Malignant lymphoma presenting as right heart failure.
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Biopsy↗
Biomedical subjects
C H Wang
Publications and source records attributed to C H Wang.
Large right atrial thrombus with pulmonary embolism.
We present the cases of two patients, aged 67 and 77 years, who were admitted for the evaluation of rapidly progressive dyspnea and syncope, respectively. Both patients developed large right atrial thrombi with pulmonary embolism. The first patient received recombinant tissue plasminogen activator and survived with an uneventful result, whereas the second patient received operative thrombectomy followed by intravenous heparin and died 15 days later of pulmonary infarction with pulseless electrical activity. Data from these limited experiences suggest that thrombolytic therapy might be considered in patients with right heart thrombi with pulmonary embolism.
Aged↗
Head injury in facial impact--a finite element analysis of helmet chin bar performance.
The chin bar of a motorcycle helmet protects the rider from facial and head injuries. To evaluate the protective performance of chin bars against head injuries from facial impacts, an explicit finite element method was used to simulate the Snell Memorial Foundation test and a proposed drop test. The maximum acceleration and Head Injury Criterion (HIC) were employed to assess the impact-absorbing capability of the chin bar. The results showed that the proposed approach should be more practical than the Snell test, and provided more information for improving the chin bar design to protect against head injuries. The shell stiffness was important in determining the protective ability of the chin bar, but a chin bar with only an outer shell and comfort foam offered inadequate protection. An energy-absorbing liner was essential to increase the protective performance of the chin bar and the liner density should be denser than that used in the cranial portion of the helmet. For the chin bar with energy-absorbing liner, a shell design that is less stiff would provide better protection.
Craniocerebral Trauma↗
Nitric oxide modulates interleukin-1beta and tumor necrosis factor-alpha synthesis by alveolar macrophages in pulmonary tuberculosis.
Interleukin (IL)-1beta and tumor necrosis factor (TNF)-alpha released from alveolar macrophages (AM) in pulmonary tuberculosis (TB) are important in host defense against mycobacterial infection. Nitric oxide (NO) production is enhanced in AM of TB patients. We examined whether NO was implicated in (IL)-1beta and TNF-alpha synthesis by AM of TB patients. Purified AM were retrieved by bronchoalveolar lavage from 11 TB patients and 10 normal subjects, and were cultured with or without the NO inhibitor N(G)-monomethyl-L-arginine (L-NMMA). The release of IL-1beta and TNF-alpha, and expression of their messenger RNAs (mRNAs), were determined by enzyme-linked immunosorbent assay and Northern blot analysis. The release of IL-1beta and TNF-alpha was greater from AM of TB patients than from AM of normal subjects. L-NMMA inhibited nitrite, IL-1beta, and TNF-alpha production in TB patients. The mRNA expression for IL-1beta and TNF-alpha was upregulated in TB patients and was depressed by L-NMMA. Immunocytochemistry done with a monoclonal antibody against the p65 subunit of nuclear factor (NF)-kappaB showed that NF-kappaB was highly expressed and translocated to the nuclei of AM from TB patients, and was inhibited by L-NMMA. Inhibition of NF-kappaB by pyrrolidine dithiocarbamate attenuated IL-1beta and TNF-alpha synthesis. In conclusion, enhanced NO generation by AM of TB patients plays an autoregulatory role in amplifying the synthesis of proinflammatory cytokines, probably through NF-kappaB activation.
Adult↗
Lipopolysaccharide enhances substance P-mediated neutrophil adherence to epithelial cells and cytokine release.
Lipopolysaccharide (LPS) is implicated in many respiratory tract inflammatory diseases. Tachykinins, especially substance P (SP) through the NK-1 receptor, mediate leukocyte adhesion to the endothelial or airway epithelial cells. Here we assessed the enhancement by LPS of tachykinin-mediated neutrophil adherence to alveolar epithelial cells, and associated interleukin-1 beta (IL-1beta) and tumor necrosis factor (TNF-alpha) release. Neutrophil adherence to A549 epithelial cell was not increased by LPS (100 ng/ml), or SP (10(-)(12)-10(-)(8) M) alone, but was significantly enhanced by their combination (LPS + SP). Neutrophil adherence to epithelial cells induced IL-1beta and TNF-alpha release from A549 cells either spontaneously or stimulated by SP or LPS. LPS + SP significantly enhanced IL-1beta and TNF-alpha release. The NK-1 receptor antagonist L-732,138 inhibited this enhancement response. Prevention of neutrophil adherence by CD11b/CD18 blocking antibody or by placing a filter on the epithelial monolayer diminished spontaneous or LPS + SP-enhanced IL-1beta and TNF-alpha release. Pretreatment with the serine protease inhibitor cocktail also inhibited LPS + SP-enhanced neutrophil adherence-dependent IL-1beta and TNF-alpha release as well as their mRNA expression. In conclusion, we have demonstrated LPS enhanced SP-mediated neutrophil adherence and associated IL-1beta and TNF-alpha release from the A549 epithelial monolayer, partly through NK-1 receptors. Neutrophil adherence to epithelial cells may release serine protease to induce IL-1beta and TNF-alpha release and their synthesis.
CD18 Antigens↗
Pathogenicity and gene analysis of adenovirus from pigeons with inclusion body hepatitis.
The pathogenicity of an adenovirus isolated from pigeons (Pigeon adenovirus, PA) with inclusion body hepatitis in Taiwan was investigated in specific-pathogen-free (SPF) chicks and in racing pigeons. One-day-old SPF chicks were inoculated subcutaneously with 10(4) 50% tissue culture infective dose (TCID50, low dose) and 10(8) TCID50 (high dose) of the virus, respectively. The chicks began to die three days post inoculation (DPI) with high dose of the virus and the mortality reached 100%; the chicks began to die 6 DPI and the mortality reached 90% at 14 DPI with low dose. The adult pigeons seemed to be resistant to the PA. However, this virus decreased the production of antibody against Newcastle disease virus in pigeons. It is found that this PA belongs to genetic group D from the restriction patterns produced by BamH I and Hind III.
Animals↗
Pedal (99m)Tc-sulfur colloid lymphoscintigraphy in primary isolated chylopericardium.
Primary isolated chylopericardium is a rare disorder in which chylous fluid accumulates in the pericardial space. In this case report of a 61-year-old man with chylopericardium, pedal (99m)Tc-sulfur colloid (SC) lymphoscintigraphy was performed after emergent pericardiocentesis, and when there was a recurrent massive pericardial effusion. The results showed that (99m)Tc-SC lymphoscintigraphy can clearly reveal the lymphodynamics in patients with primary isolated chylopericardium. This noninvasive investigation is valuable and can be easily performed either before or after pericardiocentesis.
Humans↗
Polymorphism in the transmembrane region of the MICA gene and type 1 diabetes.
Although MHC class II genes have a stronger association with type 1 diabetes than MHC class I genes, studies have shown that MHC class I molecules play an independent role in the etiology of type 1 diabetes, and the existence of susceptibility genes within a segment of MHC between the HLA-B and TNF genes has been predicted, where MHC class I chain-related gene A (MICA) resides. MICA has a triplet repeat polymorphism in the transmembrane region consisting of five alleles. We analyzed this polymorphism in 162 unrelated children (82 boys) with type 1 diabetes (age at diagnosis 7.01 +/- 3.76 yr) and 154 randomly selected unrelated children (87 boys), age 2.81 +/- 2.12 yr. Phenotype frequency of allele A9 in children with type 1 diabetes was significantly higher than in controls (RR = 2.42, 95% CI = 1.52-3.85, p = 0.000162, pc = 0.00081). Gene frequency of allele A9 was also significantly higher in children with type 1 diabetes when compared with control children (RR = 2.73, 95% CI = 1.85-4.03, p = 2.62 x 10(-7), pc = 1.31 x 10(-6)). This study demonstrates that MICA allele A9 confers risk of type 1 diabetes.
Alleles↗
Distribution and seasonal occurrence of Forcipomyia taiwana (Diptera: Ceratopogonidae) in the Nantou area in Taiwan.
We studied the distribution of Forcipomyia taiwana (Shiraki) in Taiwan, and found this species almost island-wide. Midge seasonality was studied for 4 yr at 3 sites in Nantou, central Taiwan, to identify the extent and causes of midge population outbreaks. The midge population in 1995 was significantly lower than in 3 other years because several typhoons inundated breeding sites. Maximum populations of F. taiwana occurred in June, July, and August. There was a highly significant correlation between the monthly abundance of F. taiwana and temperature and rainfall. A step-up multiple regression indicated that temperature was the most important factor leading to the outbreaks of F. taiwana. Temperature increases from 15 degrees C to near 30 degrees C will increase the midge abundance.
Animals↗
Endotoxemia augments neurogenic plasma exudation in guinea pig lungs.
BACKGROUND: Lipopolysaccharide (LPS) is closely associated with the development of infection-induced deleterious pulmonary reactions. In this study, we investigated the enhancement effects of LPS on tachykinin-mediated plasma exudation in the lungs of guinea pigs. The role of oxidants was also explored. METHODS: Intravenous LPS (100 mu kg-1) or its vehicle was administered 0 to 3 hours prior to bilateral electrical or sham stimulation of the cervical vagus nerves in animals anesthetized with urethane and artificially ventilated. Plasma exudation into the lungs was assessed by measurement of extravasated 125I-albumin which had been intravenously administered before stimulation. RESULTS: The plasma exudation in the lungs increased after bilateral cervical vagal stimulation. LPS alone did not induce significant plasma exudation. The vagally-mediated plasma exudation was enhanced by LPS with the peak effect 1 hour after LPS administration. LPS also enhanced exogenous substance P (10(-8) mol kg-1, i.v.)-induced plasma exudation. The vagally-induced plasma exudation was abolished by a specific neurokinin-1 (NK-1) receptor antagonist, L-732,138. The LPS-induced enhancement response was also attenuated by L-732,138. The vagally-induced plasma exudation was not affected by superoxide dismutase (SOD, 5000 U kg-1, i.p.) pretreatment. However, SOD significantly inhibited the LPS-enhanced neurogenic plasma leakage. The LPS-induced enhancement was not completely abolished by either L-732,138 or SOD pretreatment alone, but by a combination of both. CONCLUSION: LPS augments neurogenic plasma exudation partly through NK-1 receptors to increase vascular permeability and partly via the generation of oxidative metabolites. Tachykinins released from nerve endings may contribute to endotoxin-related pulmonary inflammatory responses.
Animals↗
[Studies of transgenic tobacco plants expressing beta-1,3-glucanase and chitinase genes and their potential for fungal resistance].
Plant bivalent expression vector pBLGC for basic tobacco beta-1, 3-glucanase and bean chitinase genes were constructed, and the tobacco tissue was transformed. Transgenic tobacco plants were carried out for analysis by PCR, PCR-Southern blot, Dot blot, Western blot, etc., and the results showed that some transgenic plants gave strong positive signal, it suggested that foreign genes have been integrated into tobacco genome, and expressed correctly. Fungal challenge with Alternaria alternata showed that transgenic plants were much more resistant to this pathogenic fungus.
Chitinases↗
Integrated control of the dengue vector Aedes aegypti in Liu-Chiu village, Ping-Tung County, Taiwan.
Because of an inadequate supply of potable water, villagers of Small Liu-Chiu Isle, Ping-Tung County, Taiwan, store water in containers supporting a large population of Aedes aegypti. In 1989-96, integrated control measures against Ae. aegypti were implemented on the basis of community participation. These measures included release of mosquito larvivorous fish in the drinking water storage facilities, application of larvicides to the water storage facilities in vegetable gardens, removal of discarded and unused containers and tires, improvement of household water storage facilities, and increase of potable water supply. Before implementation of the integrated control measures in 1988, 74% of the water-containing vessels were water storage facilities, and 24% of those were infested by Ae. aegypti. In 1989, the Breteau index for the entire island, indicating the average distribution density for larval Ae. aegypti, was 53.9, as compared to an index of 1.2 in 1996. In 4 villages located at the southwest and middle of the island, Ae. aegypti nearly became extinct because of the enthusiastic participation of the community. Before the implementation of integrated control, Ae. aegypti was the dominant species in containers both inside and outside the household, but after the integrated control, Aedes albopictus became predominant outside.
Aedes↗
Intravenous atropine relieves coronary arterial spasm and hemodynamic decompensation during recovery after exercise.
A 66-year-old man developed right coronary arterial spasm and hemodynamic decompensation during the early recovery phase of a treadmill exercise test. The unstable condition was corrected immediately after intravenous administration of atropine. A subsequent coronary angiographic study revealed insignificant right coronary artery stenosis. The pathophysiology of this response may be related to rapid alterations in autonomic balance during recovery after exercise. To our knowledge, this is the 1st reported case in which atropine effected immediate reversal of coronary arterial spasm and hemodynamic decompensation that were induced by exercise, rather than by pharmacologic agents. Atropine might be an effective treatment in patients who experience exercise-induced coronary arterial spasm and hemodynamic decompensation, but further investigation is warranted.
Aged↗
Prevention of acute and delayed cisplatin-induced nausea and vomiting with intravenous ondansetron plus intravenous dexamethasone.
BACKGROUND: We conducted a prospective study to evaluate the anti-emetic effect of cisplatin-induced nausea and vomiting with intravenous (i.v.) ondansetron plus i.v. dexamethasone. METHODS: One hundred forty-six chemotherapy (CT)-naive patients were enrolled in the study. They were scheduled to receive cisplatin 50 to 100 mg/m2 (mean, 53 mg/m2) on day 1 followed immediately by continuous infusion of 5-fluorouracil with or without other CT agents on the subsequent days. Three 8 mg doses of ondansetron i.v. were given at 4-hour intervals plus 20 mg dexamethasone i.v. infusions from the start of CT, followed by 5 mg dexamethasone i.v. every 12 hours, and the administration of dexamethasone was discontinued after the completion of CT. RESULTS: The rates of complete protection from acute and delayed vomiting/nausea obtained in these patients were 97.3%/93.2% and 71.2%/60.3%, respectively. The rates of complete protection from both acute and delayed nausea were 70.5% and 58.9%, respectively. By comparison, the total control rate of vomiting was less in female patients than in male patients (p = 0.017), and the total control rate of nausea was lower in the age group less than 50 years (p = 0.045). The time from the start of CT to the onset of nausea appeared to be earlier than that for vomiting (log-rank test, p = 0.045). Adverse events tended to be minor, with constipation and hiccups as the most common. CONCLUSION: These results indicate that i.v. ondansetron plus i.v. dexamethasone is a feasible anti-emetic therapy in an inpatient setting. I.v. ondansetron plus i.v. dexamethasone is highly effective in preventing acute cisplatin-induced nausea and vomiting.
Acute Disease↗
[Studies on transgenic oilseed rape (Brassica napus) plants transformed with beta-1,3-glucanase and chitinase genes and its resistance to Sclerotinia sclerotiorium].
By Agrobacterium-mediated method, the cotyledonary petiole of good quality rape variety H165 was transformed with plant expression vector pBLGC which constitutively express beta-1,3-glucanase and chitinase genes. We obtained some Kanamycin(Kan)-resistant regenerational green shoots, with these shoots, PCR identification was conducted. Results showed that 30% green shoots which grew in medium of Kan 15 mg/L and 53% green shoots in Kan 25 mg/L had positive reaction. We also made dot blot analysis with those green shoots, some of them gave positive signal, indicating that the foreign genes had integrated into rape genome. Fungal challenge of these transgenic plants showed that some plants were much more resistant to Sclerotinia sclerotiorium than non-transgenic control plants.
Ascomycota↗
Anesthesia for patients with aortic aneurysm for non-aneurysmal surgery--a retrospective study.
BACKGROUND: Most anesthesiologists at one time or other saw the anesthetic management of patients with aortic aneurysm who underwent surgical procedures other than correction of aneurysm with or without prior knowledge of the existence of the aneurysm. The risk of intraoperate rupture of aneurysm depends on its size, type, severity, and presentation of symptoms; stress and unstable hemodynamics have been usually held responsible for the aggravation and even rupture of aneurysm. There are numerous other factors that affect the hemodynamic force during anesthesia and surgery, the increase of which would be very dangerous to the surgical patients with aortic aneurysm whether they receive anesthesia for a radical correction of the disease per se or for a surgical procedure unrelated to its correction. Therefore the anesthetic management of a patient with aortic aneurysm is a great challenge which the anesthesiologist must accept. Here, we present eleven cases of aortic aneurysm, who underwent non-corrective surgery during 1992-1998. METHODS: There were eight cases of thoracoaortic dissecting aneurysm and three cases of abdominoaortic aneurysm. All underwent laparotomy under general anesthesia without the aneurysm being corrected. We reviewed the anesthetic management of these patients retrospectively. RESULTS: Our review showed that no aneurysm rupture was noted in these eleven cases. Seven of the eleven patients are still alive at the time of this report. CONCLUSIONS: We are of the opinion that under close monitoring and with prompt treatment, the allowance of a slow climb of arterial pulse pressure is acceptable and would not increase the risk of aneurysm rupture.
Aged↗
The value of transbronchial lung biopsy in the diagnosis of peripheral lung tumors according to cell type.
BACKGROUND: Transbronchial lung biopsy (TBLB) is a useful diagnostic tool for peripheral lung tumors. However, the success rate is variable. Our study was designed to investigate the value of TBLB without fluoroscopic guidance in the diagnosis of variable cell types of peripheral lung cancers. METHODS: A retrospective study was conducted to investigate a total of 597 patients who had undergone fiberoptic bronchoscopy for lung mass on chest X-ray in Chang Gung Memorial Hospital from January 1996 to December 1998. The lung masses were proven to be malignant by cytology and histology. RESULTS: Of 358 patients (60.0%) proven with malignancy, 107 patients presented with peripheral lung cancer (17.9%), including 59 with adenocarcinoma, 26 with squamous cell carcinoma, 11 with poorly differentiated carcinoma, 3 with small cell carcinoma, and 8 with metastatic cancers. The diagnostic rate of peripheral lung cancer by TBLB reached 54.2%. The sensitivity rates of detection of non-small cell type by TBLB were adenocarcinoma, 50.9%; squamous cell carcinoma, 61.5%; and poorly differentiated carcinoma, 72.7%, while that of small cell carcinoma was 100%. In contrast, the sensitivity rate of TBLB for metastatic cancers was lower (12.5%) than for primary lung cancers. Repeated TBLB of peripheral lung cancers increased the diagnostic rate from 49.5% to 54.2%. CONCLUSION: TBLB is an effective bronchoscopic sampling technique in the diagnosis of peripheral lung tumors without additional risk. The use of TBLB in the clinical routine should be encouraged.
Biopsy, Needle↗
Value of bronchoalveolar lavage combined with transbronchial lung biopsy in the diagnosis of peripheral lung cancer.
BACKGROUND: Bronchoalveolar lavage (BAL) is a safe and established procedure to evaluate interstitial lung diseases and pulmonary tuberculosis. The diagnostic rate of peripheral lung cancer invisible through bronchoscopy applied by transbronchial lung biopsy (TBLB) is still low. The study was designed to evaluate whether BAL combined with TBLB might improve the positive value in the diagnosis of peripheral lung cancer. METHODS: Thirty-seven of 72 patients who presented with peripheral lung lesions in chest radiography were proven to have a malignancy according to the final reports of cytology, histology, and clinical evidence. Each patient received BAL with or without TBLB. The patterns of chest radiography of the malignancies included 33 of infiltrative type and 4 of massive or nodular type. RESULTS: BAL alone revealed positive malignant cells in 18 of 37 cases (sensitivity 48.6%), and the diagnostic value significantly increased to 73.0% (p < 0.05) with BAL + TBLB. In the infiltrative type of lung cancer, the diagnostic rate of BAL + TBLB (78.8%) was significantly improved compared to that of BAL alone (51.5%, p < 0.05). There was no difference of diagnostic value in those with nodular type. BAL + TBLB can achieve a very high diagnostic rate (100%) in cases of metastatic malignancy (n = 4). Only 2 patients developed bleeding post BAL + TBLB, and it was easily controlled by epinephrine spraying. One patient developed self-limited hemoptysis. CONCLUSION: BAL + TBLB is a safe and valuable procedure to achieve a high sensitivity rate in the diagnosis of peripheral lung cancer, especially of the infiltrative type.
Adult↗