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Chen T, Ma KK, Chen LH. Tri-state median filter for image denoising. IEEE TRANSACTIONS ON IMAGE PROCESSING : A PUBLICATION OF THE IEEE SIGNAL PROCESSING SOCIETY 1999; 8:1834-1838. [PMID: 18267461 DOI: 10.1109/83.806630] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In this work, a novel nonlinear filter, called tri-state median (TSM) filter, is proposed for preserving image details while effectively suppressing impulse noise. We incorporate the standard median (SM) filter and the center weighted median (CWM) filter into a noise detection framework to determine whether a pixel is corrupted, before applying filtering unconditionally. Extensive simulation results demonstrate that the proposed filter consistently outperforms other median filters by balancing the tradeoff between noise reduction and detail preservation.
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Baker SP, Braver ER, Chen LH, Pantula JF, Massie D. Motor vehicle occupant deaths among Hispanic and black children and teenagers. ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE 1998; 152:1209-12. [PMID: 9856431 DOI: 10.1001/archpedi.152.12.1209] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine the risk of motor vehicle occupant deaths per unit of travel for Hispanic, non-Hispanic black, and non-Hispanic white children (aged 5-12 years) and teenagers (aged 13-19 years). DESIGN Comparison of 1989 to 1993 motor vehicle occupant death rates of children and teenagers by race, ethnicity, and sex by using data on mortality from the National Center for Health Statistics, travel data from the 1990 Nationwide Personal Transportation Survey, and 1990 US census data. RESULTS Among children 5 to 12 years old, race/ ethnicity differences per 100000 persons were unremarkable, but per billion vehicle-miles of travel, the rates were 14 for non-Hispanic blacks, 8 for Hispanics, and 5 for non-Hispanic whites. Among teenagers aged 13 to 19, the rates per 100000 persons were highest for non-Hispanic whites; however, the rates per billion vehicle-miles were 45 for Hispanics, 34 for non-Hispanic blacks, and 30 for non-Hispanic whites. Black and Hispanic male teenagers had substantially higher death rates per billion vehicle-miles of travel than either white male teenagers or female teenagers in any racial/ethnic group. CONCLUSIONS Black and Hispanic children and teenagers are at higher risk of dying in motor vehicle crashes when they travel. Greater public health attention is needed to address these increased risks.
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Wang PJ, Chen WJ, Chen LH, Niu CC. Spinal fusion and pedicle screw instrumentation in the treatment of spondylolisthesis over the age of 60. CHANGGENG YI XUE ZA ZHI 1998; 21:436-41. [PMID: 10074730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Spinal fusion or instrumentation for the treatment of spondylolisthesis in elderly people is still an issue of controversy. The purpose of this study was to assess the clinical results of laminectomy, posterolateral fusion, and pedicle screw instrumentation in patients over age 60. MATERIALS AND METHODS From 1993 through 1994, 94 spondylolisthesis patients over age 60 underwent laminectomy, posterolateral fusion and pedicle screw instrumentation. All the patients had follow-up examinations 3 months, 6 months, 1 year and then annually after the operation. At each follow-up visit, the clinical results and complications were evaluated and a radiographic assessment was performed. The follow-up period ranged from 2 to 4 years. At the final follow-up visit, we administered a questionnaire designed for clinical evaluation. RESULTS Seventy-five patients (80%) obtained improvement in back pain, 75 patients (80%) got improvement in leg pain, and 65 patients (69%) needed no medications. The average distance the patients were able to walk, at one time was 2.2 km. Sixty-seven patients (71%) could walk more than 500 m at a time. Seventy-four patients (79%) showed solid fusion, 20 patients inadequate fusion, and no psuedoarthrosis was found. Complications were rare. CONCLUSION Laminectomy with spinal fusion and instrumentation is a good method for the treatment of spondylolisthesis in elderly people, and it can achieve a satisfactory clinical outcome.
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Xi S, Cohen D, Chen LH. Effects of fish oil on cytokines and immune functions of mice with murine AIDS. J Lipid Res 1998; 39:1677-87. [PMID: 9717729] [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 effects of fish oil, which is rich in n-3 fatty acids, on cytokine levels in a murine model of acquired immune deficiency syndrome (AIDS) were studied. Thirty-two C57BL/6 female mice were divided into two dietary groups and fed either a corn oil diet or a fish oil diet. After 4 weeks, each diet group was further divided into two subgroups, and mice in one subgroup were injected i.p. with LP-BM5 murine retrovirus (MAIDS) stock. After 4 weeks, all mice were killed, blood samples were collected, and the spleens and the livers were excised. Splenocytes were isolated immediately and cultured in RPMI-1640 medium and stimulated by either lipopolysaccharide (LPS) or Concanavalin A (ConA) for 24 h. The supernatant was collected for cytokine assays. The results showed that MAIDS infection increased the levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1-beta (IL-1beta), while fish oil partially prevented this elevation. MAIDS infection depressed interleukin-2 (IL-2) and interferon-gamma (IFNgamma), while fish oil partially prevented the depression of IL-2. In addition, MAIDS infection depressed LPS- and ConA-stimulated cell proliferation, while fish oil partially prevented the depression. The results suggest that fish oil may slow down the progression of murine AIDS by modulating levels of cytokines including TNF-alpha, IL-1beta, and IL-2.
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Liew KL, Choong CS, Liu PN, Tsai DH, Chen LH, Yang WC. Pyomyositis in childhood: a case report. ZHONGHUA YI XUE ZA ZHI = CHINESE MEDICAL JOURNAL; FREE CHINA ED 1998; 61:488-91. [PMID: 9745166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Pyomyositis is a primary infection of skeletal muscle. We report the case of a previously healthy six-year-old who suffered from pyomyositis in the right lower back. He presented with lower back pain and low-grade fever for one week. After a series of laboratory and imaging studies, the diagnosis of right multifidus muscle pyomyositis with abscess formation was made. The patient recovered rapidly after incision and drainage therapy, accompanied by antibiotic treatment. Methicillin-resistant Staphylococcus aureus was cultured from the abscess discharge. It was strongly suspected that herbal medicines and common cold medication the patient had been prescribed before admission to our hospital produced a masking effect that delayed the diagnosis.
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Sia AT, Chong JL, Tay DH, Lo WK, Chen LH, Chiu JW. Intrathecal sufentanil as the sole agent in combined spinal-epidural analgesia for the ambulatory parturient. Can J Anaesth 1998; 45:620-5. [PMID: 9717591 DOI: 10.1007/bf03012089] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To compare the effect of a combination of intrathecal (i.t.) sufentanil plus bupivacaine with i.t. sufentanil alone, on the incidence of hypotension and the success of ambulation in parturients. METHODS This was a controlled, double-blind prospective trial involving 50 parturients in early labour who had received combined spinal-epidural analgesia (CSE). They were divided equally into two groups; group A received 10 micrograms i.t. sufentanil while group B received i.t. 10 micrograms sufentanil plus 2.5 mg plain bupivacaine. The blood pressure, pain scores, the highest sensory block and the degree of motor blockade were documented over the first 30 min by an unbiased anaesthetist. The ability and the desire to ambulate was studied 30 min after CSE. The side effects were documented throughout labour. RESULTS Group B had a higher incidence of hypotension; (12 vs 3: P < 0.01). Fewer parturients in group B could ambulate (19 vs 25: P < 0.05). Group B also had a higher sensory blockade than group A (median T4 VS T7-8: P < 0.01). Of all the 44 parturients who could ambulate, 13 desired not to do so, usually due to sedation. CONCLUSION The quality of analgesia in all subjects in the study was excellent. Side effects were more common in the i.t. sufentanil-bupivacaine combination group.
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Lee PC, Chen WJ, Tu YK, Chen LH. Solitary osteochondroma of the lumbar spine with cord compression: a case report. CHANGGENG YI XUE ZA ZHI 1998; 21:227-31. [PMID: 9729661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Solitary osteochondromas are usually of little significance. However, if they are located near neurologic structures, they may cause irritation due to compression. Spinal cord compression is a rare but potentially catastrophic manifestation of solitary osteochondromas. As far as can be ascertained, a solitary osteochondroma in the lumbar region with spinal cord compression has not been reported in Taiwan. This article includes the treatment of an 11-year-old girl with osteochondromas which was complicated by the late development of kyphoscoliosis and a review of the literature.
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83
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Wood TD, Guan Z, Borders CL, Chen LH, Kenyon GL, McLafferty FW. Creatine kinase: essential arginine residues at the nucleotide binding site identified by chemical modification and high-resolution tandem mass spectrometry. Proc Natl Acad Sci U S A 1998; 95:3362-5. [PMID: 9520370 PMCID: PMC19840 DOI: 10.1073/pnas.95.7.3362] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Phenylglyoxal is an arginine-specific reagent that inactivates creatine kinase (CK). Previous results suggest that modification of the dimeric enzyme at a single arginine residue per subunit causes complete inactivation accompanied by the loss of nucleotide binding; the actual site of modification was not identified. Here, high-resolution tandem mass spectrometry (MS/MS) was used to identify three phenylglyoxal-modified Arg residues in monomeric rabbit muscle CK. Electrospray ionizaton Fourier-transform MS of the phenylglyoxal-modified CK that had lost approximately 80% activity identified three species: unmodified, once-modified (+116 Da), and twice-modified (+232 Da) enzyme in a ratio of approximately 1:4:1. MS/MS restricts the derivatized sites to P122-P212 and P283-V332, whereas MS of Lys-C digestions revealed two modified peptides, A266-K297 and G116-K137. The only Arg in A266-K297 is Arg-291 (invariant), whereas MS/MS of modified G116-K137 shows that two of the three sites Arg-129, Arg-131, or Arg-134 (all invariant) can contain the modification. The recently reported x-ray crystal structure for the octameric chicken mitochondrial CK indicates that its nucleotide triphosphate-binding site indeed contains the equivalent of R291, R129, and R131 reported here to be at the active site of rabbit muscle CK.
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Chang JT, See LC, Liao CT, Chen LH, Leung WM, Chen SW, Chen WC. Early stage nasopharyngeal carcinoma: radiotherapy dose and time factors in tumor control. Jpn J Clin Oncol 1998; 28:207-13. [PMID: 9614445 DOI: 10.1093/jjco/28.3.207] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate radiotherapy dose and length of treatment in the control of early stage nasopharyngeal carcinoma (NPC) treated with a combination of external radiotherapy and brachytherapy, MATERIALS & METHODS We reviewed the records of 133 patients with early stage nasopharyngeal carcinoma (stage I or II, AJC/UICC staging system) who received definitive radiotherapy in Chang Gung Memorial Hospital from 1979 to 1991. The median follow-up time was 7.1 years with a minimum of 2 years. All patients were treated with megavoltage external radiotherapy to the nasopharynx area (63-72 Gy) followed by high dose rate intracavitary brachytherapy (5-16.5 Gy in one to three fractions, spaced 1-2 weeks apart). The median total dose and time of irradiation was 75 Gy (69.8-81.4 Gy) and 11.6 weeks (7.8-20 weeks) respectively. Survival analysis was used to examine the effect of several variables on prognosis. RESULTS The 5-year rates were 86.4% for local control, 84.7% for disease free survival, 88.5% for actuarial survival and 84.2% for overall survival. The treatment group (combination of time and dose of irradiation) was the most important prognostic factor according to Cox's proportional hazard model. Patients receiving radiation at a total dose of < or = 75 Gy completed in < 12 weeks showed the best prognosis. CONCLUSION Treatment time and total treatment dose are both important factors in treating early stage NPC. Decreasing the total radiation time to < 12 weeks and not exceeding a radiation dose of 75 Gy gave the best results.
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Cheng YM, Huang PJ, Fu YC, Lu YM, Hong SH, Lin SY, Chen LH, Chiang SC. Ankle arthrography and chronic lateral ankle instability. Kaohsiung J Med Sci 1998; 14:81-7. [PMID: 9542364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Sixty-five ankle arthrograms of the patients who underwent surgical reconstruction for their chronic ankle instability from 1987 to 1995 were studied retrospectively by comparing their operative findings. There were 15 cases (23.1%) with definite positive arthrographic findings. In the remaining 50 cases (76.9%), the arthrograms showed a "tear-drop" extravasation of dye beneath the fibular tip which we called "suspectable positive". Of these all but one, which had normal ligament, proved to correspond to the operative finding. As there was only one false positive finding among our surgical cases with both the "definite" and "suspectable" positive arthrograms, we concluded that ankle arthrography is relatively reliable and may be worth doing even in chronic cases if only for reference. Even when other diagnostic methods are negative, arthrography might help surgeons make surgical decisions in clinical symptomatic cases.
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Cheng GS, Chen JF, Chen X, Chen LH, Tao YG, Yang YJ. Effect of infection brain edema on NMDA receptor binding in rat brain in vivo. ACTA NEUROCHIRURGICA. SUPPLEMENT 1998; 70:282-4. [PMID: 9416347 DOI: 10.1007/978-3-7091-6837-0_87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to determine the effect of infection brain edema (IBE) in the rat model induced by injecting pertussis bacilli (PB) into the left carotid artery. The specific binding of N-methyl-D-aspartate (NMDA) receptor with [3H] MK-801 was measured in the neuronal membrane of cerebral cortex. The Scatchard plots were performed. The Bmax values were 0.623 +/- 0.082 and 0.606 +/- 0.087 pmol/mg protein in the group that received normal saline (NS) and PB respectively (P < 0.05). The Kd values were 43.1 +/- 4.2 and 30.5 +/- 3.0 nM in the groups NS and PB respectively. The results indicated that the affinity of NMDA receptor was significantly higher in the group PB than group NS, whereas the total number of NMDA receptors had not changed in the IBE model. The increase of affinity of NMDA receptor can be blockaded by MK-801 pretreatment in vivo.
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87
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Chen YW, Huang PJ, Hsu CY, Kuo CH, Cheng YM, Lin SY, Chen LH, Chiang HC. Surgical treatment for pilon fracture of the ankle-open reduction and internal fixation. Kaohsiung J Med Sci 1998; 14:31-5. [PMID: 9519687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
From 1991 to 1994, 39 ankles of 38 patients underwent surgical open reduction and internal fixation for pilon fractures. These patients included 29 males and 9 females with an average age of 38.6 y/o (range 28 y/o-58 y/o). The follow up and evaluation period averaged 31.7 months (range 22Ms-44Ms), during which time a standing x-ray for arthrosis grading and functional scale was used for clinical evaluation. Complications included 1 case of infection, 1 case of loss reduction, 2 cases of partial skin necrosis and 2 cases of delayed union. Post-traumatic arthritis occurred in 23 ankles (59%) but only 4 ankles of grade 4 arthrosis resulted in poor functional scale and the overall satisfactory rate was 82%. It was found that anatomic reduction, rigid fixation and early motion exercise are important to successful treatment of ankle fractures. Regarding pilon fracture, specifically the severity of fracture pattern and delay of reduction are important problems to overcome to ensure successful results. Therefore, adequate surgical approach for entire view of ankle joint, reduction and fixation of fibula, sufficient bone graft for articular support, intraoperative x-ray check and postoperative immobilization are essential for the achievement of better clinical results.
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Wu JL, Hsu MS, Hsu TC, Chen LH, Yang WJ, Tsai YC. The efficacy of intrathecal coadministration of morphine and bupivacaine for labor analgesia. ACTA ANAESTHESIOLOGICA SINICA 1997; 35:209-16. [PMID: 9553236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Intrathecal (i.t.) opioids can provide labor analgesia, but the onset of pain relief is slow. Bupivacaine has the beneficial property of less motor blockade than other local anesthetics. This study retrospectively examined the efficacy of concomitant use of i.t. morphine and bupivacaine for labor pain relief. METHODS Fifty five nulliparas who requested analgesia in the active phase (IA group) prior to a cervical dilation 3.9 +/- 0.6 cm and received i.t. morphine 0.5 mg and 0.1% bupivacaine 2.5 mg served as the treatment group, and 88 similar nulliparas who did not request and receive analgesia served as the control group. RESULTS The mean onset time of analgesia was 2.6 +/- 0.5 min, the duration was 4-12 h and 93% of parturients did not request additional analgesia after a single injection of i.t. morphine and bupivacaine. The active phase of the first and second stages of labor in the treatment group were significantly longer [318 +/- 214 min vs. 176 +/- 120 min; 74 +/- 29 min vs. 37 +/- 26 min]. Frequency of instrument-assisted vaginal delivery was higher compared with the control group (30.9% vs. 14.1%). However, there were no significant differences in the rate of cesarean section and the Apgar scores of newborns at 1 min and 5 min between the treatment and control group. The major side effects of the treatment group included pruritus (48%), nausea (40%), vomiting (37%), somnolence (27%), shivering (27%), urinary retention (21%), hypotension (15%), and bradycardia (13%). Most of the side effects were mild and could be alleviated by naloxone. Neither post-spinal headache nor respiratory depression was noted. CONCLUSIONS Our results showed that a single injection of i.t. morphine and bupivacaine provided rapid onset and effective analgesia with manageable side effects and without major complications. Thus, i.t. morphine and bupivacaine provides an alternative to epidural analgesia for most women in labor.
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Cheng YM, Huang PJ, Chen SK, Tien YC, Lin SY, Chen LH, Chiang SC. Salvage operation for neglected ankle fractures. Kaohsiung J Med Sci 1997; 13:618-25. [PMID: 9385778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
From 1986 to 1993, 49 cases of untreated or poorly treated ankle fractures who received salvage surgery were followed up for an average of 36.4 months. The patients included 31 males & 18 females with an average age of 41.6y/o and the time interval from initial injury to reconstructive surgery average due 17.6 months. They were classified and treated according to their grade of reduction and degree of arthrosis. The surgical methods included arthrotomy & joint debridement, revised open reduction, lower tibial osteotomy and ankle arthrodesis, depending on different individual conditions. After surgery, all cases had symptomatic relief and functional improvement with an average score increased from 26.3 preoperatively to 86.8 at follow up. The goals of ankle fractures is as articular fractures, they are treated by surgical anatomic reduction with rigid fixation as early as possible in order to provide good functional results. Nevertheless they are varied in neglected ankle fractures according to their individual conditions: open reductions were performed on cases with no or little arthritic change even though arthrosis might occur later because, if necessary, future conversion to osteotomy or arthrodesis would be easier. As for late cases with advanced arthritis, ankle arthrodesis were done by compressive arthrodesis with necessary bone graft to secure fusion in an optimal position.
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Chen LH, Zhou ZN. [Differences between effects of hypoxia on rabbit aorta and pulmonary artery]. SHENG LI XUE BAO : [ACTA PHYSIOLOGICA SINICA] 1997; 49:521-5. [PMID: 9813490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The difference of morphological injury between rabbit aorta and pulmonary artery was compared after the animal was exposed to the altitude 5 km (PO2 = 10.8 kPa) for 24 h. Hypoxia caused subendothelial edema, increased vacuoles and injured mitochondria and endoplasmic reticulums in both kinds of endothelial cells. The impairment of pulmonary artery was obviously more severe than aorta and its smooth muscle cells were also affected. Forthermore, the exposure increased mitochondria in pulmonary artery endothelial cells. Bubbled with a mixture air of 95% N2-5% CO2 (PO2 = 4 kPa) led to an increase of pulmonary in tension, while hypoxia to the same extent induced aorta relaxation. These results indicate that hypoxia produces the differential effects on these two kinds of vessels, providing a possible explanation for the production of hypoxic pulmonary hypertension.
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Chen LH, Tsutsumi S, Iizuka T. A CAD/CAM technique for fabricating facial prostheses: a preliminary report. INT J PROSTHODONT 1997; 10:467-72. [PMID: 9495166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A computer-aided designing and manufacturing (CAD/CAM) technique for clinical fabrication of facial prostheses was developed. Laser surface scanning was applied to acquire three-dimensional imaging data of the patient's facial defect. The three-dimensional imaging data was then transferred to a CAD/CAM interactive program for image processing, which then mathematically designed and produced a model for fabrication of the facial prosthesis. This CAD/CAM technique has the potential to simplify the procedure and decrease the laboratory work required compared to that required for the conventional plaster-cast method. This new technique also provides a novel approach to the fabrication of prostheses for the reconstruction of facial defects. Two alternative three-dimensional modeling processes, laser lithographic modeling and numerically controlled milling modeling, were integrated in this study. The possibilities and current limitations of the techniques are also discussed.
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Yang CT, Chang WC, Chen LH, Leung WM, Lee CH, Liaw CC. Concurrent 5-fluorouracil, leucovorin, etoposide, cisplatin and radiotherapy for locally advanced non-small cell lung cancer. CHANGGENG YI XUE ZA ZHI 1997; 20:187-94. [PMID: 9397609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The prognosis of Stage III unresectable non-small cell lung cancer may be improved by concurrent chemoradiotherapy. In this study, we attempted to evaluate the feasibility, tolerance, efficacy and toxicities of the combination of thoracic radiation and chemotherapy with a novel regimen that included 5-fluorouracil, leucovorin, etoposide and cisplatin (the FLEP regimen) in the treatment of this group of patients. PATIENTS AND METHODS From July 1995 to September 1996, 20 untreated patients with locally advanced non-small cell lung cancer were enrolled in the study. Radiation at a dose of 44 Gy was initially delivered in daily fractions of 2 Gy 5 days a week to the tumor and mediastinum, followed by a boost to the tumor (20 to 26 Gy according to patients tolerance). Concurrently with thoracic irradiation, patients were treated with chemotherapy consisting of cisplatin at the dose of 60 mg/m2/d for 1 day, etoposide at the dose of 60 mg/m2/d for 2 days, and 5-FU 500 mg/m2/d plus leucovorin 50 mg/d infusion for 48 hours. Cycles of chemotherapy were repeated every 3 weeks for a maximum of 3 cycles. RESULTS Seventeen of 20 patients were assessable. The overall response rate was 70.6% (95% confidence interval = 49-92%). No complete response was achieved. The median response duration for all responding patients is not yet estimable, with a range of 3.5 to 15.5+ months. Eleven patients remain progression-free for 4 to 15 months. The median survival for the entire group is not estimable. The major toxicity was esophagitis. Other grade 3 or 4 toxicities were not frequently observed. CONCLUSION Combined-modality therapy with FLEP regimen and radiation is a promising treatment with a high response rate and acceptable toxicity for locally advanced non-small cell lung cancer.
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Chien SH, Hung SH, Cheng YM, Lin GT, Lin SY, Ko CY, Chen LH, Chiang HC. Surgical treatment of pathologic fracture of the femur. Kaohsiung J Med Sci 1997; 13:556-61. [PMID: 9348733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A retrospective study of the surgical treatment of 32 metastatic lesions of the femur in 30 patients at the Kaohsiung Medical College Hospital was performed from 1987 to 1994. There were 16 women and 14 men with an average age of 61 years. A surgical technique combining internal fixation or prosthesis and methylmethacrylate cement was used in all cases. Adequate pain relief was achieved in thirty-one cases (97 %). Of the entire group, 20 cases (62%) remained ambulatory, 10 cases (31%) were confined to a wheelchair, only two cases had implant failure and one suffered from infection.
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Chen WJ, Niu CC, Chen LH, Shih CH. Survivorship analysis of DKS instrumentation in the treatment of spondylolisthesis. Clin Orthop Relat Res 1997:113-20. [PMID: 9186209 DOI: 10.1097/00003086-199706000-00016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This retrospective study analyzed the survivorship of DKS instrumentation and the clinical outcomes in 185 patients with spondylolisthesis. These patients were treated with Zielke DKS instrumentation for a mean followup period of 3.5 years. Eight (4.3%) patients had late removal of implants, 25 (14%) had rod breakage, three (1.7%) had screw breakage, and 16 (8.7%) had nut loosening. The survivor rate of DKS instrumentation was 96% within 3 months after operation, 80% at 2 years, and 61% at 5 years after surgery. One hundred sixty-three (88%) patients had solid posterolateral fusion, and 167 (90%) patients had good to excellent results. Adjacent instability developed in 18 (9.7%) patients. Although Zielke DKS instrumentation has a smaller rod and relatively insecure locking system between the rod and screw, it is an effective implant for the treatment of spondylolisthesis.
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Chang JT, Chen LH, Tang SG, Liao CT, Chen WC, Leung WM, Wang CH, Hsui-Tsai M. Acute toxicities and feasibility of altered fractionated radiotherapy in nasopharyngeal carcinoma. CHANGGENG YI XUE ZA ZHI 1997; 20:107-14. [PMID: 9260370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Altered fractionated radiotherapy (AFR) has been used for many years in the treatment of cancer. Although AFR therapy improves tumor control, it also increases acute radiation toxicities, which may make patients withdraw from treatment. Here, we report on the efficacy of AFR in the treatment of nasopharyngeal cancer (NPC). METHODS From September 1993 to October 1994, 68 NPC patients received AFR in Chang Gung Memorial Hospital-Linkou. The efficacy of two types of AFR were studied: (a) Hyperfractionated radiotherapy (HFT) in which irradiation was given twice a day throughout the radiotherapy course with a total radiation dose of 81.6 Gy/68 fractions in 7 weeks; and (b) Concomitant boost radiotherapy (CBT) in which additional concommitant radiotherapy was administered only during the last 2 weeks of the radiotherapy course. The total radiation dose of CBT was 72.3 Gy/42 fractions in 6 weeks. Twenty-six patients received HFT and 42 received CBT. RESULTS The percentage of grade 3 complications was 73% in CBT and 65% in HFT. The mean number of treatment days was 57.1 in HFT (median, 53; range 48-63) and 43.9 in CBT (median, 43; range 40-60). No patient withdrew from or prolonged the treatment because of acute radiation toxicities. CONCLUSION Our results demonstrated that NPC patients can tolerate HFT and CBT radiotherapy with sufficient psychological support. Further randomized trials will be continued in our institution.
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Chen LH, Zhou ZN. [Role of cytosolic calcium balance on cell injury in cultured bovine aortic endothelial cells during hypoxia and reoxygenation]. SHENG LI XUE BAO : [ACTA PHYSIOLOGICA SINICA] 1997; 49:249-54. [PMID: 9812807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Making use of an in vitro model of bovine aortic endothelial cell monolayers, the cell viability and changes of intracellukar calcium concentration of the preparation were submitted to hypoxia with or without reoxygenation. It was shown that the cell viability declined under hypoxia but increased under reoxygenation when the endothelial cells were incubated in calcium-free HBSS, as compared with control HBSS incubation. It was observed that a significant reduction of intracellular calcium from 99 to 69 nmol/L during 2 h of hypoxia, which was further decreased in Ca(2+)-free HBSS medium. After 4 h hypoxia followed by 40 min reoxygenation, [Ca2+]i recovered to the nomal concentration. It is speculated that the calcium homeostasis may be an important condition for cells to carry out normal function and either decrease or increase of [Ca2+]i may injury bovine aortic endothelial cells.
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97
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Chen LH, Yeong CT, Yeo GS. Three cases of fatal pulmonary embolism in obstetrics. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 1997; 26:356-9. [PMID: 9285032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We conducted a retrospective analysis of maternal deaths in our hospital from January 1992 to December 1995. Cases of fatal pulmonary embolism were identified and analysed with respect to their past history, antenatal and peripartum progress, clinical presentation and investigation. There were 7 maternal deaths during this period and autopsies were performed in all cases. Pulmonary embolism was the leading cause of maternal mortality, responsible for 3 deaths. The incidence of fatal pulmonary embolism was 4.9 per 100,000 maternities. One case occurred antepartum and 2 occurred postpartum. The antepartum case occurred after a period of immobilisation, and both postpartum cases occurred after emergency Caesarean sections. Dyspnoea and sudden cardiovascular collapse were the commonest presentations. Electrocardiograph and arterial blood gases were abnormal in both patients in whom the tests were performed. Death occurred within 11 hours of presentation of symptoms in all 3 cases. Pulmonary embolism was more common among our population than previously reported, and was the leading cause of maternal mortality in our institution over the last 4 years. Immobilisation and Caesarean section were the major risk factors. Identification of high risk situation, antithrombotic prophylaxis and a high degree of suspicion were the key to reducing the incidence of fatal pulmonary embolism in obstetric patients.
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98
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Chen LH, Liu ML, Hwang HY, Chen LS, Korenberg J, Shane B. Human methionine synthase. cDNA cloning, gene localization, and expression. J Biol Chem 1997; 272:3628-34. [PMID: 9013615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Human cDNAs for methionine synthase (5-methyltetrahydrofolate:L-homocysteine S-transmethylase; EC 2.1.1. 13) have been isolated from fetal and adult liver and HepG2 libraries. The cDNAs span 7.2 kilobases (kb) and consist of a 394-base pair upstream untranslated region, a 3795-base pair open reading frame encoding a 1265-residue 140.3-kDa protein, and about 3 kb of 3' region. The deduced protein sequence shares 53 and 63% identity with the Escherichia coli and the presumptive Caenorhabditis elegans proteins, respectively, and contains all residues implicated in B12 binding to the E. coli protein. Several potential polymorphisms and a cryptic splice deletion were detected in the coding region of the cDNAs. A polymorphism that results in a D919G modification in the protein is fairly common in human DNA samples. Northern analyses of poly(A) mRNA indicated two major species of about 8 and 10 kb in human tissues and some minor, partially spliced species. mRNA levels were highest in the pancreas, skeletal muscle, and heart of the adult and in the kidney in the fetus and were low in adult liver. Genomic clones were isolated and the 5' region was analyzed. Exon 1 is preceded by a number of potential promoter sites, including an E box, CAAT boxes, and a GC box, but this region lacks a TATA element. The human methionine synthase gene was localized to chromosome region 1q42.3-43 by in situ hybridization.
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99
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Stover PJ, Chen LH, Suh JR, Stover DM, Keyomarsi K, Shane B. Molecular cloning, characterization, and regulation of the human mitochondrial serine hydroxymethyltransferase gene. J Biol Chem 1997; 272:1842-8. [PMID: 8999870 DOI: 10.1074/jbc.272.3.1842] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The human mitochondrial serine hydroxymethyltransferase (mSHMT) gene was isolated, sequenced, and characterized. The 4.5-kilobase gene contains 10 introns and 11 exons, with all splice junctions conforming to the GT/AG rule. The 5' promoter region contains consensus motifs for several regulatory proteins including PEA-3, Sp-1, AP-2, and a CCCTCCC motif common to many genes expressed in liver. Consensus TATA or CAAT sequence motifs are not present, and primer extension and 5'-rapid amplification of cDNA ends studies suggest that transcription initiation occurs at multiple sites. The mitochondrial leader sequence region of the deduced mRNA contains two potential ATG start sites, which are encoded by separate exons. The intervening 891-base pair intron contains consensus promoter elements suggesting that mSHMT may be transcribed from alternate promoters. 5'-Rapid amplification of cDNA ends analysis demonstrated that the first ATG is transcribed in human MCF-7 cells. However, transfection of Chinese hamster ovary cells deficient in mSHMT activity with the human mSHMT gene lacking exon 1 overcame the cell's glycine auxotrophy and restored intracellular glycine concentrations to that observed in wild-type cells, showing that exon 1 is not essential for mSHMT localization or activity and that translation initiation from the second ATG is sufficient for mSHMT import into the mitochondria. Mitochondrial SHMT mRNA levels in MCF-7 cells did not vary during the cell cycle and were not affected by the absence of glycine, serine, folate, thymidylate, or purines from the media.
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100
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Lee CH, Chen LH. A fast motion estimation algorithm based on the block sum pyramid. IEEE TRANSACTIONS ON IMAGE PROCESSING : A PUBLICATION OF THE IEEE SIGNAL PROCESSING SOCIETY 1997; 6:1587-1591. [PMID: 18282917 DOI: 10.1109/83.641419] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In this correspondence, a fast approach to motion estimation is presented. The algorithm uses the block sum pyramid to eliminate unnecessary search positions. It first constructs the sum pyramid structure of a block. Successive elimination is then performed hierarchically from the top level to the bottom level of the pyramid. Many search positions can be skipped from being considered as the best motion vector and, thus, the search complexity can be reduced. The algorithm can achieve the same estimation accuracy as the full search block matching algorithm with much less computation time.
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