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Biomedical subjects

C K Lin

Publications and source records attributed to C K Lin.

At least 91 records · Page 5Linked to original sources

Gallbladder function and recurrent stones of the biliary tract in patients after endoscopic sphincterotomy.

BACKGROUND: Change in gallbladder function may occur in patients with an intact gallbladder after endoscopic sphincterotomy (EST). This study was designed to evaluate the factors influencing gallbladder filling after EST and the correlation between gallbladder function and stone recurrence. METHODS: Sixty Chinese patients with symptomatic choledocholithiasis and an intact gallbladder received EST to clear the bile ducts. They were further investigated with sphincter of Oddi manometry (SOM), quantitative cholescintigraphy (QC), and long-term clinical follow-up. RESULTS: Fifty-six of the 60 patients in the study group were confirmed to have a loss of sphincteric function by SOM. QC showed normal gallbladder filling in 35 of these patients and delayed or non-filling in 21 patients. A significantly higher incidence of normal gallbladder filling occurred in patients with juxtapapillary diverticulum than in those without (P < 0.02), but preexisting cholecystolithiasis had no effect on it. During the follow-up period (median, 32 months: range, 9-54 months) 10 of 56 patients developed recurrent choledocholithiasis. There was no correlation between the status of gallbladder filling, preexisting cholecystolithiasis, and recurrent stones, but 9 of the 10 patients with recurrent stones had a juxtapapillary diverticulum. Repeated endoscopic treatment was satisfactory in eight patients, and only two patients received cholecystectomy. CONCLUSIONS: EST does not alter gallbladder function in most patients. Juxtapapillary diverticulum may facilitate gallbladder filling after EST, but it is also a possible factor for recurrent choledocholithiasis.

Aged↗

A case of hydrops fetalis, probably due to antibodies directed against antigenic determinants of GP.Mur (Miltenberger class III) cells.

The GP.Mur (Miltenberger class III) phenotype was found to occur in about 6.3 percent of Hong Kong (HK) Chinese blood donors. The incidence of antibodies directed against antigenic determinants of GP.Mur cells (anti-Mi) among patients was 0.34 percent, similar to that in Taiwan Chinese. A case of hydrops fetalis probably attributable to maternal anti-Mi was encountered in an HK Chinese woman during her sixth pregnancy. The anti-Mi was potent (titer 512, score 99). It fixed complement and was a mixture of IgG1 and IgG3. Two biological assays, the monocyte monolayer assay and the chemiluminescence test, were strongly positive. The father was found to be heterozygous for the GP.Mur gene.

Journal Article↗

Production of hematopoietic regulatory cytokines by peripheral blood mononuclear cells in patients with aplastic anemia.

The aim of this study was to measure the level of cytokines produced by peripheral blood mononuclear cells (PBMNC) in patients with aplastic anemia (AA) and determine their effect on normal bone marrow (BM) colony growth. Thirty-five patients with AA and 21 normal controls were enrolled in the study. Medium conditioned by PBMNC of AA patients in the presence of phytohemagglutinin (PHA) was found to be suppressive to the clonal growth of normal BM cells. Thus, we further determined the presence in the PBMNC conditioned medium (CM) of inhibitory cytokines (macrophage inflammatory protein-1 alpha [MIP-1 alpha], transforming growth factor-beta 2 [TGF-beta 2], interferon-gamma [IFN-gamma], and tumor necrosis factor-alpha [TNF-alpha]) and stimulatory cytokines (granulocyte-macrophage colony-stimulatory factor [GM-CSF], interleukin-3 [IL-3], and stem cell factor [SCF]). The results show no significant difference between AA patients and normal controls in the spontaneous production of all cytokines by PBMNC. After PHA stimulation, the production of MIP-1 alpha, IFN-gamma, TNF-alpha, and GM-CSF significantly increased in the cultures of AA patients (p = 0.0009, 0.0002, 0.0022, and 0.0156, respectively). However, both TGF-beta 2 and SCF were undetectable in most of the tested samples. IL-3 was measured in the conditioned medium only after PHA stimulation, but without significant difference between the two groups (p = 0.67). Furthermore, the myelopoietic suppressing effect of AA-PBMNC CM could be significantly blocked by pretreatment with specific antibodies to the corresponding inhibitory cytokines (MIP-1 alpha, IFN-gamma, and TNF-alpha). After antibody neutralization, an apparent change occurred in the clonal growth of normal BM cells incubated with AA-PBMNC CM, resulting in colony enhancement of 205, 131, and 237% by anti-MIP-1 alpha, anti-IFN-gamma, and anti-TNF-alpha, respectively. These results suggest that overproduction of inhibitory cytokines, rather than underproduction of stimulating cytokines, may play a role in the progression of at least some patients with AA.

Anemia, Aplastic↗

Regulation of low-density lipoprotein receptors and assessment of their functional role in Burkitt's lymphoma cells.

The status of low-density lipoprotein receptors (LDLR) in Daudi Burkitt's lymphoma (BL) cells was examined using a flow cytometric assay employing the fluorescent ligand DiI-LDL, and a radioligand-binding assay using [125I]LDL. The binding is concentration-and time-dependent; and is specific, as judged by its competitive displacement in the presence of unlabeled LDL, and inhibition by heparin, EGTA, and 4 degrees C incubation. The regulation of the receptor and its functional role were then explored. Our results suggest the following: (a) In sharp contrast to normal peripheral blood lymphocytes, the LDLR levels in BL cells are basally elevated when cultured in fetal bovine serum (FBS) medium. (b) In accord with normal peripheral blood lymphocytes, incubation in lipoprotein-deficient serum (LPDS) medium further up-regulates the level of the receptor in BL cells, and co-incubation with LDL or 25-hydroxycholesterol down-regulates the receptor level. The magnitude of the up-regulation is significantly smaller than in normal peripheral blood lymphocytes. (c) Northern blots using a plasmid-DNA probe for LDLR mRNA point to a similar pattern for message regulation as is observed in direct binding studies. (d) Although the LDLR level is constitutively high in BL cells, availability of LDL, unlike transferrin, is not a growth requirement since incubation of cells in LPDS medium does not prevent proliferation of these cells. (e) In contrast to anti-transferrin receptor antibody which results in apoptosis upon binding, anti-LDLR antibody does not inhibit growth or induce apoptosis. Our results suggest LDLR is expressed at a significantly higher level in BL cells than in normal peripheral blood lymphocytes. Although up-regulation and down-regulation of LDLR are observed, this applies only to a small population of LDLR. The bulk receptor population is significantly resistant to down-regulation. Furthermore, notable differences in the functional role of the LDLR are found relative to the transferrin receptor which is also up-regulated in the BL cells.

Apoptosis↗

Dimethyl sulfoxide suppresses apoptosis in Burkitt's lymphoma cells.

Previous reports have suggested that dimethyl sulfoxide (DMSO) may be a useful reversible G1 arresting agent for synchronizing Raji Burkitt's lymphoma cells (K. Takase et al. (1992) Cell Growth Differ. 3, 515-521; M. Sawai et al. (1990) Exp. Cell Res. 187, 4-10). We have therefore critically evaluated several aspects of DMSO's effects using Daudi and Ramos Burkitt's lymphoma (BL) cells. In BL cells starved in the presence or absence of DMSO for 4 to 6 days (approximately four to six doubling times), the following observations were noted: (A) Both Daudi and Ramos cells show increased cell synchrony accompanied by apoptosis when starved in RPMI 1640 supplemented with 10% fetal calf serum (FCS). Inclusion of 1.5% DMSO causes a diminution in apoptosis with minimal effects on synchrony. (B) Lowering the FCS concentration to 5% induces apoptosis. DMSO-mediated protection from apoptosis is observed in Daudi but not in Ramos. (C) When human serum (10%) is used instead of FCS, Daudi cells show no apoptosis and DMSO is without effect on cell cycle distribution. By contrast, Ramos cells show significant apoptosis, which is prevented by the inclusion of DMSO. (D) When starved in a chemically defined medium (AIM-V), both Daudi and Ramos cells show significant apoptosis. DMSO protects Ramos from apoptosis under these conditions. (E) Upon removal of DMSO, both Daudi and Ramos cells reenter the cell cycle but with significant apoptosis. (F) The protective effect of DMSO from apoptosis is observed in a narrow range of concentration between 1 and 2%. At higher concentration, DMSO itself induces apoptosis. These results suggest that DMSO itself prevents apoptosis, an effect which may present as an apparent effect on cell synchrony.

Apoptosis↗

Overproduction of inhibitory hematopoietic cytokines by lipopolysaccharide-activated peripheral blood mononuclear cells in patients with aplastic anemia.

The aim of this study was to measure the level of cytokines produced by peripheral blood mononuclear cells (PBMNC) in patients with aplastic anemia (AA) and to determine their effect on the clonal growth of normal bone marrow (BM) cells. Twenty-one patients with AA and 11 normal controls were enrolled in this study. Medium conditioned by PBMNC of AA patients in the presence of lipopolysaccharide (LPS) was found to be suppressive to the colony growth of normal BM cells. Thus, we further determined the presence in the PBMNC-conditioned medium (CM) of both inhibitory cytokines: macrophage inflammatory protein-1 alpha (MIP-1 alpha), tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta 2 (TGF-beta 2), and interferon-gamma (IFN-gamma), and stimulatory cytokines: interleukin-3 (IL-3) and stem cell factor (SCF). Spontaneous production of MIP-1 alpha was higher in the AA patients than the normal controls (1887 +/- 174 pg/ml vs 1643 +/- 93 pg/ml), but the difference was not significant. After LPS stimulation, the production of MIP-1 alpha was markedly increased in the AA patients, and its level was significantly higher than that of the normal controls (2360 +/- 149 pg/ml vs 1517 +/- 92 pg/ml, p = 0.0022). The level of TNF alpha was also higher in the AA patients. However, IFN-gamma, TGF-beta 2, SCF, and IL-3 were not detectable in the PBMNC-CM of either AA patients or normals. The myelopoietic suppressing effect of AA-PBMNC-CM from each AA patient was significantly blocked by pretreatment with anti-TNF-alpha, resulting in a colony-forming enhancement of 174% +/- 12%. A similar effect was noted in six of 11 AA patients by pretreatment with anti-MIP-1 alpha. We conclude that TNF alpha and MIP-1 alpha can be overproduced by the PBMNC of some AA patients, which may play a role in the progression of AA.

Anemia, Aplastic↗

Synergy between signal transduction pathways is obligatory for expression of c-fos in B and T cell lines: implication for c-fos control via surface immunoglobulin and T cell antigen receptors.

Expression of the protooncogene c-fos is controlled by three main regulatory pathways involving kinase C, cAMP, and calcium. Kinase C mediates its effects via phosphorylation of serum response factor (SRF) which interacts with the serum response element (SRE); cAMP and calcium mediate their effects via phosphorylation of CREB (cAMP regulatory element binding protein) presumably by activation of a protein kinase A or calmodulin-regulated kinase. We have examined the function of these elements in Burkitt's lymphoma cells (Ramos and Daudi) as well as a T lymphocytic cell line (Jurkat). We have found that stimulation of any one of these pathways alone has little or no effect on c-fos induction. However, kinase C activation (PMA stimulation) combined with either cAMP (forskolin plus MIX) or calcium stimulation (ionophore) leads to greatly enhanced c-fos induction. By contrast, cAMP in the presence of calcium shows no synergy in c-fos induction. Okadaic acid augments PMA- as well as calcium-mediated activation of c-fos, and has little or no effect when combined with cAMP. The main difference between Ramos (B cells) and Jurkat (T cells) in the regulation of c-fos is that cAMP plus calcium is strongly synergistic in Jurkat and is without effect in Ramos. Analysis of AP-1 activity using gel mobility shift assays confirms that the requirements for synergy in c-fos mRNA induction are paralleled by requirements for synergy in induction of AP-1 activity. Signaling in B cells due to anti-Ig stimulation involves both kinase C activation and release of intracellular calcium, and results in c-fos mRNA induction. Our results indicate that synergy between the kinase C activation and calcium is needed for efficient c-fos induction since neither of these two alone induces c-fos well. That synergy of signaling pathways is relevant for the anti-Ig induction of c-fos is supported by the fact that cAMP-inducing agents and okadaic acid further enhance anti-Ig induction of c-fos. These results suggest that cell-specific patterns of synergy are an essential feature for c-fos induction and may be relevant for c-fos control through B and T cell antigen receptors.

Antibodies, Anti-Idiotypic↗

Large granular lymphocyte leukemia. A study of nine cases in a Chinese population.

Large granular lymphocyte (LGL) leukemia is a neoplastic disorder of lymphocytes that is characterized by the presence of prominent cytoplasmic granules, and involves the proliferation of at least two distinct cell types, T cells and natural killer (NK) cells. The authors report the clinical and pathologic features of 9 Chinese patients with LGL leukemia, who represented 14% of 64 cases of chronic lymphoproliferative disorders diagnosed at their centers in 3 years. Three different groups could be defined on immunophenotypic and clinical grounds. The first group of 4 cases were CD2+CD3+CD4-CD8+. With the exception of a pediatric case, these cases ran an indolent course that was similar to the T-cell LGL leukemia most common in Western patients. However, thrombocytopenia and pure red cell aplasia were more common in the patients in this study, which was similar to the experience in Japanese patients. The second group of two cases were CD2+CD3+CD4+CD8-, and appeared to have worse outcomes than the first group. The third group of 3 cases were CD2+CD3-CD4-CD8-CD56+. Although phenotypically similar to the NK-cell LGL leukemia reported in Western patients, these cases were clinically more aggressive than their Western counterparts. This study is the first to report comprehensively the different types of LGL leukemias in Chinese patients, and provides useful information on the similarities and similarities and differences of these disorders as compared to those cases in the West.

Adult↗

Hemolytic transfusion reaction due to Rh antibodies detectable only by manual polybrene and polyethylene glycol technique.

The authors report two cases of severe hemolytic transfusion reaction (HTR) attributable to Rh antibodies, which were not detectable by the saline indirect antiglobulin test (SIAT), low ionic strength saline solution technique (LISS), or two-stage enzyme (Enz) indirect antiglobulin test (IAT), but were readily detectable by the manual polybrene technique (MPT), MPT-IAT, and polyethylene glycol (PEG) IAT. With rare exceptions, Rh antibodies can usually be easily detected by the SIAT or Enz-IAT, and seldom cause intravascular HTR. The two cases in this report illustrate the value of the MPT and PEG-IAT in the detection of clinically significant Rh antibodies that would not otherwise be detectable by conventional methods.

Adult↗

In-vitro activity of oxazolidinones against Mycobacterium avium complex.

Options for treating disseminated Mycobacterium avium complex (MAC) disease have improved. However, efficacy is not always certain, resistance is common and rapidly bactericidal agents would improve efficacy and prevent resistance. Certain oxazolidinones were tested against MAC strains and inhibited growth at expected serum concentrations or lower. Activity correlated with hydrophobicity and one agent was bactericidal at concentrations two to five times greater than the MIC.

Amikacin↗

Use of NS-4 peptides to identify type-specific antibody to hepatitis C virus genotypes 1, 2, 3, 4, 5 and 6.

The 5' end of the NS-4 protein of different genotypes of hepatitis C virus (HCV) is highly variable in nucleotide and inferred amino acid sequence, with frequent predicted amino acid substitutions between all six of the major HCV genotypes described to date. This region has been shown to be antigenic by epitope mapping, and elicits antibody in HCV-infected individuals with a detectable type-specific component. We have used this sequence data to specify branched peptides for an indirect binding/competition assay to detect type-specific antibody to each major genotype. A total of 183 out of 210 samples (87%) from blood donors and patients with chronic hepatitis C infected with genotypes 1 to 6 showed detectable type-specific antibody to NS-4 peptides that in almost all cases (> 97 %) corresponded to the genotype detected by a PCR typing method. These findings demonstrate the existence of major antigenic differences between genotypes of HCV, and indicate how infection with different variants of HCV may be detected by a serological test.

Amino Acid Sequence↗

Development and evaluation of two novel oligonucleotide probes based on 16S rRNA sequence for the identification of Salmonella in foods.

DNA sequence in the V3 to V6 region of the 16S rRNA gene of Salmonella enteritidis was determined. By comparison of this sequence with those of Escherichia coli and Proteus vulgaris obtained from GenBank/EMBL database, three oligonucleotides termed as 16S I, 16S II and 16S III were synthesized. Hybridization of these oligonucleotides with 325 Salmonella isolates and some non-Salmonella isolates including the Salmonella closely related species of the family of Enterobacteriaceae showed that 16S II could not be used as a Salmonella specific-probe. 16S I and 16S III hybridized with all the Salmonella isolates tested, the former also hybridizing with Citrobacter spp. and the latter hybridizing with Klebsiella pneumoniae as well as Serratia marcescens. Since enrichment of the target cells in food samples was usually required prior to the DNA hybridization assay, the interference from those non-Salmonella isolates could be prevented by enrichment by culturing in lactose-combined tetrathionate (CTET) broth followed by Gram-negative (GN) broth at 37 degrees C and/or 43 degrees C. Such a culture step could inhibit the growth of Klebsiella spp., Ser. marcescens and/or Citrobacter spp. and allowed the specific detection of Salmonella.

Base Sequence↗

Hydrosonography in the evaluation of colorectal polyps.

Prewarmed saline enemas and transabdominal ultrasound (hydrosonography) were used to evaluate 17 consecutive children with rectal bleeding before colonoscopy. Twelve patients with polyps were identified (10 by ultrasound, 10 by endoscopy): these included multiple hyperplastic polyps (1), multiple polyps (1), solitary polyps (9), and pseudopolyps (1). Ultrasound identified 11 polyps in 10 patients, missing two patients with small polyps less than 0.5 cm in diameter. The polyps were hyperechoic ovoid masses fixed to the colonic wall, with a stalk (7), submucosal infolding (5), and intraluminal floating (5). There was one false positive. Colonoscopy was refused by one patient and failed to reach beyond the distal sigmoid in another following previous surgery for malrotation. Colonoscopy was superior in identifying finer mucosal detail (colitis, ulcers, proctitis, anal fissure) and in detecting smaller polyps (sessile polyps, hyperplastic polyps). Hydrosonography of the colon is a simple, relatively non-invasive procedure that provides an alternative, radiation-free examination of the whole colon before colonoscopy. It is complementary to colonoscopy in the management of rectal bleeding in children.

Child↗

The first example of anti-Gya detected in Hong Kong.

The incidence of anti-Gya is known to be extremely rare, and only a few examples have been reported in Japanese persons and in Caucasians. This case history reports the first example of anti-Gya detected in a Chinese person. The propositus is an 83-year-old male patient whose anti-Gya was revealed because of incompatibility of all units of blood tested by a saline indirect antiglobulin test (SIAT). Although the antibody had a titer of 512 by SIAT, 10 units of Gy(a+) red cells were transfused without any adverse effect.

Journal Article↗

Hepatocellular carcinoma with metastasis to right atrium--a report of three cases.

Hepatocellular carcinoma (HCC) is one of the most common neoplasma in Taiwan. The tumor itself has the tendency of extension into the venous system, such as to the portal vein, hepatic vein and inferior vena cava (IVC), but intra-atrial metastasis is unusual. Antemortem diagnosis was difficult before the availability of two-dimensional echocardiography (2-DE). Sometimes, the first symptoms and signs are cardiogenic manifestations such as dyspnea on exertion, syncope, edema of the lower legs, and shock. Clinicians may mistakenly make the wrong diagnosis of heart failure. Because of this, we hereby report three cases of HCC with right intra-atrial metastasis to raise the physician's awareness. All three cases initially presented as right side heart failure. Imaging study revealed hepatocellular carcinoma with right intra-atrial metastasis. Two of the three cases died within one month after diagnosis.

Aged↗

Induction of megakaryocytic differentiation in a newly established human leukemic cell line by 12-o-tetradecanoylphorbol-13-acetate.

BACKGROUND: Biological studies on megakaryopoiesis have been hampered by the scarcity of megakaryocytes in normal bone marrow and difficulty in long term culture. Alternatively, leukemic cell lines with megakaryocytic differentiation potential may provide good models to counter these problems. METHODS: Leukemic cells from a patient with acute megakaryocytic leukemia were put into long-term culture and established into a cell line which was designated as VGH-MK1. The VGH-MK1 cells were challenged with differentiation agents and/or cytokines, and the differentiation of these cells was examined using morphological, immunocytochemical and surface-marker studies. RESULTS: Morphologically, VGH-MK1 cells had prominent nucleoli and basophilic cytoplasm with some protrusions, but large cells were occasionally seen. Under regular culture condition, the cells had a doubling time of 36-48 hours. The cloned cell line exhibited markers characteristic of megakaryoblasts after differentiation induction. Specifically, when stimulated with 12-o-tetradecanoylphorbol-13-acetate (TPA), cells became larger and had large or multinuclei. They were induced to express platelet glycoproteins GPIb (CD42b), GPIIb/IIIa (CD41), and GPIIIa (CD61) antigens, but not erythroid nor lymphoid markers. Platelet peroxidase (PPO) activity was also induced. Retinoic acid did not exhibit similar differentiation-inducing effects. In contrast, it counteracted the effects induced by TPA. CONCLUSIONS: An unique human leukemic cell line, VGH-MK1, has been established here. It could be induced to exhibit some characteristics of megakaryocytic lineage, and may be an useful model for the biological studies of megakaryopoiesis.

Adult↗