1
|
Pan JH, Lee MK, Chang MH, Crowley LN, Le BL, Lee DS, Kim TG, Kim D, Lee K, Ko SG, Lee JH, Lee SH, Kim JK. Optimized combination of Cervus nippon (Sika deer), Angelica (Dangui), and Rehmannia (Suk-jihwang) mitigates LPS-induced inflammation: exploring signaling pathways through plasma metabolomics. Food Sci Biotechnol 2024; 33:1671-1683. [PMID: 38623429 PMCID: PMC11016027 DOI: 10.1007/s10068-023-01476-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 10/01/2023] [Accepted: 10/12/2023] [Indexed: 04/17/2024] Open
Abstract
This study aimed to determine the optimal combination of three anti-inflammatory materials [i.e., Cervus nippon Temminck (CT), Angelica gigas Nakai (AN), and Rehmannia glutinosa (RG)] for the strongest anti-inflammatory potential. Eighteen combinations of the three materials were tested in LPS-stimulated RAW264.7 cells via assessing nitric oxide (NO). The best combination from in vitro studies was administered to LPS-treated C57BL/6J mice for five days. Subsequently, plasma metabolites were profiled by bioinformatics analyses and validations. As results, 2, 20, and 50 µg/mL of CT, AN, and RG (TM) were the most effective combination suppressing inflammation. In mice, TM mitigated hepatic inflammatory markers. Similarly, the metabolomics indicated that TM may suppress NF-κB signaling pathway, thereby alleviating hepatic inflammation. TM also decreased systemic and hepatic pro-inflammatory cytokines. Collectively, we found the optimal combination of TM for mitigating inflammation; thus further studies on safety, mechanisms, and clinical models are warranted for human applications. Supplementary Information The online version contains supplementary material available at 10.1007/s10068-023-01476-x.
Collapse
Affiliation(s)
- Jeong Hoon Pan
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19716 USA
- Department of Food and Nutrition, Chosun University, Gwangju, 61452 Republic of Korea
| | - Min Kook Lee
- Department of Food and Biotechnology, Korea University, 2511 Sejong-ro, Sejong, 30019 Republic of Korea
- BK21 FOUR Research Group for Omics-based Bio-health in Food Industry, Korea University, Sejong, Republic of Korea
| | - Moon Han Chang
- Department of Food and Biotechnology, Korea University, 2511 Sejong-ro, Sejong, 30019 Republic of Korea
- BK21 FOUR Research Group for Omics-based Bio-health in Food Industry, Korea University, Sejong, Republic of Korea
| | - Liana N. Crowley
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19716 USA
| | - Brandy L. Le
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19716 USA
| | - Da Seul Lee
- Agricultural Microbiology Division, National Institute of Agricultural Sciences, Rural Development Administration, Wanju, 55365 Republic of Korea
| | - Tae Gyun Kim
- The Bioinformatix Inc, Cheongju, 28674 Republic of Korea
| | - Dahye Kim
- Animal Genomics and Bioinformatics Division, National Institute of Animal Science, Rural Development Administration, Wanju, 55365 Republic of Korea
| | - Kangwook Lee
- Department of Food and Biotechnology, Korea University, 2511 Sejong-ro, Sejong, 30019 Republic of Korea
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 02447 Republic of Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 02447 Republic of Korea
| | - Jin Hyup Lee
- Department of Food and Biotechnology, Korea University, 2511 Sejong-ro, Sejong, 30019 Republic of Korea
- BK21 FOUR Research Group for Omics-based Bio-health in Food Industry, Korea University, Sejong, Republic of Korea
- Biological Clock-Based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea
| | - Suk Hee Lee
- Department of Food and Biotechnology, Korea University, 2511 Sejong-ro, Sejong, 30019 Republic of Korea
- BK21 FOUR Research Group for Omics-based Bio-health in Food Industry, Korea University, Sejong, Republic of Korea
- Biological Clock-Based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea
| | - Jae Kyeom Kim
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19716 USA
- Department of Food and Biotechnology, Korea University, 2511 Sejong-ro, Sejong, 30019 Republic of Korea
- Department of Behavioral Health and Nutrition, University of Delaware, 15 Innovation Way, Newark, DE 19711 USA
| |
Collapse
|
2
|
Hee Jo E, Eun Moon J, Han Chang M, Jin Lim Y, Hyun Park J, Hee Lee S, Rae Cho Y, Cho AE, Pil Pack S, Kim HW, Crowley L, Le B, Nukhet AB, Chen Y, Zhong Y, Zhao J, Li Y, Cha H, Hoon Pan J, Kyeom Kim J, Hyup Lee J. Sensitization of GSH synthesis by curcumin curtails acrolein-induced alveolar epithelial apoptosis via Keap1 cysteine conjugation: A randomized controlled trial and experimental animal model of pneumonitis. J Adv Res 2023; 46:17-29. [PMID: 35772713 PMCID: PMC10105072 DOI: 10.1016/j.jare.2022.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/09/2022] [Accepted: 06/23/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Epidemiological studies have reported an association between exposures to ambient air pollution and respiratory diseases, including chronic obstructive pulmonary disease (COPD). Pneumonitis is a critical driving factor of COPD and exposure to air pollutants (e.g., acrolein) is associated with increased incidence of pneumonitis. OBJECTIVES Currently available anti-inflammatory therapies provide little benefit against respiratory diseases. To this end, we investigated the preventive role of curcumin against air pollutant-associated pneumonitis and its underlying mechanism. METHODS A total of 40 subjects was recruited from Chengdu, China which is among the top three cities in terms of respiratory mortality related to air pollution. The participants were randomly provided either placebo or curcumin supplements for 2 weeks and blood samples were collected at the baseline and at the end of the intervention to monitor systemic markers. In our follow up mechanistic study, C57BL/6 mice (n = 40) were randomly allocated into 4 groups: Control group (saline + no acrolein), Curcumin only group (curcumin + no acrolein), Acrolein only group (saline + acrolein), and Acrolein + Curcumin group (curcumin + acrolein). Curcumin was orally administered at 100 mg/kg body weight once a day for 10 days, and then the mice were subjected to nasal instillation of acrolein (5 mg/kg body weight). Twelve hours after single acrolein exposure, all mice were euthanized. RESULTS Curcumin supplementation, with no noticeable adverse responses, reduced circulating pro-inflammatory cytokines in association with clinical pneumonitis as positive predictive while improving those of anti-inflammatory cytokines. In the pre-clinical study, curcumin reduced pneumonitis manifestations by suppression of intrinsic and extrinsic apoptotic signaling, which is attributed to enhanced redox sensing of Nrf2 and thus sensitized synthesis and restoration of GSH, at least in part, through curcumin-Keap1 conjugation. CONCLUSIONS Our study collectively suggests that curcumin could provide an effective preventive measure against air pollutant-enhanced pneumonitis and thus COPD.
Collapse
Affiliation(s)
- Eun Hee Jo
- Toxicological Evaluation and Research Department, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju, Republic of Korea; Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea
| | - Ji Eun Moon
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea; BK21 FOUR Research Group for Omics-based Bio-health in Food Industry, Korea University, Sejong, Republic of Korea; Biological Clock-based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea
| | - Moon Han Chang
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea; BK21 FOUR Research Group for Omics-based Bio-health in Food Industry, Korea University, Sejong, Republic of Korea; Biological Clock-based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea
| | - Ye Jin Lim
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea; Health Functional Food Policy Division, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju, Republic of Korea
| | - Jung Hyun Park
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea; Division of Brain Disease Research, Department of Chronic Disease Convergence Research, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Suk Hee Lee
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea; Biological Clock-based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea
| | - Young Rae Cho
- Biological Clock-based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea; Department of Bioinformatics, Korea University, Sejong, Republic of Korea
| | - Art E Cho
- Biological Clock-based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea; Department of Bioinformatics, Korea University, Sejong, Republic of Korea
| | - Seung Pil Pack
- Biological Clock-based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea; Department of Bioinformatics, Korea University, Sejong, Republic of Korea
| | | | - Liana Crowley
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Brandy Le
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Aykin-Burns Nukhet
- Department of Pharmaceutical Sciences, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Yinfeng Chen
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, Sichuan Agricultural University, Chengdu, China
| | - Yihang Zhong
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, China
| | - Jiangchao Zhao
- Department of Animal Science, University of Arkansas, Fayetteville, AR, USA
| | - Ying Li
- Guangdong Provincial Key Laboratory of Animal Molecular Design and Precise Breeding, Foshan University, Foshan, China
| | - Hanvit Cha
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea; BK21 FOUR Research Group for Omics-based Bio-health in Food Industry, Korea University, Sejong, Republic of Korea; Biological Clock-based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea
| | - Jeong Hoon Pan
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA
| | - Jae Kyeom Kim
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, USA.
| | - Jin Hyup Lee
- Department of Food and Biotechnology, Korea University, Sejong, Republic of Korea; BK21 FOUR Research Group for Omics-based Bio-health in Food Industry, Korea University, Sejong, Republic of Korea; Biological Clock-based Anti-aging Convergence RLRC, Korea University, Sejong, Republic of Korea; Institutes of Natural Sciences, Korea University, Sejong, Republic of Korea.
| |
Collapse
|
3
|
Yu WS, Chang MH, Lee HL, Lee YT, Tsai MC, Wang CC. Recurrent umbilical varix rupture with hemoperitoneum: a case report and review of literature. BMC Gastroenterol 2022; 22:160. [PMID: 35365084 PMCID: PMC8973573 DOI: 10.1186/s12876-022-02167-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Background Non-traumatic hemoperitoneum was a rare event with the risk of sudden death. Spontaneous rupture of hepatocellular carcinoma is the most intuitive diagnosis when hemoperitoneum occurs in cirrhotic patients who are not regularly followed up. However, other etiologies of hemoperitoneum, such as intra-abdominal varix rupture, should be kept in mind.
Case presentation A 44-year-old man with alcoholic liver cirrhosis, Child–Pugh B was sent to our emergency department (ED) because of recurrent abdominal pain and hypovolemic shock. He had similar symptoms one month ago and was diagnosed as hepatocellular carcinoma (HCC) rupture with hemoperitoneum, therefore he underwent trans-arterial embolization (TAE). However, the follow-up magnetic resonance imaging (MRI) showed less possibility of hepatocellular carcinoma. Contrast enhanced abdominal computed tomography (CT) showed possible umbilical vein contrast agent extravasation. Exploratory laparotomy confirmed the diagnosis of rupture umbilical varix with hemoperitoneum. Conclusion Although umbilical varix rupture is a rare cause of hemoperitoneum, it should be kept in mind in cirrhotic patients with unexplained hemoperitoneum. Supplementary Information The online version contains supplementary material available at 10.1186/s12876-022-02167-3.
Collapse
Affiliation(s)
- W S Yu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - M H Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - H L Lee
- Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Y T Lee
- Infection Control, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - M C Tsai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - C C Wang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan. .,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| |
Collapse
|
4
|
Kim JW, Jo EH, Moon JE, Cha H, Chang MH, Cho HT, Lee MK, Jung WS, Lee JH, Heo W, Kim YJ. In Vitro and In Vivo Inhibitory Effect of Citrus Junos Tanaka Peel Extract against Oxidative Stress-Induced Apoptotic Death of Lung Cells. Antioxidants (Basel) 2020; 9:E1231. [PMID: 33291640 PMCID: PMC7761914 DOI: 10.3390/antiox9121231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/27/2022] Open
Abstract
Various stresses derived from both internal and external oxidative environments lead to the excessive production of reactive oxygen species (ROS) causing progressive intracellular oxidative damage and ultimately cell death. The objective of this study was to evaluate the protective effects of Citrus junos Tanaka peel extract (CE) against oxidative-stress induced the apoptosis of lung cells and the associated mechanisms of action using in vitro and in vivo models. The protective effect of CE was evaluated in vitro in NCI-H460 human lung cells exposed to pro-oxidant H2O2. The preventive effect of CE (200 mg/kg/day, 10 days) against pulmonary injuries following acrolein inhalation (10 ppm for 12 h) was investigated using an in vivo mouse model. Herein, we demonstrated the inhibitory effect of CE against the oxidative stress-induced apoptosis of lung cells under a highly oxidative environment. The function of CE is linked with its ability to suppress ROS-dependent, p53-mediated apoptotic signaling. Furthermore, we evaluated the protective role of CE against apoptotic pulmonary injuries associated with the inhalation of acrolein, a ubiquitous and highly oxidizing environmental respiratory pollutant, through the attenuation of oxidative stress. The results indicated that CE exhibits a protective effect against the oxidative stress-induced apoptosis of lung cells in both in vitro and in vivo models.
Collapse
Affiliation(s)
- Jin Woo Kim
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
| | - Eun Hee Jo
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
| | - Ji Eun Moon
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
| | - Hanvit Cha
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
| | - Moon Han Chang
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
| | - Hyung Taek Cho
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
| | - Min Kook Lee
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
| | - Wan Sik Jung
- Immunotech, Inc., Cheonan-si, Chungnam 31094, Korea;
| | - Jin Hyup Lee
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
- Institutes of Natural Sciences, Korea University, Sejong 8244, Korea
| | - Wan Heo
- Institutes of Natural Sciences, Korea University, Sejong 8244, Korea
| | - Young Jun Kim
- Department of Food and Biotechnology, Korea University, Sejong 8244, Korea; (J.W.K.); (E.H.J.); (J.E.M.); (H.C.); (M.H.C.); (H.T.C.); (M.K.L.)
| |
Collapse
|
5
|
Chae JM, Chang MH, Heo W, Cho HT, Lee DH, Hwang BB, Kim JW, Yoon SM, Yang S, Lee JH, Kim YJ. LB-9, Novel Probiotic Lactic Acid Bacteria, Ameliorates Dextran Sodium Sulfate-Induced Colitis in Mice by Inhibiting TNF-α-Mediated Apoptosis of Intestinal Epithelial Cells. J Med Food 2019; 22:271-276. [DOI: 10.1089/jmf.2018.4236] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Jung Min Chae
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| | - Moon Han Chang
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| | - Wan Heo
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| | - Hyung Taek Cho
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| | - Dong Hun Lee
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| | - Bo Byeol Hwang
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| | - Jin Woo Kim
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| | | | | | - Jin Hyup Lee
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| | - Young Jun Kim
- Department of Food and Biotechnology, Korea University, Sejong, Korea
| |
Collapse
|
6
|
Kim JH, Yu SH, Cho YJ, Pan JH, Cho HT, Kim JH, Bong H, Lee Y, Chang MH, Jeong YJ, Choi G, Kim YJ. Preparation of S-Allylcysteine-Enriched Black Garlic Juice and Its Antidiabetic Effects in Streptozotocin-Induced Insulin-Deficient Mice. J Agric Food Chem 2017; 65:358-363. [PMID: 28001066 DOI: 10.1021/acs.jafc.6b04948] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
S-Allylcysteine (SAC), produced in large amounts during the aging process of garlic via enzymatic hydrolysis, is known as a key compound responsible for the multiple pharmacological activities of aged black garlic. This study investigated the effects of enzyme- and high hydrostatic pressure (HHP)-assisted extraction on the content of the bioactive compounds, including SAC, in black garlic juice (BGJ) and evaluated the antidiabetic effects of SAC-enriched BGJ in streptozotocin (STZ)-treated mice. The aging process increased the contents of SAC, total polyphenols, and total flavonoids in garlic juice. More importantly, pretreatment of pectinase cocktail with HHP resulted in a greater increase in those compounds during aging. Enzyme-treated BGJ reduced hyperglycemia and improved islet architecture and β-cell function in STZ-treated mice. Moreover, these effects were more potent than those of BGJ prepared by the conventional aging process. These findings provide useful information for the production of black garlic with improved bioactivities.
Collapse
Affiliation(s)
- Jun Ho Kim
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Su Hyun Yu
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Yun Jeong Cho
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Jeong Hoon Pan
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Hyung Taek Cho
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Jeong Ho Kim
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Hyejin Bong
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Yeojin Lee
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Moon Han Chang
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Ye Jin Jeong
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Garam Choi
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| | - Young Jun Kim
- Department of Food and Biotechnology, Korea University , Sejong 30019, Republic of Korea
| |
Collapse
|
7
|
Akinci A, Al Shaker M, Chang MH, Cheung CW, Danilov A, José Dueñas H, Kim YC, Guillen R, Tassanawipas W, Treuer T, Wang Y. Predictive factors and clinical biomarkers for treatment in patients with chronic pain caused by osteoarthritis with a central sensitisation component. Int J Clin Pract 2016; 70:31-44. [PMID: 26558538 PMCID: PMC4738415 DOI: 10.1111/ijcp.12749] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AIMS The aim of this non-systematic review was to provide a practical guide for clinicians on the evidence for central sensitisation in chronic osteoarthritis (OA) pain and how this pain mechanism can be addressed in terms of clinical diagnosis, investigation and treatment. METHODS The authors undertook a non-systematic review of the literature including a MEDLINE search (search terms included central sensitisation, osteoarthritis, osteoarthrosis) for relevant and current clinical studies, systematic reviews and narrative reviews. Case reports, letters to the editor and similar literature sources were excluded. Information was organised to allow a pragmatic approach to the discussion of the evidence and generation of practical recommendations. RESULTS There is good evidence for a role of central sensitisation in chronic OA pain in a subgroup of patients. Clinically, a central sensitisation component in chronic OA pain can be suspected based on characteristic pain features and non-pain features seen in other conditions involving central sensitisation. However, there are currently no diagnostic inventories for central sensitisation specific to OA. Biomarkers may be helpful for confirming the presence of central sensitisation, especially when there is diagnostic uncertainty. Several non-pharmacological and pharmacological treatments may be effective in OA patients with central sensitisation features. Multimodal therapy may be required to achieve control of symptoms. DISCUSSION Clinicians should be aware of central sensitisation in patients with chronic OA pain, especially in patients presenting with severe pain with unusual features.
Collapse
Affiliation(s)
- A Akinci
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Hacettepe University, Ankara, Turkey
| | - M Al Shaker
- King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia
| | - M H Chang
- Taichung Veterans General Hospital, Taichung, Taiwan
| | - C W Cheung
- Department of Anaesthesiology, Laboratory and Clinical Research Institute for Pain, The University of Hong Kong, Hong Kong, China
| | - A Danilov
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Y C Kim
- Seoul National University School of Medicine, Pain Management Center of the Seoul National University Hospital, Seoul, Korea
| | - R Guillen
- Pain Clinic, National Cancer Institute, México DF, México
| | - W Tassanawipas
- Department of Orthopaedics, Phramongkutklao Army Hospital, Bangkok, Thailand
| | - T Treuer
- Eli Lilly and Co, Budapest, Hungary
| | - Y Wang
- Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
8
|
Chang JW, Chen CY, Yan BR, Chang MH, Tseng SH, Kao YM, Chen JC, Lee CC. Cumulative risk assessment for plasticizer-contaminated food using the hazard index approach. Environ Pollut 2014; 189:77-84. [PMID: 24631976 DOI: 10.1016/j.envpol.2014.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2013] [Revised: 02/05/2014] [Accepted: 02/07/2014] [Indexed: 06/03/2023]
Abstract
Phthalates strongly and adversely affect reproduction, development and liver function. We did a cumulative risk assessment for simultaneous exposure to nine phthalates using the hazard index (HI) and the levels of nine phthalates in 1200 foodstuff samples. DEHP (di-2-ethylhexyl phthalate) present the highest level (mean: 0.443 mg/kg) in 1200 samples, and the highest average daily dose (ADD) was found in DEHP, ΣDBP(i + n) (the sum of dibutyl phthalate [DBP] isomers [DnBP + DiBP]) posed the highest risk potential of all the phthalates. In seven phthalates, the 95th percentiles of the ADDs for ΣDBP(i + n) in 0-6-yr-old children accounted for 91% (79-107%) of the tolerable daily intake, and the 95th percentiles of the HIs for the anti-androgenic effects of five phthalates in 0-3-yr-old children and 4-6-yr-old girls were >1. We conclude that the health of younger Taiwanese may be adversely affected by overexposure of phthalate-contaminated foods.
Collapse
Affiliation(s)
- J W Chang
- Research Center for Environmental Trace Toxic Substances, National Cheng Kung University, Tainan, Taiwan
| | | | - B R Yan
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan
| | - M H Chang
- Food and Drug Administration, Ministry of Health and Welfare, Executive Yuan, Taiwan
| | - S H Tseng
- Food and Drug Administration, Ministry of Health and Welfare, Executive Yuan, Taiwan
| | - Y M Kao
- Food and Drug Administration, Ministry of Health and Welfare, Executive Yuan, Taiwan
| | - J C Chen
- Department of Food Science and Nutrition, Meiho University, Pingtung, Taiwan
| | - C C Lee
- Research Center for Environmental Trace Toxic Substances, National Cheng Kung University, Tainan, Taiwan; Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
| |
Collapse
|
9
|
Liang SM, Chang MH, Yang ZY. Development and performance evaluation of an electromagnetic-type shock wave generator for lipolysis. Rev Sci Instrum 2014; 85:015113. [PMID: 24517818 DOI: 10.1063/1.4861178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study aims at the design and development of electromagnetic-type intermittent shock wave generation in a liquid. The shock wave generated is focused at a focal point through an acoustic lens. This hardware device mainly consists of a full-wave bridge rectifier, 6 capacitors, a spark gap, and a flat coil. A metal disk is mounted in a liquid-filled tube and is placed in close proximity to the flat coil. Due to the repulsive force existing between the coil and disk shock waves are generated, while an eddy current is induced in the metal disk. Some components and materials associated with the device are also described. By increasing the capacitance content to enhance electric energy level, a highly focused pressure can be achieved at the focal point through an acoustic lens in order to lyse fat tissue. Focused pressures were measured at the focal point and its vicinity for different operation voltages. The designed shock wave generator with an energy intensity of 0.0016 mJ/mm(2) (at 4 kV) and 2000 firings or higher energy intensities with 1000 firings is found to be able to disrupt pig fat tissue.
Collapse
Affiliation(s)
- S M Liang
- Department of Industrial Design, Far East University, No. 49, Zhonghua Road, Xinshi District, Tainan City 744, Taiwan
| | - M H Chang
- Department of Aeronautics and Astronautics, National Cheng Kung University, No. 1, University Road, East District, Tainan City 701, Taiwan
| | - Z Y Yang
- Department of Industrial Design, Far East University, No. 49, Zhonghua Road, Xinshi District, Tainan City 744, Taiwan
| |
Collapse
|
10
|
Chang MH, Tsai FH, Chou SJ, Wang JH, Lo DY, Zheng ZZ, Chan KW, Lai JM. Positive influence of L-carnitine on the different muscle fibres types of racing pigeons. J Anim Physiol Anim Nutr (Berl) 2013; 98:739-46. [PMID: 24164218 DOI: 10.1111/jpn.12135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 09/16/2013] [Indexed: 11/29/2022]
Abstract
Succinate dehydrogenase (SDH), Ca(2+) ATPase, Lactate dehydrogenase (LDH), are involved in energy metabolism. These enzymes can be used as indicators of the energy capacity of aerobic cells. The study investigated the effects of L-carnitine supplementation on M. pectoralis superficialis, M. pectoralis profundus, M. extensor carpi radialis muscle and M. flexor carpi ulnaris. Twenty-eight racing pigeons hatched at the same time were divided randomly into three groups. Eight pigeons, which were used as the control group, were sacrificed at 92-day old. The remaining twenty pigeons continued training until they reached 157-day old, with half the pigeons getting 25 mg/head/day of L-carnitine, while the other half given the same amount of water. The pigeons were assessed by histochemical methods and reverse transcription polymerase chain reaction (RT-PCR). To assess influence of L-carnitine on muscle fibre composition and the performance of three genes' mRNA, this study applied SDH localization, SDH, Ca(2+) ATPase and LDH mRNA expression to examine the results after oral administration of L-carnitine in vivo in racing pigeons. The results showed that L-carnitine significantly elevated the amount of white muscle fibre type IIa (p < 0.05). The mRNA expression quantities of SDH and LDH gene was higher via RT-PCR method. However, the expression of Ca(2+) ATPase remains similar. In conclusion, appropriate oral administration of L-carnitine of 25 mg/pigeon/day will result in an improvement of muscles related to flying.
Collapse
Affiliation(s)
- M H Chang
- Department of Veterinary Medicine, College of Agriculture, National Chiayi University, Chiayi City, Taiwan, China
| | | | | | | | | | | | | | | |
Collapse
|
11
|
|
12
|
Tsai MC, Chen TH, Chang MH, Chen TY, Lin CC. Gallbladder perforation with formation of hepatic subcapsular biloma, treated with endoscopic nasobiliary drainage. Endoscopy 2010; 42 Suppl 2:E206-7. [PMID: 20845274 DOI: 10.1055/s-0030-1255709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- M C Tsai
- Department of Internal Medicine, Chung Shan Medical University Hospital and Institute of Medicine of Chung Shan Medical University, Taichung, Taiwan
| | | | | | | | | |
Collapse
|
13
|
King M, Poya H, Rao J, Natarajan S, Butch AW, Aziz N, Kok S, Chang MH, Lyons JM, Ault K, Kelly KA. CXCL13 expression in Chlamydia trachomatis infection of the female reproductive tract. Drugs Today (Barc) 2009; 45 Suppl B:125-134. [PMID: 20011704 PMCID: PMC3319045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Chlamydia trachomatis is the most common cause of acute salpingitis worldwide. The socioeconomic impact of sexually transmitted infections (STI) caused by C. trachomatis is considerable. The purpose of this study was to investigate secretion of a unique chemokine, CXCL13, during the inflammatory process in human fallopian tube tissue in response to infection with C. trachomatis. We employed two models for our experiments: archived fallopian tube paraffin sections from known cases of salpingitis of unknown etiology and human fallopian tube organ culture established from fresh fallopian tube biopsies subsequently infected in vitro with C. trachomatis serovar E. We used immunohistochemistry, microarray analysis and cytometric bead array to study these specimens. In both models, we found that the fallopian tissue infected with C. trachomatis expressed CXCL13 and other characteristics of tertiary lymphoid tissue. In addition, we found that CXCL13 was expressed in multiple cell types, including endothelial cells, demonstrating a mechanism for the lymphoid aggregation seen in fallopian tube tissue during salpingitis and infection with C. trachomatis.
Collapse
Affiliation(s)
- M King
- Division of Neonatology, Department of Pediatrics, David Geffen UCLA Medical Center, Los Angeles, California, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Kim SJ, Oh SY, Hong JY, Chang MH, Lee DH, Huh J, Ko YH, Ahn YC, Kim HJ, Suh C, Kim K, Kim WS. When do we need central nervous system prophylaxis in patients with extranodal NK/T-cell lymphoma, nasal type? Ann Oncol 2009; 21:1058-63. [PMID: 19850636 DOI: 10.1093/annonc/mdp412] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The incidence and risk factors of central nervous system (CNS) invasion is still unclear in extranodal natural killer (NK)/T-cell lymphoma, nasal type. PATIENTS AND METHODS We analyzed 208 patients to study the clinical features and outcomes of CNS disease in extranodal NK/T-cell lymphoma. RESULTS Twelve patients (5.76%, 12/208) experienced CNS disease during treatment or follow-up period (median 11.62 months, range 0.2-123.2 months). The clinical variables associated with CNS disease were Ann Arbor stage III/IV (15.87%, P <0.001), regional lymph node involvement (10.41%, P = 0.006), group III/IV of NK/T-cell lymphoma prognostic index (NKPI; 10.20%, P = 0.003), high/high-intermediate international prognostic index (9.30%, P = 0.072) and extra-upper aerodigestive primary sites (9.75%, P = 0.008). In multivariate analysis, NKPI retained the strongest statistical power to predict CNS disease (P = 0.007, relative risk 9.289, 95% confidence interval 1.828-47.212) in extranodal NK/T-cell lymphoma. CONCLUSIONS Despite extranodal NK/T-cell lymphoma frequently involves paranasal sinus, a routine CNS evaluation and prophylaxis do not seem to be necessary in NKPI group I or II patients due to a very low incidence. Nevertheless, CNS prophylaxis should be considered in NKPI groups III and IV.
Collapse
Affiliation(s)
- S J Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
Bromism, chronic bromide intoxication, can be caused by a variety of medicines, but bromism due to pain-relieving injectable medications has not been reported. In this study, the methods used were internet searching on bromide-containing injectables available in Taiwan and the first case report of bromism due to mixed-formulated injectable medication. Many analgesic/antipyretic and antihistamine injections containing bromides are still being used in Taiwan. They contain sodium bromide up to 1000 mg/ampoule or calcium bromide up to 800 mg/amp. A 25-year-old female suffered from forgetfulness and unstable gait after long-term frequent injections of a preparation to relieve head and neck pain. Blood tests showed hyperchloremia (171 mEq/L) and a negative anion gap (-48.7 mEq/L). Serum bromide measured 2150 mg/L. She recovered completely in 3 days with saline treatment. Many bromide-containing injections are still being used in Taiwan. Clinicians should keep alert on this issue to avoid iatrogenic bromism or making misdiagnoses.
Collapse
Affiliation(s)
- P F Hsieh
- Department of Internal Medicine, Division of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
| | | | | | | | | | | |
Collapse
|
16
|
Chang MH, Frampton MJ, Anderson HL, Herz LM. Intermolecular interaction effects on the ultrafast depolarization of the optical emission from conjugated polymers. Phys Rev Lett 2007; 98:027402. [PMID: 17358647 DOI: 10.1103/physrevlett.98.027402] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2006] [Indexed: 05/14/2023]
Abstract
We have investigated the effect of interchain interactions on the ultrafast depolarization of the photoluminescence from solid films of a conjugated polymer. Accurate control was exercised over the interchain separation by threading of the conjugated chains with insulating macrocycles or complexation with an inert host polymer. Our measurements indicate that excitation into the higher electronic states of a chain aggregate is followed by a fast (<100 fs) relaxation into lower excited states with an associated rotation of the transition dipole moment. These findings emphasize the need for consideration of initial excitonic delocalization across more than one polymeric chain.
Collapse
Affiliation(s)
- M H Chang
- Clarendon Laboratory, University of Oxford, Parks Road, Oxford OX1 3PU, United Kingdom
| | | | | | | |
Collapse
|
17
|
Lee YC, Chang MH, Lin KP, Soong BW. Gene symbol: MPZ. Disease: Charcot-Marie-Tooth disease type 1B. Hum Genet 2005; 118:547-8. [PMID: 16521307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Affiliation(s)
- Y C Lee
- Section of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan 00407 (ROC)
| | | | | | | |
Collapse
|
18
|
Chen JT, Chang MH, Chung LL, Cheng YC. Comment on "Eigenmode analysis of arbitrarily shaped two-dimensional cavities by the method of point matching". J Acoust Soc Am 2002; 111:33-36. [PMID: 11831805 DOI: 10.1121/1.1410966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
|
19
|
Ni YH, Chang MH, Huang LM, Chen HL, Hsu HY, Chiu TY, Tsai KS, Chen DS. Hepatitis B virus infection in children and adolescents in a hyperendemic area: 15 years after mass hepatitis B vaccination. Ann Intern Med 2001; 135:796-800. [PMID: 11694104 DOI: 10.7326/0003-4819-135-9-200111060-00009] [Citation(s) in RCA: 265] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) infection is hyperendemic in Taiwan. Before universal HBV immunization was started in Taiwan in 1984, the carrier rate for hepatitis B surface antigen (HBsAg) was 15% to 20% in the general population. OBJECTIVE To quantify the population impact of a mass vaccination program for HBV 15 years after its implementation. DESIGN Descriptive analysis of serologic markers of HBV in healthy children and adolescents. SETTING Chung-Cheng District, Taipei City, Taiwan, in 1999. PARTICIPANTS 1357 persons younger than 15 years of age, who were born after the implementation of universal HBV vaccination, and 559 persons 15 to 20 years of age, who were born before the program began. MEASUREMENTS Repeated serologic surveys similar to those done before and 5 and 10 years after the national vaccination program was implemented. All participants were tested for serum HBsAg, its antibody (anti-HBs), and hepatitis B core antibody (anti-HBc). RESULTS During the 15 years since the vaccination program was implemented, the prevalence of HBsAg among persons younger than 15 years of age decreased from 9.8% in 1984 to 0.7% in 1999; among persons 15 to 20 years of age, the 1999 prevalence of HBsAg was 7% (P < 0.001). Hepatitis B core antibody seropositivity, which represents HBV infection, was found in 2.9% of persons younger than 15 years of age and in 20.6% of persons 15 to 20 years of age (P < 0.001); in the same age groups, the rate of anti-HBs seropositivity was 75.8% and 70.7%, respectively (P = 0.02). CONCLUSIONS Universal vaccination significantly decreased the HBV carrier rate and infection rate among children and adolescents born since the program began. By decreasing the carrier pool, continuation of the national HBV immunization program should prevent HBV infection in the children of Taiwan, and, subsequently, adults as well.
Collapse
Affiliation(s)
- Y H Ni
- National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Kelly KA, Natarajan S, Ruther P, Wisse A, Chang MH, Ault KA. Chlamydia trachomatis infection induces mucosal addressin cell adhesion molecule-1 and vascular cell adhesion molecule-1, providing an immunologic link between the fallopian tube and other mucosal tissues. J Infect Dis 2001; 184:885-91. [PMID: 11550128 DOI: 10.1086/323341] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2001] [Revised: 06/04/2001] [Indexed: 11/03/2022] Open
Abstract
The development of a protective vaccine against the sexually transmitted disease caused by Chlamydia trachomatis may prevent complications associated with insidious infection. Vaccination via the vaginal route may not be practical, and other routes should be investigated. To this end, the adhesion molecules induced on the fallopian tube endothelium during infection with C. trachomatis were characterized. Adhesion molecules were identified in fallopian tube biopsy specimens cultured with 5 x 10(6) infection-forming units of C. trachomatis serovar E. Frozen sections were prepared from these tissues and were stained by immunohistochemical techniques. Infection with live, but not UV-inactivated, C. trachomatis induced a significant increase in levels of vascular cell adhesion molecule-1 and the mucosal addressin cell adhesion molecule-1 but not of other adhesion molecules. Therefore, infection with C. trachomatis induces adhesion molecules that are associated with other mucosal tissues and inflammatory sites, which suggests that mucosal routes of immunization may be effective.
Collapse
Affiliation(s)
- K A Kelly
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, USA.
| | | | | | | | | | | |
Collapse
|
21
|
Abstract
An elderly man with ocular type myasthenia gravis (MG) was found to have monoclonal gammopathy (IgM). Waldenström's macroglobulinemia (WM) was proven later. This is the second case report of MG associated with WM. However, this case is unique due to the presence of anti-acetylcholine receptor (anti-AChR) antibody (IgG). MG is considered to be an autoimmune disease and WM an immunoproliferative disorder. The association of MG and WM is not clear.
Collapse
Affiliation(s)
- Y T Lin
- Section of Neurology, Kaohsiung Veterans' General Hospital, Taiwan
| | | | | | | |
Collapse
|
22
|
Hsu HY, Chang MH, Ni YH, Huang SF. Cytomegalovirus infection and proinflammatory cytokine activation modulate the surface immune determinant expression and immunogenicity of cultured murine extrahepatic bile duct epithelial cells. Clin Exp Immunol 2001; 126:84-91. [PMID: 11678903 PMCID: PMC1906176 DOI: 10.1046/j.1365-2249.2001.01558.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Murine extrahepatic bile duct epithelial cells (MEBEC) were isolated from extrahepatic bile ducts of BALB/c mice and established in primary culture. The epithelial origin was confirmed by positive cytokeratin 19 staining for these cells and the presence of microvilli and tight junctions under electron microscopy. By immunofluorescent staining with monoclonal antibodies and flow-cytometric analysis, MEBEC in culture constitutively express low levels of intercellular adhesion molecule (ICAM)-1, class I and class II major histocompatibility (MHC) antigens. The expression of ICAM-1 was significantly increased by interferon gamma (INF-gamma) or tumour necrosis factor alpha (TNF-alpha) stimulation. Class I and class II antigen expression were significantly enhanced by INF-gamma and in vitro murine cytomegalovirus (MCMV) infection. MEBEC infected with MCMV revealed a progressive cytopathic effect. MEBEC activated by INF-gamma or infected by MCMV induced a low but significant proliferation of allogeneic T cells and displayed a significant decrease in the absorbance at O.D. 550 nm in a microtitre tetrazolium assay after these treated cells were co-cultured with allogeneic T cells. These results suggest that following the up-regulation of surface MHC antigen and adhesion molecule expression with cytokines or MCMV, the MEBEC can function as antigen-presenting cells and initiate T-cell proliferation, which in turn trigger the recognition of MEBEC by effector T-cell-mediated cytotoxic responses. These findings may be implicated in the pathogenesis of virally induced, immune-mediated extrahepatic bile duct damage disorders.
Collapse
Affiliation(s)
- H Y Hsu
- Department of Paediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | | | | |
Collapse
|
23
|
Abstract
BACKGROUND Intradialytic hypotension is a frequent complication of hemodialysis. Some authors have pointed to autonomic neuropathy as a major cause of intradialytic hypotension. However, other authors have found no such association. METHODS Tilt-table test and time-domain measures of heart rate variation were used to determine autonomic function. Conventional nerve conduction studies (NCS) were also performed to assess whether intradialytic hypotension is associated with polyneuropathy and autonomic neuropathy. RESULTS The incidences of polyneuropathy confirmed by standard NCS were similar for the intradialytic hypotensive and normotensive subjects, implying that polyneuropathy is not strongly related to intradialytic hypotension. However, heart rate variation decreased significantly in intradialytic hypotensive subjects, suggesting that isolated autonomic neuropathy plays a major role in the pathogenesis of intradialytic hypotension. One of 9 intradialytic hypotensive subjects had normal autonomic tests and 2 of 18 normotensive subjects had abnormal autonomic function, implying that intradialytic hypotension is not caused by autonomic neuropathy alone. CONCLUSION Autonomic neuropathy plays an important role in the genesis of intradialytic neuropathy. Tilt-table is easily performed and time-domain measures for heart rate variation are easily determined. Tilt-table test and time-domain measures provide useful information concerning autonomic function.
Collapse
Affiliation(s)
- M H Chang
- Section of Neurology, Taichung Veterans General Hospital, No. 160 Chung-Kang Road, Section 3, Taichung 40705, Taiwan.
| | | |
Collapse
|
24
|
Abstract
OBJECTIVES To assess the annual mortality rate associated with fulminant hepatitis in infants before and after the mass immunization program that was launched in Taiwan in July 1984. STUDY DESIGN From the National Mortality Registry System, the data on the mortality from fulminant hepatitis in infants from 1975 to 1998 were retrieved. Poisson regression analysis was used to assess the difference in average mortality from fulminant hepatitis in infants before (1975-1984) and after (1985-1998) the implementation of the mass hepatitis B vaccination program. RESULTS The ratio of yearly mortality from 1975 to 1998 was 1.10 (P <.001), representing a progressive decrease in the number of the cases. The average mortality associated with fulminant hepatitis in infants from 1975 to 1984 and from 1985 to 1998 was 5.36 and 1.71 per 100,000 infants, respectively. The ratio of the average mortality in the period from 1985 to 1998 to that in the period from 1975 to 1984 was 0.32 (P <.001). CONCLUSIONS These data indicate that since the institution of a program of mass hepatitis B vaccination in Taiwan, the mortality associated with fulminant hepatitis in infants has declined significantly.
Collapse
Affiliation(s)
- J H Kao
- Graduate Institute of Clinical Medicine, Department of Pediatrics, and Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | | |
Collapse
|
25
|
Lee IH, Chen HL, Jeng YM, Cheng MT, Tsao LY, Chang MH. Congenital generalized lipodystrophy in a 4-month-old infant. J Formos Med Assoc 2001; 100:623-7. [PMID: 11695279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Congenital generalized lipodystrophy (CGL, Berardinelli-Seip syndrome) is a rare autosomal recessive disorder with a clinical presentation of paucity of adipose tissue, muscular hypertrophy, organomegaly, and insulin-resistant diabetes. A 4-month-old Taiwanese female infant had hepatosplenomegaly and low body weight gain despite a voracious appetite. Hypermetabolism, hyperhidrosis, loss of subcutaneous fat, muscular hypertrophy, acanthosis nigricans, hypertrichosis, and marked hypertriglyceridemia were also noted. Liver histology revealed fatty change and portal-to-portal bridging fibrosis. Clinical features, serum biochemistry, and liver histology were compatible with the diagnosis of CGL. She was given a special diet characterized by calorie restriction and partial substitution of long-chain triglycerides with medium-chain triglycerides. The serum triglyceride concentration subsequently decreased. This present case suggests that extensive fatty infiltration and subsequent cirrhosis of the liver may be the earliest complication of CGL.
Collapse
Affiliation(s)
- I H Lee
- Department of Pediatrics, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
26
|
Tseng HY, Lu CY, Lee CY, Yeh CC, Lin SC, Shih WY, Wu SY, Chang MH, Huang LM. Hepatitis A virus infection in Taipei in 1999. J Formos Med Assoc 2001; 100:604-7. [PMID: 11695275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND AND PURPOSE Hepatitis A is a disease that is heavily affected by sanitation status. Hepatitis A is much less prevalent compared with decades ago in Taiwan, as in many rapidly developing regions. Hepatitis A vaccine is still self-paid under the National Health Insurance program and is still not widely utilized by the general public in Taiwan. This seroepidemiologic study evaluated the prevalence of antihepatitis A virus (anti-HAV) seropositivity in Taipei in 1999. METHODS A total of 1017 serum samples from healthy inhabitants in Taipei were examined for anti-HAV antibody by qualitative enzyme immunoassay. RESULTS The overall seroprevalence rate was 25.2% (255/1013) in the nonvaccinated population. The seropositivity rate for anti-HAV antibody among children younger than 12 months old was 23.3%. The rates dropped to between 1% and 4.8% among subjects between 1 and 20 years of age. A markedly higher rate of 40% was observed in subjects aged between 20 and 30 years. The seropositivity rate in subjects aged 31 to 50 was 80%. More than 90% of subjects older than 50 years were seropositive. The vaccination rate was low (0.5%). CONCLUSION Our findings indicate that Taipei is an area of intermediate endemicity for hepatitis A virus. To achieve better herd immunity, a more active approach to the adoption of hepatitis A vaccine is warranted.
Collapse
Affiliation(s)
- H Y Tseng
- Department of Pediatrics, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Hsiao SM, Lee LC, Chang MH. Large pelvic accessory spleen mimicking an adnexal malignancy in a teenage girl. J Formos Med Assoc 2001; 100:565-7. [PMID: 11678010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
A large pelvic accessory spleen in a teenage female is rare and may be misdiagnosed as an adnexal tumor. A 17-year-old girl, gravida 0, had suffered from intermittent and dull pain in the lower abdomen for 1 month. Laboratory evaluation showed a low platelet count (136,000/microL). Abdominal sonography showed a large solid mass situated at the right pelvis, containing abundant vascular supply with low resistant blood flow. At laparotomy, an accessory spleen fed by a tortuous vascular pedicle from the omentum was found and then excised. Histopathologic examination revealed congestive accessory splenomegaly. Follow-up platelet count returned to normal levels (374,000/microL). The importance of including accessory spleen in the differential diagnosis of a solid adnexal tumor with thrombocytopenia is emphasized.
Collapse
Affiliation(s)
- S M Hsiao
- Departments of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | | | | |
Collapse
|
28
|
Abstract
Bacterial cholangitis (BC) is a common complication in patients with biliary atresia (BA) and is characterized by fever, acholic stools and positive blood cultures. The diagnosis is often empirical because the yield of blood cultures is low. It is difficult to differentiate BC from other febrile episodes. In order to characterize the clinical and laboratory features of BC in patients with BA, identify risk factors, and correlate cholangitis with outcome, 37 patients with BA from 1993 to 1998 who underwent a Kasai operation in our hospital were studied. The follow-up period ranged from 6 to 59 months. A total of 107 febrile episodes were documented in these patients. The diagnostic criteria for cholangitis were fever, increased jaundice, or acholic stools. The clinical features, laboratory data, results of bacterial cultures, and outcomes were analyzed retrospectively. A total of 107 febrile episodes, including 78 bouts of cholangitis and 29 non-cholangitis infections, were found in 34 patients. Patients with BC had higher postoperative bilirubin levels (P = 0.02) and less frequent use of prophylactic antibiotics (P = 0.05) than those with non-cholangitis infections. Abnormal white blood cell counts (> 12,000 or <4,000 mm3) tended to be present in patients with BC (P = 0.08). There were no statistical differences in the risk factors and laboratory data between culture-positive (n = 16) and -negative (n = 62) cholangitis cases. The occurrence of cholangitis significantly reduced survival in both patients with good (P = 0.03) and inadequate bile flow (P = 0.03). All 9 patients who had never had cholangitis survived during the follow-up period. Repeated attacks of BC further decreased survival probability. The responsive organisms were mainly enteric bacteria, including Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumanni, and Salmonella typhi. The sensitivity tests justified empirical therapy with ceftriaxone. The effectiveness of prophylactic trimethoprim-sulfamethoxazole or neomycin warrants further studies. BC was a highly prevalent postoperative complication in patients with BA, especially those with inadequate bile drainage. It significantly affected early mortality. Aggressive and complete treatment with empirical ceftriaxone was appropriate.
Collapse
Affiliation(s)
- E T Wu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Republic of China
| | | | | | | | | | | | | |
Collapse
|
29
|
Abstract
BACKGROUND Little is known about the prevalence of antibiotic-resistant Helicobacter pylori infection in children. Culture and antimicrobial susceptibility testing are generally time-consuming and not a routine in many hospitals. OBJECTIVE To investigate the prevalence of clarithromycin-resistant H. pylori strains in children, to identify those isolates via rapid methodology and to examine the severity of gastritis caused by the antibiotic-resistant H. pylori isolates. METHODS Enrolled were 245 children investigated for H. pylori infection by endoscopic examination. The gastric antral specimens were subjected to DNA extraction and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with primers specific to the H. pylori 23S rRNA gene. Conventional bacterial cultures were performed simultaneously as the diagnostic standard. Minimal inhibitory concentrations of clarithromycin and metronidazole were determined by E test. This was used as a standard to determine the sensitivity and specificity of the above PCR-RFLP assay. The specimens were processed for histologic examination and evaluated by the updated Sydney system. RESULTS H. pylori was isolated in 67 of the 245 children; 12 (18%) of them were clarithromycin-resistant and 6 (9%) were metronidazole-resistant. No difference in histologic examinations was noted between the antibiotic-resistant and -susceptible strains. We performed PCR-RFLP with all 12 clarithromycin-resistant isolates: 10 had a 23S ribosomal RNA A2144G point mutation; 1 had a mixture of an A2143G point mutant and susceptible strains; and 1 had neither of the 2 mutations. CONCLUSIONS The prevalence of clarithromycin-resistant H. pylori isolates in Taiwanese children is 18%. PCR-RFLP had a high sensitivity (92%) and specificity (100%) for the clarithromycin resistance gene mutation determination. The dominant mutation is A2144G. PCR-RFLP provides a rapid and accurate approach to detect clarithromycin-resistant strains within 24 h.
Collapse
Affiliation(s)
- Y J Yang
- Department of Pediatrics, National Taiwan University, College of Medicine and Hospital, Taipei
| | | | | | | | | |
Collapse
|
30
|
Chen HL, Chang PS, Hsu HC, Lee JH, Ni YH, Hsu HY, Jeng YM, Chang MH. Progressive familial intrahepatic cholestasis with high gamma-glutamyltranspeptidase levels in Taiwanese infants: role of MDR3 gene defect? Pediatr Res 2001; 50:50-5. [PMID: 11420418 DOI: 10.1203/00006450-200107000-00011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
MDR3 P-glycoprotein mediates canalicular phospholipid transport in hepatocytes. Defects in the MDR3 gene have been found to cause a subtype of progressive familial intrahepatic cholestasis (PFIC) with high gamma-glutamyltranspeptidase (GGT) levels. Affected children develop proliferation of biliary epithelium, portal inflammation, and biliary cirrhosis. The frequency of MDR3 mutations in patients with high GGT-PFIC is unclear. There have been no Asian patients reported to carry MDR3 mutations. To determine the role of MDR3 defects in chronic cholestatic patients, we studied six Taiwanese children from five families who presented high GGT-PFIC among 47 patients with infantile onset chronic intrahepatic cholestasis. Sequence analysis of MDR3 cDNA from liver tissues was performed. Only one patient had mutation in the MDR3 gene. This patient had a homozygous 719-bp deletion (nucleotide 287 to 1005) of liver cDNA encompassing exon 5 to 9 and leading to protein truncation. The onset age was 1 y in contrast with the other five patients who presented neonatal cholestasis. Four patients without mutation, including one sibling pair, exhibited histologic features of prominent portal fibrosis leading to advanced biliary cirrhosis that were indistinguishable from the case of MDR3 mutation. We concluded that mutations in MDR3 accounted for approximately 2% (1/47) of infantile onset chronic cholestasis in Taiwan. Those patients presenting high GGT-PFIC with early onset cholestasis but without MDR3 mutation probably had inheritable disorders remaining to be clarified.
Collapse
Affiliation(s)
- H L Chen
- Departments of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan
| | | | | | | | | | | | | | | |
Collapse
|
31
|
Lai PH, Chen PC, Chang MH, Pan HB, Yang CF, Wu MT, Li JY, Chen C, Liang HL, Chen WL. In vivo proton MR spectroscopy of chorea-ballismus in diabetes mellitus. Neuroradiology 2001; 43:525-31. [PMID: 11512579 DOI: 10.1007/s002340100538] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The most common cause of chorea-ballismus (CB) is a vascular lesion; it is also associated with nonketotic hyperglycaemia in diabetes mellitus (DM) and may be the first manifestation of this disorder. We describe the CT, MRI and proton MR spectroscopy (1H-MRS) of CB in eight patients. Six had hemichorea-hemiballismus (HC-HB) and two bilateral CB. Single-voxel (SV) 1H-MRS was performed using point-resolved spectroscopy (PRESS). Voxels were positioned in the basal ganglia of the patients and control subjects. PRESS was also used to obtain spectroscopic imaging (1H-MRSI) of the slice of interest in two patients. CT showed a slightly dense striatum in all the patients with CB, and T1-weighted images revealed high signal. The CB correlated well with the neuroimaging findings. SV 1H-MRS showed the mean (+/- SD) N-acetylaspartate (NAA)/ creatine (Cr) ratio to be 1.45 +/- 0.19 in HC-HB and 1.82 +/- 0.06 on the opposite normal side (P = 0.01). The choline (Cho)/ Cr ratio was 1.3 +/- 0.12 in HC-HB and 1.11 +/- 0.13 on the opposite normal side (P = 0.005). A lactate peak was seen in seven patients. The NAA/Cr ratio was 1.44 +/- 0.15 in bilateral CB and 1.74 +/- 0.16 in the controls (P = 0.017); the Cho/Cr ratios were 1.36 +/- 0.1 and 1.19 +/- 0.07 (P = 0.015). The low NAA/Cr suggests neuronal loss or damage and the high Cho/Cr probably indicates gliosis. The presence of lactate may suggest mild ischaemia due to acute vascular events during hyperglycaemia and underlying chronic focal cerebrovascular diseases in DM.
Collapse
Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang-Ming College, Taiwan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Yang CM, Hsu HY, Tsao PN, Chang MH, Lin FY. Recurrence of intussusception in childhood. Acta Paediatr Taiwan 2001; 42:158-61. [PMID: 11431861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Intussusception is the most common cause of intestinal obstruction between 3 months and 6 years of age. Recurrence after reduction of intussusception in childhood is not rare. To assess the incidence and determinants of recurrence of intussusception in childhood, we conducted a prospective observation in an emergency service of a large referral center during a four-year period. We encountered 89 cases with intussusception of whom nine cases (10.1%) had episodes of recurrent intussusception. Five patients had a single recurrence, three had double recurrence and one had triple recurrence. Age of first intussusception, sex, or concurrent adenovirus infection was not related to the recurrence. None of the 27 patients who needed operative reduction had recurrence, while 9 of 62 patients who were reduced successfully by barium enema developed recurrence (P = 0.05). Compared with the first episode, significantly less vomiting, rectal bleeding and shorter duration of abdominal pain or irritable crying were noted during recurrent episodes. All the recurrent episodes were reduced successfully by barium enema. We conclude that recurrent intussusception in childhood tends to be diagnosed earlier than previous episodes and treated successfully by hydrostatic reduction without complication. Surgical reduction of recurrent intussusception may be reserved for cases of failure of hydrostatic reduction, positive peritoneal sign or existence of pathological lead point because of favorable response to barium reduction. Recurrent intussusception seldom occurs in patients who underwent surgical reduction.
Collapse
Affiliation(s)
- C M Yang
- Department of Pediatrics, National Taiwan University Hospital, 7 Chung Shan South Road, Taipei, Taiwan
| | | | | | | | | |
Collapse
|
33
|
Huang YC, Chen HL, Hsu WM, Chen SJ, Lai MW, Chang MH. Left paraduodenal hernia presenting as intestinal obstruction: report of one case. Acta Paediatr Taiwan 2001; 42:172-4. [PMID: 11431865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
We report a case of internal hernia of the small intestine in a 13-year-old boy with presentation of partial intestinal obstruction. The patient suffered from recurrent abdominal pain and chronic constipation over the past few years. An abdominal mass was suspected from clinical manifestations and images derived from abdominal echography. Upper gastrointestinal contrast study revealed poor motility at the distal jejunum with barium stasis. Follow-up film on the next day delineated medially and downwardly displaced splenic flexure and proximal descending colon. At operation, total herniation of small intestine into a retroperitoneal space through a defect on left mesocolon was noted. A left paraduodenal (mesocolic) hernia was diagnosed. The patient made an uneventful recovery after the hernia was repaired. This report provides unusual image clues of internal hernias of the small intestine presenting as ileus. Though rare, paraduodenal hernia should be taken into account in a differential diagnosis of intestinal obstruction. Early surgical intervention allows uneventful recovery to occur and also prevents the possible complication of gangrenous bowels.
Collapse
Affiliation(s)
- Y C Huang
- Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
34
|
Chen HC, Tang YB, Chang MH. Reconstruction of the voice after laryngectomy. Clin Plast Surg 2001; 28:389-402. [PMID: 11400832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Voice reconstruction and rehabilitation are important for quality of life for patients after surgical ablation of tumors in the larynx or pharynx. In addition to the esophageal voice, the artificial larynx, and external voice devices, the following procedures have been developed: (1) after laryngectomy with preservation of pharynx, neoglottis or TEP can be performed; (2) after laryngopharyngectomy a forearm flap with TEP, or a jejunal transfer with TEP or voice tube shunt can be selected; and (3) after laryngopharyngoesophagectomy, either pharyngogastrotomy with TEP, or colon segment interposition with TEP can be employed. The voice tube shunt is improving, and allograft transplantation is currently under investigation.
Collapse
Affiliation(s)
- H C Chen
- Department of Plastic Surgery, Chang Gung Memorial Hospital, and College of Medicine, Chang Gung University, Taipei, Taiwan
| | | | | |
Collapse
|
35
|
Kildal M, Wei FC, Chang YM, Chen HC, Chang MH. Mandibular reconstruction with fibula osteoseptocutaneous free flap and osseointegrated dental implants. Clin Plast Surg 2001; 28:403-10. [PMID: 11400833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
The fibula osteoseptocutaneous free flap is ideal for reconstruction of composite mandible defects. Osseointegration is possible and advantageous. Primary osseointegration of dental implants is a safe and reliable procedure in selected groups of patients, promoting early total oral rehabilitation with restoration of both function and cosmesis. Further studies are necessary to assess the specific indications for osseointegration teeth in patients with malignant tumors and in those patients who have received radiation therapy.
Collapse
Affiliation(s)
- M Kildal
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taipei, Taiwan, ROC
| | | | | | | | | |
Collapse
|
36
|
Yang YJ, Chang MH, Ni YH. Sigmoid volvulus in children: report of two cases. J Formos Med Assoc 2001; 100:134-6. [PMID: 11393102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Volvulus of the sigmoid colon is rare in children. An early, accurate diagnosis can avoid unnecessary surgery and reduce the risk of complications. This condition is mainly due to a redundant sigmoid colon with a narrow mesosigmoid attachment. We describe two cases of sigmoid volvulus, which showed different clinical severities and were treated with different methods. Patient 1, a 9-year-old boy, presented with acute abdominal pain and vomiting. Patient 2, an 11-year-old boy, presented with abdominal pain, abdominal distention, and bloody mucoid stool. Plain abdominal radiographs revealed a distended colonic loop extending upward from the pelvis in patient 1 and a typical "coffee bean" sign in patient 2. Barium enema examination was used to confirm the diagnosis in both cases. The volvulus was reduced by insertion of a rectal tube in patient 1 and surgically in patient 2. Sigmoid colon volvulus should be included in the differential diagnosis of childhood abdominal pain or distention. This report suggests that nonsurgical reduction should be attempted first for uncompromised sigmoid volvulus in children, unless bowel ischemia or perforation develops.
Collapse
Affiliation(s)
- Y J Yang
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
| | | | | |
Collapse
|
37
|
Abstract
CONTEXT Hepatocellular carcinoma (HCC) has a male predominance and is closely related to hepatitis B virus (HBV) infection. Hepatitis B virus vaccination was launched in 1984 in Taiwan for neonates of mothers carrying hepatitis B e antigen, resulting in a decreased incidence of HCC in children. The effect on boys vs girls is not known. OBJECTIVE To evaluate the association between a HBV vaccination program with incidence of childhood HCC by sex. DESIGN AND SETTING Analysis of data collected from Taiwan's National Cancer Registry System and the Taiwan Childhood Hepatoma Study Group between 1981 and 1996. PARTICIPANTS Children aged 6 to 14 years who were diagnosed as having HCC (201 boys and 70 girls). MAIN OUTCOME MEASURE Incidence of HCC in boys and girls before and after implementation of the vaccination program. RESULTS The boy-girl incidence ratio decreased steadily from 4.5 in 1981-1984 (before the program's introduction) to 1.9 in 1990-1996 (6-12 years after the vaccination program was launched). The incidence of HCC in boys born after 1984 was significantly reduced in comparison with those born before 1978 (relative risk [RR], 0.72; P =.002). No significant decrease in HCC incidence was observed in girls born in the same periods (RR, 0.77; P =.20). The incidence of HCC in boys remained stable with increasing age, while an increase of HCC incidence with age in girls was observed. These age and sex effects remained the same regardless of birth before or after the vaccination program. CONCLUSION Our results suggest that boys may benefit more from HBV vaccination than girls in the prevention of HCC.
Collapse
Affiliation(s)
- M H Chang
- Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan S. Road, Taipei, Taiwan, Republic of China.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Affiliation(s)
- M C Ho
- Department of Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
Studies were conducted to investigate the impact of a selected lactobacilli mixed culture on Campylobacter jejuni in simulated chicken digestive tract models. Veronal buffer solutions corresponding to the pH of successive segments of the chicken digestive tract were prepared. The lactobacilli mixtures were prepared by mixing four fresh lactobacilli cultures, including Lactobacillus acidophilus, Lactobacillus fermenentum, Lactobacillus crispatus, and Lactobacillus brevis. The C. jejuni and lactobacilli mixture were mixed with sterile poultry feed, and the previously prepared veronal buffer solutions were then added separately. The mixture was incubated at 41.1 degrees C for various lengths of time with periodic agitation. The feed passage time for five segments of the digestive tract were adopted: crop (pH 4.5), 30 min; proventriculus (pH 4.4), 15 min; gizzard (pH 2.6), 90 min; small intestine (pH 6.2), 90 min; and large intestine (pH 6.3), 15 min. The Campylobacter and lactobacilli were enumerated. An antagonistic effect on C. jejuni by the tested lactobacilli spp. was found in individual sections and the complete simulated digestive tract models. In the simulated complete chicken digestion system, no C. jejuni were found during the final incubation period when a lactobacilli mixture was present. The results of this in vitro study indicate the potential value of future in vivo studies.
Collapse
Affiliation(s)
- M H Chang
- Poultry Science Department, Mississippi State University, Mississippi 39762, USA
| | | |
Collapse
|
40
|
Abstract
The combination of hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccinations can offer convenience, increased compliance and cost saving. We have studied the immunogenicity, reactogenicity and safety of combined hepatitis A and B vaccination in young adults (16-35 years old). Eighty healthy young adults were divided into two random groups. One group received the combined hepatitis A and B vaccine (HAB) in one arm while the other group was administered concomitant hepatitis A and B vaccines (HAV + HBV) in the right and left arms, respectively. The immunogenicity, reactogenicity and safety were assessed after each dose in both the groups. In local symptoms, the percentage of the combined HAB group was lower than the HAV + HBV group, and the general symptoms were noted in approximately 30% of each group without any significant difference. No serious adverse effects were noted. All the subjects were seropositive for antibody to hepatitis A virus (anti-HAV) after one dose of vaccine, and remained seropositive after three doses in both groups. The seropositive rate for antibody to hepatitis B surface antigen (anti-HBs) was significantly higher (84%) in the combined HAB group than the concomitant HAV + HBV group (62%), (p<0.05) after dose two, and all the subjects were seropositive (100%) after the third dose. The GMTs of anti-HAV and anti-HBs were not significantly different between groups 1 and 2 (p>0.1) except in month 6 when the GMT of anti-HBs was higher in HAB group (p=0.0039). The combined HAB vaccine was found to be safe, well tolerated and had less local symptoms in young adults. The immunogenicity and reactogenicity were similar to the concomitant HAV + HBV vaccines.
Collapse
Affiliation(s)
- I J Tsai
- Department o Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | | | | | | | | | | |
Collapse
|
41
|
Chiang SC, Lee YM, Chang MH, Wang TR, Ko TM, Hwu WL. Glucose-6-phosphatase gene mutations in Taiwan Chinese patients with glycogen storage disease type Ia. J Hum Genet 2000; 45:197-9. [PMID: 10944847 DOI: 10.1007/s100380070026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Glycogen storage disease type Ia (GSD Ia) is caused by a deficiency of glucose-6-phosphatase (G6Pase) activity. Eighteen GSD Ia families were studied for G6Pase gene mutations. Thirty-two mutations were found in 36 GSD Ia chromosomes: 16 were 727 G-->T (44.44%); 13 were R83H (327 G-->T; 36.11%); 1 was 341delG; 1 was 933insAA; and 1 was 793 G-->T. The 727 G-->T and R83H mutations together accounted for 80.56% (29/36) of the GSD Ia chromosomes. These two mutations were easily examined by polymerase chain reaction-based methods, and the prenatal diagnosis of a non-affected fetus was successfully made. The 727 G-->T mutation is the predominant mutation in Japanese GSD Ia patients, but is rarely seen in Western counties. The 727 G-->T mutation is also the most prevalent mutation in Taiwan Chinese, although the incidence is not as high as in Japan.
Collapse
Affiliation(s)
- S C Chiang
- Department of Medical Genetics, College of Medicine, National Taiwan University, R.O.C
| | | | | | | | | | | |
Collapse
|
42
|
Affiliation(s)
- M H Chang
- Department of Pediatrics, National Taiwan University Hospital, Taipei.
| |
Collapse
|
43
|
Yang TY, Chen HL, Ni YH, Hwu WL, Chang MH. Hereditary fructose intolerance presenting as Reye's-like syndrome: report of one case. Acta Paediatr Taiwan 2000; 41:218-20. [PMID: 11021009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Hereditary fructose intolerance (HFI) is an autosomal recessive disease caused by catalytic deficiency of aldolase B (fructose-1, 6-bisphosphate aldolase). Herein we report on a case of hereditary fructose intolerance with initial presentation of episodic unconsciousness, seizure, hypoglycemia, hepatomegaly, and abnormal liver function since the patient was 11 months old. She was diagnosed as Reye's-like syndrome according to a liver biopsy done at 20 months of age. As she grew up, cold sweating, abdominal pain or gastrointestinal discomfort shortly after the intake of fruits was noted and she developed an aversion to fruits, vegetables and sweet-tasting foods. At 9 years of age, a fructose tolerance test signified a positive result that induced hypoglycemia, transient hypophosphatemia, hyperuricaemia, elevation of serum magnesium, and accumulation of lactic acid. Appropriate dietary management and precautions were recommended. The patient has been symptom-free and exhibited normal growth and development when followed up to 12 years of age.
Collapse
Affiliation(s)
- T Y Yang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | | |
Collapse
|
44
|
Abstract
Core gene deletion mutants of hepatitis B virus (HBV) have been identified in adults. Because the acquisition of HBV occurs mainly in infancy and childhood in hyperendemic areas, this study aimed to learn the temporal profile of such mutants in children with chronic HBV infection. We have followed up 365 HBV-infected children for more than 10 years and screened out HBV core gene deletion from their sera. Serial serum samples of positive cases were subjected to HBV-DNA nucleotide sequence analyses and quantification. Deletion mutants were found in 18 of the 365 patients (4.9%). Most cases (15 of 18) with deletion mutants heralded hepatitis B e antigen (HBeAg) seroconversion phase, while the other cases (3 of 18) remained in HBeAg-seropositive phase. Deletion mutants disappeared after HBeAg seroconversion except in 1 child. Decreased HBV-DNA levels accompanied deletion mutants for those who finally underwent HBeAg seroconversion, but the HBV-DNA level did not decline if there was no seroconversion. Deletion mutants were not associated with a particularly high peak liver enzyme. Core gene deletion mutants could appear as early as the age of 5. The duration of their appearance was 0.5 to 5 years. Horizontal rather than perinatal transmission of HBV was a favorable factor for these mutants to develop. Deletion fragments were located in the middle part of core gene. The emergence of the mutants was likely the result of host-viral interaction and mostly signified HBeAg seroconversion within 1 year. Core gene deletion mutants appeared preferably in children acquiring HBV by horizontal transmission.
Collapse
Affiliation(s)
- Y H Ni
- Department of Pediatrics, College of Medicine, National Taiwan University, and National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | |
Collapse
|
45
|
Ni YH, Lin JT, Huang SF, Yang JC, Chang MH. Accurate diagnosis of Helicobacter pylori infection by stool antigen test and 6 other currently available tests in children. J Pediatr 2000; 136:823-7. [PMID: 10839883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Invasive and noninvasive tests have been developed for the diagnosis of Helicobacter pylori infection. Because H pylori infection is acquired in childhood and adolescence, accurate diagnosis of the infection in the pediatric population is important. We conducted a study to compare invasive tests: culture, biopsy urease test, histology, and polymerase chain reaction on gastric biopsy specimens, with noninvasive tests: serology, (13)C-urea breath test, and a new diagnostic modality, stool antigen test to diagnose H pylori infection. A total of 53 children with symptoms were enrolled in this study, and all had completed the 7 diagnostic tests for H pylori. All the diagnostic tests except serology were excellent methods of diagnosing H pylori infection in children; the diagnostic accuracy was as follows: stool antigen test 96.2%, biopsy urease test 96.2%, histology 98.1%, polymerase chain reaction 94.3%, culture 98.1%, (13)C-urea breath test 100%, and serology 84.9%. The stool antigen test, being highly sensitive and specific, will be potentially very helpful in diagnosing H pylori infection in children.
Collapse
Affiliation(s)
- Y H Ni
- Departments of Pediatrics, Internal Medicine, and Pathology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei
| | | | | | | | | |
Collapse
|
46
|
Abstract
OBJECTIVES Attempting to answer a debate concerning the etiopathogenesis of the decreased forearm median motor conduction velocity (FMMCV), we tried to use proximal stimulation at the wrist, elbow, mid-arm and axillary regions to determine segmental median motor conduction velocity (MMCV). We also correlated the FMMCV with median motor distal latency (MMDL) and compound muscle action potential (CMAP) amplitudes of the abductor pollicis brevis (APB) muscle in order to assess whether the conduction block of large myelinating fibers or retrograde axonal atrophy was the major cause of the decreased FMMCV. BACKGROUND The cause of the decreased FMMCV resulting from either the conduction block of the large myelinating fibers at the wrist or distal compression with retrograde axonal atrophy remains an unresolved issue at the moment. Animal models have supported the hypothesis that the retrograde axonal atrophy might also occur in humans. Other authors believe the standard FMMCV is calculated by subtracting the distal latency which may not represent an exact assessment of FMMCV but rather the velocity of small fibers that persist through the carpal tunnel. SUBJECTS AND METHODS Patients with the clinical symptoms and signs of carpal tunnel syndrome (CTS) confirmed using standard electrodiagnosis were included. The patients were arbitrarily divided into two groups based on the FMMCV, one with reduced FMMCV (n = 20, FMMCV < 50 m/s) and the other with normal FMMCV (n = 35, FMMCV> or =50 m/s). Age-matched volunteers served as controls. We explored motor conduction proximally at wrist, elbow, mid-arm and axillary stimulation, and recorded at the APB muscles. Based on the latency differences, we calculated the FMMCV, distal arm MMCV (DAMMCV) and proximal arm MMCV (PAMMCV), and compared the conduction velocity (CV) differences of DAMMCV-FMMCV, PAMMCV-FMMCV and PAMMCV-DAMMCV in the two patient groups and the control. Furthermore, we correlated FMMCV with MMDL and CMAP amplitudes of APB muscle because MMDL and CMAP amplitudes might reflect the integrity of the large myelinating fibers. RESULTS CMAP amplitudes of APB muscle at wrist stimulation and MMDL were not correlated with FMMCV in either of the two patient groups; however, the CMAP amplitude was markedly decreased and MMDL was significantly prolonged when compared with normal controls. The significant increase of CV gradient of DAMMCV-FMMCV and PAMMCV-FMMCV without an equal increase of CV gradient of PAMMCV-DAMMCV only occurred in the reduced FMMCV patient group, suggesting that the conduction block is not the primary cause. The CV gradient of DAMMCV-FMMCV and PAMMCV-DAMMCV did not show any significant difference between patients with the normal FMMCV and the control group. CONCLUSION The retrograde axonal atrophy, not selective damage of the large fibers at the wrist, was the direct cause of the decreased FMMCV.
Collapse
Affiliation(s)
- M H Chang
- Section of Neurology, Veterans General Hospital - Kaohsiung, No 386 Ta-Chung 1st Road, Kaohsiung, Taiwan.
| | | | | | | | | |
Collapse
|
47
|
Abstract
Hepatitis B virus (HBV) infection during childhood can cause acute, fulminant or chronic hepatitis, liver cirrhosis, and liver cancer. Approximately 90% of the infants of hepatitis B e antigen (HBeAg) seropositive mothers become hepatitis B surface antigen (HBsAg) carriers. Children chronically infected are mostly asymptomatic. Although liver damage is usually mild during childhood, severe liver disease, including cirrhosis and hepatocellular carcinoma, may develop insidiously for 2-7 years. Spontaneous HBeAg seroconversion occurs gradually as the age of the child increases. Viral replication is reduced during this process, which is usually preceded by an elevation of aminotransferases. In a long-term follow-up study, the annual HBeAg seroconversion rate was 4-5% in children older than 3 years of age and less than 2% in children under 3 years. The annual seroconversion rate of HBsAg was very low (0.56%). Age at infection, maternal HBsAg and HBeAg status, host immune status, and possibly the HBV strain are the main factors determining the course of HBV infection in children.
Collapse
Affiliation(s)
- M H Chang
- Department of Paediatrics, College of Medicine, National Taiwan University, Taipei.
| |
Collapse
|
48
|
Abstract
Hepatoblastoma (HB) is the most common malignant hepatic tumor during early childhood. Its molecular pathogenesis is still poorly understood. Mutations of adenomatous polyposis coli (APC) gene have been identified in sporadic cases and in individuals associated with familial adenomatous polyposis syndrome. beta-catenin is a key element in the cadherin-mediated cell adhesion system and Wnt/wingless pathway, and is controlled by APC. APC affects the degradation of beta-catenin by its NH(2)-terminal phosphorylation on the serine/threonine residues of exon 3. Mutations of these phosphorylation sites are primary targets for activating mutations in several types of human cancer and lead to nuclear accumulation of beta-catenin protein. In this study, we examined nine patients with HB using immunohistochemistry and direct DNA sequencing. All nine cases showed predominant nuclear expression of beta-catenin. Eight cases (89%) showed mutations involving exon 3 of the beta-catenin gene, including five with deletions and three with missense mutations. All five deletions were in-frame deletions without frameshift. The very high frequency of mutations in the beta-catenin gene suggests that beta-catenin mutations are crucial in the tumorigenesis of HB.
Collapse
Affiliation(s)
- Y M Jeng
- Department of Pathology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan
| | | | | | | | | |
Collapse
|
49
|
Chang PF, Ni YH, Lin WT, Yu CH, Shih HH, Chang PS, Chang MH. Endoscopy-guided nasoenteral tube placement in infants by the stylet method. Endoscopy 2000; 32:S15-6. [PMID: 10774981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- P F Chang
- Department of Pediatrics, National Taiwan University Hospital, Taipei
| | | | | | | | | | | | | |
Collapse
|
50
|
Chang PF, Huang SF, Hwu WL, Hou JW, Ni YH, Chang MH. Metabolic disorders mimicking Reye's syndrome. J Formos Med Assoc 2000; 99:295-9. [PMID: 10870312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Several metabolic disorders such as encephalopathy and hepatic dysfunction have been described as Reye's-like syndrome because they present with similar clinical manifestations that mimic Reye's syndrome. We performed a retrospective study to explore the underlying metabolic etiologies of Reye's-like syndrome in patients treated at National Taiwan University Hospital. METHODS From January 1991 to June 1998, 19 children with a syndrome fitting the Reye's-like syndrome description were identified for study. Urine organic acid analysis, plasma amino acid analysis, liver pathology, and skin fibroblast enzyme assays were studied during the acute stage of illness. RESULTS The etiologies of patients' syndromes included urea cycle disorders (n = 7), glycogen storage disease type Ia (4), primary carnitine deficiency (2), hereditary fructose intolerance (1), methylmalonic acidemia (2), and 3-hydroxy-3-methylglutaric acidemia (1). Fatty acid oxidation defects were suspected in the remaining two cases. CONCLUSIONS A significant number of patients who present with Reye's-like syndrome have an underlying inherited metabolic disorder. In patients with Reye's-like syndrome, an accurate diagnosis is essential to ensure normal growth and development and to prevent recurrence of the condition.
Collapse
Affiliation(s)
- P F Chang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|