnormal MMPI measuring scores on depression, hysteria, paranoia, and masculinity/femininity scales. In addition, they also had more severe psychological distress in the items of HSCL-90 measurement. In conclusion, vagal dysfunction characterizes Oriental constipation-predominant IBS patients seeking medical help. Abnormal psychoneurotic profiles also exist in these IBS patients, irrespective of their bowel habits.
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Lu CL, Chen CY, Chang FY, Lee SD. Characteristics of small bowel motility in patients with irritable bowel syndrome and normal humans: an Oriental study. Clin Sci (Lond) 1998; 95:165-9. [PMID: 9680498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
1. Small bowel dysmotility may be one of the clinical manifestations in Occidental patients with irritable bowel syndrome. Here we studied the characteristics of small bowel motility in Oriental patients with irritable bowel syndrome and identified the factors responsible for disturbed small bowel motility. 2. We enrolled 90 patients with irritable bowel syndrome and 45 healthy controls to the study. The patients with irritable bowel syndrome were further divided according to their predominant bowel habits. Of those, 45 were constipation-predominant and 45 were diarrhoea-predominant. Small bowel transit was measured by the non-invasive hydrogen breath test in the fasting state. 3. The transit times obtained in constipation-predominant and diarrhoea-predominant patients with irritable bowel syndrome and in controls were 108.4+/-34.3, 67. 4+/-19.6 and 85.3+/-37.3 min respectively (P<0.05). Delayed transit characterized constipation-predominant patients with irritable bowel syndrome, whereas accelerated transit was observed in diarrhoea-predominant patients with irritable bowel syndrome. The ages of constipation-predominant and diarrhoea-predominant patients with irritable bowel syndrome and of controls displayed a significant positive correlation with their small bowel transit times (r=0.34, 0.31 and 0.39 respectively; P<0.05) and body mass indexes also demonstrated a positive correlation (r=0.31, 0.41 and 0. 30 respectively; P<0.05). Other demographic characteristics did not influence the small bowel transit times. 4. Accelerated or delayed small intestinal transit is exhibited in Oriental patients with irritable bowel syndrome showing either diarrhoea-predominant or constipation-predominant symptoms. Age and body mass index must be taken into consideration to study patients with suspected small intestinal dysmotility.
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Wong MY, Lu CL, Liu CM, Hou LT, Chang WK. Clinical response of localized recurrent periodontitis treated with scaling, root planing, and tetracycline fiber. J Formos Med Assoc 1998; 97:490-7. [PMID: 9700247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The purpose of this study was to compare the clinical efficacy of scaling and root planing alone versus tetracycline fiber therapy used adjunctively with scaling and root planing in the treatment of nonresponsive active periodontitis in patients under supportive periodontal therapy. Thirty patients who were receiving supportive treatment and had at least two nonadjacent periodontitis sites with a probing depth of between 4 and 8 mm and bleeding on probing, or had aspartate aminotransferase (AST) levels above 800 microIU in the gingival crevicular fluid in separate quadrants participated in this study. For each patient, the test sites were treated with scaling and root planing plus tetracycline fibers while the control site was treated with scaling and root planing only. Probing depths, clinical attachment levels, gingival recession, AST levels, and bleeding on probing were recorded and subgingival plaque samples were collected at baseline and 1, 3, and 6 months following treatment. At 3 months after treatment, there was a reduction of bleeding on probing and probing depth, and a gain of clinical attachment in both test and control sites. The mean reduction in probing depth of the test sites was 1.38 mm and the attachment gain was 0.8 mm after 6 months. The clinical response obtained at 3 months following therapy was maintained throughout the 6-month follow-up period. However, there were no statistically significant differences between sites treated with scaling and root planing alone and those treated with combined tetracycline therapy. Most of the reductions of probing depths in the fiber group were attributed to gingival recession. The present study did not confirm the efficacy of adjunctive tetracycline fibers in treating nonresponsive sites in maintenance subjects with regard to probing depth reduction or clinical attachment gain. Reinfection of the pockets from untreated sites and extra-crevicular regions may explain the insignificant response to local tetracycline therapy.
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95
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Luo JC, Hwang SJ, Lai CR, Lu CL, Li CP, Tsay SH, Wu JC, Chang FY, Lee SD. Relationships between serum aminotransferase levels, liver histologies and virological status in patients with chronic hepatitis C in Taiwan. J Gastroenterol Hepatol 1998; 13:685-90. [PMID: 9715418 DOI: 10.1111/j.1440-1746.1998.tb00714.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
In patients with chronic hepatitis C, the relationships between serum alanine aminotransferase (ALT) levels, histological liver injury and serum hepatitis C virus (HCV) RNA titres remain controversial. To evaluate these relationships, 93 Chinese patients with histological diagnosis of chronic hepatitis C were enrolled for this study. Serum ALT levels, HCV-RNA titres and HCV genotypes were examined. The histology was evaluated according to a modified histological activity score based on the degree of periportal necro-inflammation, intralobular necro-inflammation, portal inflammation, total necro-inflammation and fibrosis. The mean serum ALT level was significantly higher in patients with severe intralobular necro-inflammation activity than in patients with mild or no activity (P = 0.013). However, scores of intralobular activity were only weakly correlated with serum ALT levels (r = 0.27) and could not be used to adequately predict ALT values. Serum ALT levels showed no significant correlation with the scores of portal inflammation, periportal necro-inflammation, total necro-inflammation and fibrosis. Also, there was no significant difference in the mean serum ALT level among different serum HCV-RNA levels and HCV genotypes. Serum HCV-RNA titres and genotypes showed no significant correlation with liver histology and serum HCV-RNA titres were only weakly correlated with the total necro-inflammatory score (r = 0.27). In conclusion, although serum ALT levels were higher in patients with more severe intralobular necro-inflammatory activity, the correlation was not strong enough to adequately predict ALT values. Serum HCV-RNA titres and genotypes also showed no significant correlation with serum ALT levels and liver histologies.
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96
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Chen CY, Lu CL, Huang YS, Tam TN, Chao Y, Chang FY, Lee SD. Age is one of the risk factors in developing gallstone disease in Taiwan. Age Ageing 1998; 27:437-41. [PMID: 9883999 DOI: 10.1093/ageing/27.4.437] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To assess the prevalence and risk factors of gallstone disease (GSD) in Taiwan. DESIGN Descriptive and cross-sectional. METHODS A prospective ultrasonographic study of GSD was conducted in 3647 Chinese subjects who received a paid hospital physical check-up. Their demographic characteristics and biochemical parameters were recorded and compared. Ultrasonographic diagnosis revealed 2946 (M/F: 1838/1108) with normal gallbladder, 286 (M/F: 196/90) with gallbladder stones, 100 (M/F: 56/44) with previous cholecystectomy for gallstones, 243 (M/F: 174/69) with gallbladder polyps, 17 (M/F: 10/7) with mixed gallbladder stones/polyps and 35 as 'miscellaneous'. We enrolled subjects showing either gallbladder stones or cholecystectomy for gallstones in the GSD group. RESULTS Excluding those subjects with mixed gallbladder stones/polyps, the overall prevalence of GSD in the studied group was 10.7%. The studied factors manifesting an increase in risk for the development of GSD were age (P<0.05), high body mass index (P< 0.05), diabetes mellitus (adjusted odds ratio: 1.998; P< 0.05) and glucose intolerance (adjusted odds ratio: 2.056; P<0.05) by multivariate analysis. Other demographic characteristics and biochemical parameters, such as body height, ABO blood type, cigarette smoking, alcohol consumption, blood pressure, lipid profiles, hepatitis B virus infection, liver function and multiparity did not show any correlation to GSD. CONCLUSIONS Age, high body mass index, diabetes mellitus and glucose intolerance are the risk factors for developing GSD in Taiwan.
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97
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Jiang CL, Lu CL. Interleukin-2 and its effects in the central nervous system. BIOLOGICAL SIGNALS AND RECEPTORS 1998; 7:148-56. [PMID: 9672758 DOI: 10.1159/000014541] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Interleukin-2 (IL-2) is not only an important immunoregulatory molecule: it is also an important neuroregulatory molecule in the CNS. Investigations in vivo and in vitro have elucidated the following: IL-2 and IL-2 receptors (IL-2R) have been detected in the brain; IL-2 promotes survival and neurite extension of cultured neurons, stimulates oligodendrocyte proliferation and maturation, affects the hypothalamic-pituitary function and produces behavioral and electrocorticogram spectrum changes. Investigations in some laboratories, including ours, have also demonstrated an analgesic effect of IL-2 in the CNS. The molecular structure of the analgesic domain of IL-2 is distinct from the immune domain mediating immunoregulatory effects. A possible mechanism of action of cytokines on the CNS and the immune system or both exists: multiple actions of cytokines could be mediated by distinct domains or functional sites of cytokines interacting with different receptors or receptor subtypes.
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98
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Lu CL, Chang FY, Chen TS, Chen CY, Jiun KL, Lee SD. Helicobacter pylori colonization does not influence the symptomatic response to prokinetic agents in patients with functional dyspepsia. J Gastroenterol Hepatol 1998; 13:500-4. [PMID: 9641648 DOI: 10.1111/j.1440-1746.1998.tb00676.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Functional dyspepsia (FD) is very common, but the pathogenesis of Helicobacter pylori leading to FD is still debated. The aim of this study was first to evaluate the impact of H. pylori colonization on the efficacy of Paspertase (a metoclopramide plus exogenous enzymes regimen for FD patients) and, second, to compare the prevalence of H. pylori infection in FD patients with the general population. Seventy-four consecutive FD patients were enrolled undergoing Paspertase treatment. The symptomatic response was evaluated according to 1-4 scales of six main dyspeptic symptoms (i.e. epigastric pain/discomfort, early satiety, heartburn, nausea/vomiting, abdominal fullness/bloating, and belching). Nine hundred and seventy healthy subjects undergoing a paid physical check-up were included to study the status of H. pylori colonization. The demographic data and basal symptom scores between 43 H. pylori-positive and 31 H. pylori-negative patients were not significantly different. Total and individual symptom scores improved significantly after 4 weeks of Paspertase therapy (P < 0.05), irrespective of H. pylori infection. The prevalences of H. pylori were very similar in FD patients and the general population (58.1 vs 58.0%, NS). In conclusion, these observations suggest that H. pylori colonization is not significant in FD patients of Taiwan while a short-term prokinetic medication is effective for these patients, irrespective of H. pylori status.
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99
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Chang FY, Lu CL, Chen TS, Hou MC, Lee SD. The relationship of Helicobacter pylori colonization, the serum pepsinogen A level, and gastric resection. Surg Today 1998; 28:139-44. [PMID: 9525001 DOI: 10.1007/s005950050095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The serum levels of pepsinogen A (PGA) were measured in patients who underwent various forms of gastric resection to assess whether Helicobacter pylori (HP) colonization has any influence. Included in this study were 48 patients who underwent subtotal gastrectomy for a peptic ulcer (SGPU), 36 who underwent radical subtotal gastrectomy for gastric carcinoma (SGGC), 16 who underwent truncal vagotomy plus antrectomy (TV + AE), 24 with recurrent ulcer (RU) and 27 who underwent total gastrectomy (TG). The mean serum PGA levels in these five groups and in 40 healthy controls were 49.1 +/- 30.4 ng/ml, 30.0 +/- 14.8 ng/ml, 44.8 +/- 21.7 ng/ml, 66.4 +/- 42.8 ng/ml, 8.7 +/- 3.0 ng/ml, and 94.7 +/- 27.9 ng/ml, respectively. All patients except those with RU showed a diminished PGA level. The HP colonization rates of the patients who underwent partial resection were 45.8%, 22.2%, 50%, and 54.2%, respectively (P < 0.05). Age, gender, smoking, the type of gastroenterostomy, and underlying disease did not exert any influence on the measured PGA levels. However, higher PGA levels were observed in HP-colonized patients who either underwent SGPU or had RU. We conclude that various forms of distal gastrectomy, but not RU, elicit an indistinguishable acid secretory ability while HP colonization is responsible for the higher serum PGA levels in some patients following peptic ulcer surgery.
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100
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Dong Y, He C, Lu CL. [Recent advances in the studies of Midkine family]. SHENG LI KE XUE JIN ZHAN [PROGRESS IN PHYSIOLOGY] 1998; 29:52-4. [PMID: 12501706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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