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Abstract
We have reviewed the events of an inner-ear immune response. The perilymph contains antibody, presumably derived from the systemic circulation and CSF, which would allow for neutralization and help with opsonization and complement fixation. The endolymphatic sac contains immunocompetent cells capable of processing and presenting viral or bacterial antigen, potentiating the immune response, attacking the invaders directly or attacking infected cells, and developing immunoglobulin responses in situ. The early release of mediators such as IL-2 likely emanate from the endolymphatic sac and result in potentiation and regulation of the response and may assist in changes in the SMV, including expression of ICAM-1, which aid in the egress of immune cells from the systemic circulation. PMNs arrive first, followed by T cells and B cells, with secretion of specific antibody a relatively late event. Concomitant with the increase in cellular constituents is the formation of a dense extracellular matrix. The inner ear appears to have remarkable difficulty in clearing this matrix, ultimately resulting in ossification. The immune response is unfortunately deleterious to the inner ear, resulting in degeneration of the organ of Corti, stria vascularis, and spiral ganglion. Hearing loss is consistently seen following sterile and virally induced labyrinthitis. The inner ear also appears to be a target for autoimmune disease. While inner-ear damage has been described as part of non-organ-specific autoimmune disease, specific disease against the hearing apparatus is also likely. Experimental paradigms have allowed alterations of both the afferent and efferent limbs of this response; ultimately, with the hope that we can alter the course of the response and the subsequent damage in patients.
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Leong SL, Ma WC, Chen MC, Lau YT. Inhibition of protein synthesis by reduced K+ in cultured endothelial cells. CHINESE J PHYSIOL 1997; 40:143-8. [PMID: 9434890] [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
Total protein synthesis (as precipitable [3H] leucine incorporation) was determined under various experimental conditions to examine the relationship between cellular K+ and protein synthesis in human umbilical vein endothelial cells (HUVEC). We found that under normal external K+ concentration (5 mM), total protein synthesis was inhibited by cycloheximide and ouabain, with estimated values of IC50 of 0.41 microM and 0.60 mM, respectively. Cellular K+ concentrations were determined (102 +/- 4 mM for control cells) and found to be significantly increased (P < 0.01) by high external K+ (25 mM) and significantly decreased (P < 0.001) by low external K+ (0.5 mM) as well as by ouabain (2 mM). Under high external K+, total protein synthesis and the inhibitory responses of cycloheximide and ouabain were not altered. On the contrary, cellular K+ and protein synthesis were both further reduced by about half (P < 0.001) under low external K+. While ouabain further reduced cellular K+ by half (P < 0.001), protein synthesis was only slightly reduced (P < 0.05) under low external K+ and thus the relative reduction on protein synthesis was much less than that for cellular K+. These results indicate that while elevated intracellular K+ did not alter protein synthesis, reduced intracellular K+ correlated with a reduced cellular protein synthesis in HUVEC such that K+ may play a permissible role in the regulation of protein synthesis.
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103
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Chen MC, Guo GB, Chang KC. Paroxysmal atrial tachycardia with second-degree atrioventricular block. Cardiology 1997; 88:474-7. [PMID: 9286511 DOI: 10.1159/000177379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Paroxysmal atrial tachycardia with atrioventricular block usually indicates potentially dangerous overdigitalization, and serious heart disease is almost universally present. In this report, we describe a patient with a structurally normal heart who manifested spontaneously intra-atrial reentrant tachycardia with Wenckebach atrioventricular block in the absence of medications. In this patient, the longest atrial paced cycle length that induced atrioventricular nodal block was 390 ms, and the atrial cycle length during tachycardia ranged from 360 to 400 ms. The electrophysiologic study in our patient demonstrated that second-degree atrioventricular block during atrial tachycardia may occur in patients without structural heart diseases or taking any medication.
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Sheen-Chen SM, Chou CW, Chen MC, Chen FC, Chen YS, Chen JJ. Adenocarcinoma in the middle third of the stomach--an evaluation for the prognostic significance of clinicopathological features. HEPATO-GASTROENTEROLOGY 1997; 44:1488-94. [PMID: 9356878] [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/AIMS The prognosis of patients with gastric adenocarcinoma varies with the location of the tumor. Adenocarcinoma in the middle third of the stomach has been claimed to have a better outcome than those in other locations. However, there is still very limited information specifically regarding the prognostic factors which influence the survival time of patients with adenocarcinoma in the middle third of the stomach. This retrospective study was designed with the aim to evaluate and uncover the possible significant clinicopathological parameters for adenocarcinoma in the middle third of the stomach. METHODOLOGY Between 1986 and 1992, 363 patients underwent gastric resection for primary gastric adenocarcinoma at this hospital. Fifty-two (14.3%) of these patients were included in this study and they all met the following criteria: 1) tumor primarily located in the middle third of the stomach without distant metastases or peritoneal seeding, 2) undergoing curative resection and 3) undergoing R2 nodal dissection, at least. The clinicopathological findings were obtained by detailed review of the medical records and the histologic slides. All surviving patients were also contacted and their current conditions were recorded. RESULTS The overall 5-year survival rate (Kaplan-Meier method) was 42.5%. In univariate survival analysis by Kaplan-Meier method and long-rank test, serosal invasion (p < 0.01), lymph node metastasis (p < 0.01) and lymphatic involvement (p < 0.01) had an individual prognostic significance. When a multivariate analysis using Cox proportional hazards regression was performed, serosal invasion (P < 0.01) and lymphatic involvement (p < 0.05) appeared as the only two independent prognostic factors regarding long-term survival. When these 52 patients were categorized into patients with early gastric cancer (n = 10) and patients with advanced gastric cancer (n = 42), there was a significant difference (p < 0.01) between the survival rates (90.0% vs. 29.1%). When these tumors were further categorized into early gastric cancer (n = 10), early simulating advanced gastric cancer (n = 14) and Borrmann type advanced gastric cancer (n = 28), there were significant differences (P < 0.01 and P < 0.01, respectively) in 5-year overall survival rates between early gastric cancer (90.0%) and Borrmann type advanced gastric cancer (18.9%), also between early simulating advanced gastric cancer (52.5%) and Borrmann type advanced gastric cancer (18.9%). UICC stage also had significant influence (P < 0.01) on the survival rates. CONCLUSIONS Serosal invasion and lymphatic involvement are the significant, independent prognostic factors in predicting the survival rate of patients with adenocarcinoma in the middle third of the stomach. Since more advanced stage tumors usually carry a poorer prognosis, early detection is of extreme importance for improving the survival rate.
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Pavlovic D, van de Winkel M, van der Auwera B, Chen MC, Schuit F, Bouwens L, Pipeleers D. Effect of interferon-gamma and glucose on major histocompatibility complex class I and class II expression by pancreatic beta- and non-beta-cells. J Clin Endocrinol Metab 1997; 82:2329-36. [PMID: 9215315 DOI: 10.1210/jcem.82.7.4055] [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: 02/04/2023]
Abstract
Surface major histocompatibility complex (MHC) class I and class II expression by pancreatic islet cells is considered a local initiator or regulator of immune processes that can lead to diabetes. Locally released cytokines, in particular interferon-gamma, are known to stimulate MHC antigen expression by islet cells. The present study quantifies MHC expression in cultured pancreatic beta- and non-beta-cells from both rat and human organs. Interferon-gamma increased MHC class I expression in endocrine beta- and non-beta-cells as well as in pancreatic ductal cells. The cytokine induced a 6-fold increase in the MHC class I messenger ribonucleic acid levels in pancreatic beta-cells; this effect was 2-fold amplified in the presence of elevated glucose levels (20 mmol/L instead of 6 mmol/L). No MHC class II expression was observed in endocrine beta- or non-beta-cells; human, but not rat, ductal cells exhibited MHC class II expression that increased in the presence of interferon-gamma. These data indicate that the increase in beta-cell MHC class I expression described in the pancreata of diabetic patients may result from stimulated transcription after exposure to locally released interferon-gamma and/or to a hyperglycemic state. The association of human islets with ductal cells in which MHC class II expression is stimulated by interferon-gamma makes these cells potential participants in the autoimmune process in diabetes.
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Chen MC, Lee ML. [Marital status and life expectancy]. IN'GU MUNJE NONJIP = JOURNAL OF POPULATION STUDIES 1997:19-38. [PMID: 12222460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Chou FF, Sheen-Chen SM, Chen YS, Chen MC. Single and multiple pyogenic liver abscesses: clinical course, etiology, and results of treatment. World J Surg 1997; 21:384-8; discussion 388-9. [PMID: 9143569 DOI: 10.1007/pl00012258] [Citation(s) in RCA: 115] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A total of 483 patients with pyogenic liver abscess during the years 1986 to June 1995 were studied at Chang Gung Memorial Hospital in Kaohsiung: 343 were a single abscess and 140 were multiple abscesses. Males were predominantly affected by this disease. Abdominal pain was more frequent with the single abscess than with multiple abscesses, and jaundice was more frequent with multiple abscesses. Blood levels of alkaline phosphatase, bilirubin, and creatinine and the white blood cell count were significantly higher in patients with multiple abscesses than in those with a single abscess; and the hemoglobin level was higher with single abscesses. The single abscess was usually larger than 5 cm, and the multiple abscesses were usually smaller than 5 cm. The single abscess was always located on the right side (72%) and the multiple abscesses always on the right or both sides. Single abscesses mainly had a cryptogenic origin (58.9%) and multiple abscesses a biliary origin (45.0%). Liver aspirates revealed Klebsiella pneumoniae, Escherichia coli, Streptococcus, Bacteroides, Enterococcus, among others. K. pneumoniae was more often found in a single abscess and E. coli more often in multiple abscesses. Percutaneous catheter drainage and aspiration comprised the main treatment initially, and the failure rate with multiple abscesses was higher than that with single abscesses. Surgical intervention should be considered for multiple abscesses because of the underlying disease. The overall mortality with multiple abscesses (22.1%) was higher than that with a single abscess (12.8%). Partial hepatectomy produced a low mortality rate for both single and multiple abscesses and should be considered in the presence of severe hepatic destruction by an abscess or a stone.
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Chou FF, Sheen-Chen SM, Chen YS, Chen MC, Chen CL. Surgical treatment of cholangiocarcinoma. HEPATO-GASTROENTEROLOGY 1997; 44:760-5. [PMID: 9222685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS To report the results of surgical treatment of intrahepatic cholangiocarcinoma with different procedures and to find the factors that may affect the long-term survival. MATERIALS AND METHODS From 1987 to 1994, 57 patients with intrahepatic cholangiocarcinoma underwent laparotomy. Among them, resection was performed in 27 patients, operative drainage in 14 patients and biopsy only in 14 patients. The liver resections included 9 right lobectomies, 14 left lobectomies and 4 hilar resections. All specimens were stained with carcinoembryonic antigen (CEA) and HLA-DR monoclonal antibodies. RESULTS There were 7 postoperative mortalities, one in the resection group (1/27), two in the drainage group (2/14) and 4 in the biopsy group (4/14). Patients undergoing resection survived significantly longer (median, 8 months) (mean, 19 +/- 4 months) than patients undergoing drainage (median, 4 months) (mean, 6 +/- 2 months) and biopsy (median, 2 months) (mean, 3 +/- 1 months) (p < 0.01). After resection, univariate analysis showed that positive hiliar lymphnode was a poor prognostic sign and mucobilia was a good prognostic sign. Age, sex, size of tumors cell differentiation, clear margin, and positive HLA-DR and CEA had no effect on prognosis. CONCLUSION The results support the surgical resection of intrahepatic cholangiocarcinoma. Tumor free margin should be aggressively achieved but may not be necessary. Mucobilia is a good prognostic sign and positive hilar lymphnode is a grave sign.
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Lehmann LS, Brancati FL, Chen MC, Roter D, Dobs AS. The effect of bedside case presentations on patients' perceptions of their medical care. N Engl J Med 1997; 336:1150-5. [PMID: 9099660 DOI: 10.1056/nejm199704173361606] [Citation(s) in RCA: 153] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Concern that case presentations at the bedside may make patients uncomfortable has led many residency programs to move presentations to the conference room. We performed a randomized, controlled trial of the effect of these two approaches on patients' perceptions of their care. METHODS The study patients were adults admitted to the general medical service of a teaching hospital. Four house-staff "firms" (each comprising teams of physicians) were randomly assigned to make their case presentations during morning rounds either at the patient's bedside or in a conference room for one week, to switch to the alternate site for a second week, and to return to the initial site for a third week. To assess patients' perceptions, a questionnaire was administered within 24 hours of admission. RESULTS During the three weeks of the study, 95 patients had bedside presentations and 87 patients had conference-room presentations. When the former were compared with the latter, the patients with bedside presentations reported that their doctors spent more time with them on morning rounds (10 vs. 6 minutes, P<0.001). The patients with bedside presentations were also somewhat more likely to report favorable perceptions of their inpatient care (range of adjusted odds ratios, 1.12 to 2.17), although none of the associations were statistically significant. Better-educated patients were less likely to report that physicians used confusing terminology and explained tests and medications inadequately than were patients who had not completed high school. CONCLUSIONS These data suggest that from the patient's perspective, bedside case presentations are at least as good as conference-room presentations, and perhaps preferable. When physicians make presentations at the bedside of less well educated patients, they should be especially careful to avoid medical jargon and to explain fully their plans for inpatient care.
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Chen MC, Hung JS, Chang KC, Lo PH, Chen YC, Fu M. Partially unroofed coronary sinus and persistent left superior vena cava: intracardiac echocardiographic observation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 1996; 15:875-879. [PMID: 8947865 DOI: 10.7863/jum.1996.15.12.875] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Unroofed coronary sinus, a rare congenital anomaly first described by Raghib and colleagues1 in 1965, is a result of an embryologic error involving imperfect or complete failure of development of the left atriovenous fold, which is manifested as a focal (fenestration or partial unroofing of the coronary sinus) or complete absence of the coronary sinus septum. Before the era of echocardiography, precise diagnosis of this anomaly was possible only during surgical procedure or at autopsy. Since the advent of the echocardiography, several studies have reported the usefulness of two-dimensional transthoracic and transesophageal echocardiography in the diagnosis of unroofed coronary sinus. We describe the intracardiac echocardiographic delineation of partially unroofed coronary sinus and persistent left superior vena cava in a patient with atrioventricular nodal reentrant tachycardia. Incidental finding of the dilated coronary sinus during radio frequency ablation of the tachycardia led to the diagnosis of this unusual anomaly.
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Chen MC, Brown MC, Willson RA, Nicholls S, Surawicz CM. Mesenteric vein thrombosis. Four cases and review of the literature. Dig Dis 1996; 14:382-9. [PMID: 9030470 DOI: 10.1159/000171572] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Mesenteric vein thrombosis, an uncommon but important clinical entity, can cause ischemia or infarction of the small intestine. Mesenteric vein thrombosis was first described nearly a century ago, but diagnosis remains difficult because it can affect young individuals without any known predisposing disorder and because patients often present with nonspecific abdominal symptoms. We report 4 cases of small intestinal ischemia secondary to superior mesenteric vein thrombosis. Three were due to hypercoagulable states (protein-S deficiency, factor-VII abnormalities) and one was idiopathic. In recent years, the development of modern imaging techniques (particularly ultrasonography, duplex scanning, and computed tomography) have enabled early recognition of this disease. Anticoagulation is therapeutic acutely unless there are signs of peritonitis which necessitate surgical resection of the infarcted bowel.
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Chou FF, Sheen-Chen SM, Chen YS, Chen MC, Chen CL. Postoperative morbidity and mortality of pancreaticoduodenectomy for periampullary cancer. THE EUROPEAN JOURNAL OF SURGERY = ACTA CHIRURGICA 1996; 162:477-81. [PMID: 8817225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To find out factors that may influence the mortality after Whipple's operation, whether duct to mucosa anastomosis is better than classic "dunking" pancreaticojejunostomy and whether age over 70 is a contraindication for this procedure. DESIGN Prospectively randomised study. SETTING Teaching hospital, Taiwan, R.O.C. PATIENTS 93 patients with periampullary cancer undergoing Whipple's operation were randomly divided into two groups. Forty-six with periampullary cancer underwent invaginating pancreaticojejunostomy, and 47 patients underwent duct to mucosa anastomosis for reconstruction. MAIN OUTCOME MEASURES Mortality and morbidity were compared between two groups. RESULTS The over all mortality was 8% (7/93). An albumin concentration of less than 30 g/L before operation and operative blood loss influenced the surgical mortality both in the univariate and multivariate analysis. Age over 70 years was not a factor. Patients with duct to mucosa anastomoses had a leak rate of 4% (2/47), morbidity of 21% (10/47) and mortality of 6% (3/47). Patients with an invaginated pancreaticojejunostomy had a leak rate of 15% (7/46), morbidity of 33% (15/46), and mortality of 9% (4/46). The need for total parenteral nutrition in the invaginated group (33%) was statistically greater than in the other group (11%) (p = 0.01). CONCLUSIONS The morbidity and mortality of pancreaticoduodenectomy for periampullary cancer although slightly greater for patients over the age of 70 are acceptable. The factors that may influence the mortality are an albumin concentration of less then 30 g/L and the amount of blood lost during operation. The duct to mucosa anastomosis is a safe procedure, which has a lower leak rate and less need for total parenteral nutrition than pancreaticojejunostomy.
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Lehmann FS, Golodner EH, Wang J, Chen MC, Avedian D, Calam J, Walsh JH, Dubinett S, Soll AH. Mononuclear cells and cytokines stimulate gastrin release from canine antral cells in primary culture. THE AMERICAN JOURNAL OF PHYSIOLOGY 1996; 270:G783-8. [PMID: 8967489 DOI: 10.1152/ajpgi.1996.270.5.g783] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Patients with Helicobacter pylori-associated gastritis have an increased release of gastrin. The mechanisms by which H. pylori affects the endocrine cells are unclear. We have used primary cultures containing canine antral G cells to examine the effects of human blood mononuclear cells, purified monocytes and lymphocytes, recombinant cytokines, and NH4Cl on gastrin release. Mononuclear cells and purified monocytes in direct contact with G cells stimulated gastrin release dose dependently. Separating mononuclear cells from G cells by Transwell filters with 0.4-micron pore size still produced a significant increase of gastrin release. Three human recombinant cytokines, interferon-gamma, tumor necrosis factor-alpha, and interleukin-2, but not interleukin-6 and interleukin-1 beta, each produced dose-dependent increases of gastrin stimulation. NH4Cl did not stimulate gastrin release. We conclude that mononuclear cells and purified monocytes prepared from human blood, as well as several cytokines, stimulate gastrin release from antral G cells. These factors may play an important role in the pathogenesis of H. pylori-associated hypergastrinemia.
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Chen MC, Fu M, Hung JS, Chua S, Yeh KH, Lo PH, Wu CJ. Atrial septal motion in effusive--constrictive pericarditis: transesophageal echocardiographic study and hemodynamic correlation. CHANGGENG YI XUE ZA ZHI 1995; 18:329-34. [PMID: 8851981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Transesophageal echocardiography was performed in 7 patients with effusive-constrictive pericarditis to analyze atrial septal motion(ASM). In 3 patients, the ASM was found to be normal with atrial septum (AS) moving toward the right atrium from ventricular mid-systole to early-diastole and toward the left atrium from mid-diastole to early-systole. Respiration had little effect on the ASM. In 2 patients, a brisk inversion of ASM toward the left atrium at ventricular early-to-mid systole was noted during inspiration. In the other 2 patients, a sustained ASM toward the left atrium during ventricular systole was found. In 4 of these 7 patients, hemodynamic studies were performed simultaneously with the transesophageal echocardiography. The ASM reflected the pressure gradient between the left atrium (as measured by pulmonary arterial wedge pressure) and the right atrium. The augmented ASM toward the left atrium occurred as left atrial pressure decreased markedly during inspiration. In conclusion, the ASM in patients with effusive-constrictive pericarditis showed 3 patterns: normal, sustained systolic motion toward the left atrium and a brisk systolic displacement toward the left atrium during inspiration. The ASM reflects changes in the interatrial pressure gradient.
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Chang MS, Chen MC, Chou FF, Sheen-Chen SM, Chen WJ. Spontaneous rupture of hepatobiliary cystadenoma: a case report. CHANGGENG YI XUE ZA ZHI 1995; 18:392-7. [PMID: 8851992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Hepatobiliary cystadenoma is a rare hepatic neoplasm which has a high tendency to recur and has malignant potential. We review the literature and report a case of intrahepatic cystadenoma presenting with abdominal pain and ascites following spontaneous rupture. Complete excision of the tumor offers the best chance of cure and avoids recurrence, secondary infection or malignant change.
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Lee N, Malacko AR, Ishitani A, Chen MC, Bajorath J, Marquardt H, Geraghty DE. The membrane-bound and soluble forms of HLA-G bind identical sets of endogenous peptides but differ with respect to TAP association. Immunity 1995; 3:591-600. [PMID: 7584149 DOI: 10.1016/1074-7613(95)90130-2] [Citation(s) in RCA: 245] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The class Ib antigen HLA-G is expressed as a membrane-bound protein like classical class Ia molecules (M.HLA-G) but, unlike typical class I, is also expressed as a soluble protein (S.HLA-G) with a unique C terminus. Our results show that, similar to classical class I proteins, the membrane-bound form of HLA-G associated with TAP, as evidenced by the ability to immunoprecipitate HLA-G class I heavy chain with TAP antisera. In contrast, the soluble G protein did not appear to associate with TAP in the same manner, since similar immunoprecipitation experiments failed to detect soluble G complex. A detailed analysis of peptides bound to the soluble and membrane HLA-G proteins expressed in the B lymphoblastoid cell line 721.221 showed that, like class Ia complexes, both HLA-G proteins consist of heavy and light chains complexed with nonameric peptides in a 1:1:1 ratio. The two proteins bind essentially the same set of peptides, which are derived from a variety of intracellular proteins and define a peptide motif for HLA-G. The peptides contain Leu at the C terminus and Pro or small hydrophobic amino acids in position 3 followed by Pro or Gly in position 4. The complexity of the bound peptides is lower than that found for some class Ia complexes, but is more similar to class Ia than to the limited repertoire of some murine class Ib molecules.
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Chen MC, Shih TT, Jiang CC, Su CT, Huang KM. MRI of meniscus and cruciate ligament tears correlated with arthroscopy. J Formos Med Assoc 1995; 94:605-11. [PMID: 8527960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Findings from magnetic resonance imaging (MRI) studies of 50 knees were retrospectively interpreted. The results were correlated with arthroscopic findings. Multiple pulse sequences were performed including sagittal double-echo, coronal T1-weighted and gradient echo, axial gradient echo or fat suppression imaging. Three-dimensional MRI was performed if there was a high suspicion of a tear of the anterior cruciate ligament. The individual positive predictive value, sensitivity, specificity and accuracy were calculated from the comparison between MRI and arthroscopic findings of the menisci, anterior cruciate ligament and posterior cruciate ligament. The following results were obtained: 1) Tears of the medial meniscus-positive predictive value, 72%; sensitivity, 87%; specificity, 86%; and accuracy, 86%. 2) Tears of the lateral meniscus-positive predictive value, 85%; sensitivity, 85%; specificity, 90%; and accuracy, 88%. 3) Tears of the anterior cruciate ligament-positive predictive value, 88%; sensitivity, 95%; specificity, 89%; and accuracy, 92%. 4) Tears of the posterior cruciate ligament-positive predictive value, 100%; sensitivity, 100%; specificity, 100%; and accuracy, 100%. It is concluded that MRI is a noninvasive and accurate method for detecting the internal derangement of the knee.
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Tsay MH, Chen MC, Jaung GY, Pang KK, Chen BF. Atypical skeletal tuberculosis mimicking tumor metastases: report of a case. J Formos Med Assoc 1995; 94:428-31. [PMID: 7549569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Skeletal tuberculosis (TB) generally involves the spine and large joints. Involvement of most other bones has been reported, but tuberculosis of the pubic symphysis is relatively unusual. This paper reports an unusual case of multiple bone lesions in the right symphysis, left sacroiliac joint and left elbow. The radiologic appearance simulated widespread metastatic disease or chondrosarcoma, but the diagnosis of tuberculosis was proven by biopsy and culture. Eight months after starting antituberculous treatment, the patient experienced an improvement in pain and limping gait, and felt well. Radiography of the pelvis also showed improvement. It is proposed that antituberculous therapy in such cases should be maintained for at least 1 year.
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Chen MC, Chen W, Su YC, Wu TH, Chang SJ, Lin LH, Wu KW. Breast-feeding counseling by a 24-hour telephone hot-line. ZHONGHUA MINGUO XIAO ER KE YI XUE HUI ZA ZHI [JOURNAL]. ZHONGHUA MINGUO XIAO ER KE YI XUE HUI 1995; 36:271-3. [PMID: 7572170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A 24-hour telephone hot-line functioning as a counseling service and case registry was included in a multi-faceted breast-feeding promotion program. The mothers could speak directly to especially trained staff members in a municipal hospital. All the questions were answered according to an "Answering Book" which included the anticipated question and the optimum answer. A total of 201 calls, which included 340 problems, were recorded from January 1, 1993 to October 31, 1993. Almost all the calls were made by the mothers (99%), and more than half (57.7%) of the mothers were primiparous. Most of the calls (79.6%) were made between 8 AM to 4 PM. The questions were frequently raised when the baby was aged 8 to 14 days (23.4%). The most frequently asked questions were: (1) insufficient milk? (14.1%), (2) frequent and loose stools? (13.2%), (3) weaning? (10.3%), (4) drugs? (6.8%), (5) additional formula or water? (6.2%), and (6) maternal contraindication? (6.2%). Although the impact of this telephone consultation could not be properly evaluated, the incidence of breast-feeding during hospital stay increased from 50% to 73.4%, and breast-feeding for more than 1 month increased from 22.7% to 42.2% before and after the whole promotion program. It is recommended that health care professionals provide more help when the mother leaves the hospital. A nation-wide toll-free telephone operated by the Department of Health to increase the chance of successful breast-feeding is also recommended.
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Chou FF, Sheen-Chen SM, Chen YS, Chen MC. Tracheolaryngectomy for papillary thyroid cancer. THE EUROPEAN JOURNAL OF SURGERY = ACTA CHIRURGICA 1995; 161:439-41. [PMID: 7548382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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121
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Chou FF, Sheen-Chen SM, Chen CL, Chen YS, Chen MC. Prognostic factors of resectable intrahepatic cholangiocarcinoma. J Surg Oncol 1995; 59:40-4. [PMID: 7745976 DOI: 10.1002/jso.2930590111] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Intrahepatic cholangiocarcinoma is a rare disease. The prognostic factors of resectable cholangiocarcinoma have not been previously reported. Nineteen patients (10M, 9F) with resectable cholangiocarcinoma were investigated to find factors that might influence prognosis. The cumulative survival rate was measured using the Kaplan-Meier method. The log-rank test was used to compare two survivals. Age, sex, tumor size, and positive tissue carcinoembryonic antigen were factors that had no influence on prognosis. Patients with a positive HLA-DR, a well-differentiated carcinoma, and a clear resective margin had better prognoses but were statistically undifferentiatable from the other patients. Patients with positive hilar lymph nodes had poor prognoses (P < 0.01), whereas patients with positive mucobilia had good prognoses (P < 0.05). Positive staining for HLA-DR on tumor cells was observed in nine of 19 cases of intrahepatic cholangiocarcinoma. The positive HLA-DR staining correlated with a better prognosis, but no significant difference was noted between the positive and negative HLA-DR staining group. A positive hilar lymph node was a grave sign, as almost all patients of positive lymph node died within 9 months after operation. Positive mucobilia was a good prognostic sign that correlated with the long-term survival.
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Chou FF, Chen CL, Sheen-Chen SM, Chen YS, Chen MC. Ultrasonic dissection in resection of hepatocellular carcinoma. Int Surg 1995; 80:105-7. [PMID: 8530221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
An ultrasonic dissector has been used in the resection of liver tumors and was found to be safe and efficient in noncirrhotic patients. Thirty-one (cirrhosis, 61%) liver resections for hepatoma treated with ultrasonic dissector were compared to 39 (cirrhosis, 74%) resections treated with finger fracture. We found that patients treated with an ultrasonic dissector versus those treated by finger fracture, had less blood loss (especially in cirrhotic liver), 836 +/- 593 cc vs 1348 +/- 1226 cc, more operative time, 337.6 +/- 100.5 min vs 197 +/- 92.8 min, more days of hospital stay 19.1 +/- 12.8 days vs 11.5 +/- 5.6 days and more days of removal of drains, 14.9 +/- 11.7 days vs 10.2 +/- 6.4 days. The morbidity, mortality, amount of blood transfusion and amount of drainage were quite similar between two groups.
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Chen MC, Tsai SD, Chen MR, Ou SY, Li WH, Lee KC. Effect of silver-nanoparticle aggregation on surface-enhanced Raman scattering from benzoic acid. PHYSICAL REVIEW. B, CONDENSED MATTER 1995; 51:4507-4515. [PMID: 9979295 DOI: 10.1103/physrevb.51.4507] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Chen MC, Redenius D, Osati-Ashtiani F, Fluck MM. Enhancer-mediated role for polyomavirus middle T/small T in DNA replication. J Virol 1995; 69:326-33. [PMID: 7983726 PMCID: PMC188579 DOI: 10.1128/jvi.69.1.326-333.1995] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
A major role for polyomavirus middle T/small T antigens in viral DNA synthesis was uncovered by examining the replication of middle T/small T-deficient mutants (hr-t mutants). hr-t mutants in the A2 genetic background showed a 16- to 100-fold defect in genome accumulation relative to the wild type when infections were carried out in exponentially growing NIH 3T3 cells in medium supplemented with low levels of serum (< 2.0%). A proportional decrease in the level of viral early transcripts was also seen. The replication defect of the hr-t mutants was partially overcome in the presence of the phorbol ester 12-O-tetradecanoylphorbol-13-acetate. The defect was also alleviated by a duplication encompassing the alpha core enhancer domain that contains binding sites for the transcriptional activators PEA1/AP-1 and PEA3/c-ets. Such a duplication is present in all naturally occurring hr-t mutants and absent in the A2 strain. The effects of 12-O-tetradecanoylphorbol-13-acetate and alpha core duplication were additive but did not fully complement the absence of middle T/small T. In mixed infection competition experiments with two hr-t mutants, a genome that carried an alpha core duplication had a replication advantage (up to 17-fold) over a genome without duplication. This result demonstrates that one effect of the duplication is exerted directly at the level of DNA replication. The advantage of the duplication-bearing genome was established during the earliest stages of replication and was not further amplified in later rounds of replication. In the presence of middle T/small T, both genomes replicated to high levels and the advantage of the duplication-bearing genome was eliminated. On the basis of these results, we propose that factors that bind the alpha core domain (presumably PEA1 and PEA3) are present in limiting amounts in exponentially growing NIH 3T3 cells and play a crucial role in polyomavirus DNA replication. We further suggest that middle T and/or small T stimulates viral DNA replication by activating these factors. The fact that all middle T-/small T-defective hr-t mutants have evolved to contain enhancer duplications that encompass the PEA1 and PEA3 binding sites in the alpha core domain and partially restore their replication defect (A. Amalfitano, M. C. Chen, and M. Fluck, unpublished data) provides an adequate explanation for the fact that the importance of the role of the middle T and/or small T function in DNA replication has not been recognized previously. Much evidence is available in support of separate elements of this model.(ABSTRACT TRUNCATED AT 400 WORDS)
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Chou FF, Sheen-Chen SM, Chen YS, Chen MC, Chen FC, Tai DI. Prognostic factors for pyogenic abscess of the liver. J Am Coll Surg 1994; 179:727-32. [PMID: 7952485 DOI: pmid/7952485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Percutaneous drainage and antibiotics for pyogenic abscess are well established therapeutic modalities. However, the mortality rate for hepatic abscess of liver remains high. STUDY DESIGN Three hundred fifty-two cases of pyogenic hepatic abscesses were studied to evaluate prognostic factors. RESULTS Using univariate analysis, the following factors were associated with a high mortality rate: patient age, gas-forming abscess, rupture of abscess, bilobe involvement, clinical sepsis, bilirubin (more than 2 mg per dL), blood urea nitrogen (more than 20 mg per dL), serum creatinine (more than 2 mg per dL), aspartate aminotransferase (more than 100 U per L), and albumin (less than 2.5 gm per dL). Using multivariate analysis, the following were independent significant factors in predicting mortality: patient age (more than 60 years), blood urea nitrogen (greater than 20 mg per dL), serum creatinine (greater than 2 mg per dL), total bilirubin (greater than 2 mg per dL), and albumin (less than 2.5 gm per dL). CONCLUSIONS Systemic effects of hepatic abscess with sepsis and multiple organ failure were significant factors in predicting mortality. Local findings, such as rupture of the abscesses, multiple abscesses, and gas-forming abscesses, were not independent factors. Percutaneous drainage is always considered if the condition of the patient can not be improved with antibiotic therapy. Operative treatment is indicated if the patient is unresponsive to medical treatment and percutaneous drainage or if the patient has complications of biliary tract stone or rupture of the abscess.
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