Biomedical subjects

C S Chang

Publications and source records attributed to C S Chang.

At least 55 records · Page 3Linked to original sources

PubMed2000

Endoscopic treatment of bleeding gastric varices by N-butyl-2-cyanoacrylate (Histoacryl) injection: long-term efficacy and safety.

BACKGROUND: The long-term efficacy and safety of the endoscopic injection of N-butyl-2-cyanoacrylate (Histoacryl) were evaluated to define its role as the initial treatment for bleeding gastric varices. METHODS: Ninety patients with bleeding gastric varices underwent endoscopic injections of Histoacryl for hemostasis within a 6-year period. Histoacryl was injected intravariceally as a 1:1 mixture with Lipiodol. Among the 90 patients, 5 had active bleeding and 85 had recent bleeding. Most of the varices were large (F2 or F3, 85 cases). The most common locations were the fundus and the posterior wall of the proximal body (94.4%). After Histoacryl injection, patients were followed endoscopically with retreatment as necessary. RESULTS: The rate of hemostasis at 1 week was 94.4%. Recurrent bleeding occurred in 23.3% of the patients from 3 days to 16 months after the initial injection. Recurrent bleeding was stopped with reinjections of Histoacryl in 16.7% of the patients. The rate of definitive hemostasis was 93.3% (84 of 90). The treatment failure-related mortality rate was 2.2% (2 of 90). To date, 35 patients have died, mostly as a result of malignancy or liver failure, and 55 are still alive. The determining factor for long-term survival was the underlying disease leading to portal hypertension. There were few long-term complications except for Histoacryl cast extrusion-related mucosal defects. CONCLUSIONS: Endoscopic injection of Histoacryl is highly effective for the treatment of bleeding gastric varices, with rare complications both acutely and long term. This treatment modality is appropriate as the first choice for bleeding gastric varices.

Adult↗

PubMed2000

Generation and characterization of a monoclonal antibody that recognizes an activation antigen expressed by a majority of adherent lymphokine-activated killer cells.

In an attempt to generate murine natural killer (NK) cell-specific monoclonal antibodies (MAbs) by immunizing Balb/c mice with C57BL/6 (B6) A-LAKs, we have isolated a hybridoma, CS/NicT.2, which secretes an IgM that recognizes a majority of B6 and B6 Rag-1-/- A-LAKs. The CS/NicT.2 antigen is highly expressed by A-LAKs, but only at extremely low levels on resting splenocytes, suggesting that its expression is tightly associated with IL-2 activation. Among the cell lines examined, only CTLL-2 expresses the CS/NicT.2 antigen at relatively high levels. A low level of CS/NicT.2 staining is also detected on resting allo-specific cytotoxic T lymphocytes (CTL) clones, AB.1 and C11. In addition, a similar low level of CS/NicT.2 staining is detected on the T-helper cell line HT-2. The CS/NicT.2 antigen is upregulated by ionomycin but not by phorbol 12-myristate 13-acetate (PMA). For the CTL clones examined, CS/NicT.2 staining is also dramatically increased by anti-TCRbeta or anti-CD3epsilon stimulation. Protease treatments of CTLL-2 show that this antigen is proteinase K sensitive, but relatively resistant to trypsin digestion. Furthermore, the CS/NicT.2 antigen exhibits a relatively fast turnover rate as assessed by proteinase K and cycloheximide treatments of CTLL-2, suggesting that the CS/NicT.2 antigen may have a short half-life on the cell surface.

Animals↗

PubMed2000

Can percutaneous endoscopic jejunostomy prevent gastroesophageal reflux in patients with preexisting esophagitis?

OBJECTIVE: Percutaneous endoscopic jejunostomy has been used for preventing pulmonary aspiration arising from gastric contents by concomitant jejunal feeding and gastric decompression in susceptible patients. Our objective was to evaluate gastroesophageal reflux in patients with percutaneous endoscopic jejunostomy tube feeding. METHODS: Eight cerebrovascular accident patients with percutaneous endoscopic jejunostomy tube placement caused by reflux esophagitis with hematemesis, food regurgitation or vomiting, and/or recurrent aspiration pneumonia were tested for gastroesophageal reflux using 24-h esophageal pH monitoring during continuous jejunal liquid meal or saline infusion with concomitant gastric decompression. Twenty-four hour pH monitoring was also performed during intragastric feeding on a different day. RESULTS: During the liquid meal feeding period, percutaneous endoscopic jejunostomy feeding reduced esophageal acid exposure 46% [12.9% (4.9-28.2%) versus 24.0% (19.0-40.6%), p = 0.01], compared to intragastric feeding. However, in the period of the jejunal tube infusion, esophageal acid exposure was significantly lower during saline infusion than during meal infusion [3.2 (0.0%-10.8%) versus 12.9% (4.9-28.2%), p = 0.008]. CONCLUSION: Percutaneous endoscopic jejunostomy feeding reduced but did not eliminate gastroesophageal reflux, compared to intragastric feeding in patients with severe gastroesophageal reflux. However, gastroesophageal reflux during percutaneous jejunal feeding was associated with meal infusion. This might, in part, explain the failure of percutaneous endoscopic jejunostomy tube placement to prevent pulmonary aspiration.

Aged↗

PubMed2000

Endoscopic endonasal transsphenoidal surgery for pituitary tumors.

BACKGROUND: The traditional transsphenoidal approach for pituitary surgery can be performed via transnasal, transseptal, or sublabial routes through unilateral or bilateral nostrils. It requires wide mucosal and septal dissection and postoperative nasal packing. Endoscopic surgery has been widely used because it allows excellent visualization with minimal invasion. Recently, it has also been applied to pituitary surgery. METHODS: From January, 1997 to February, 1999, 40 patients with pituitary adenomas underwent the transsphenoidal approach using a rigid endoscope via one nostril. Among the 40 cases, 18 were prolactinomas, seven were growth hormone-secreting adenomas and 15 were nonfunctional adenomas. RESULTS: After surgery, complete resolution or improvement of symptoms and restoration of normal hormone levels were achieved in 16 patients with prolactinomas, five with growth hormone-secreting adenomas and 12 with nonfunctional macroadenomas. One patient with a recurrent microprolactinoma needed a second operation to remove the cavernous portion of the tumor. Another male patient with a macroprolactinoma who experienced galactorrhea and gynecomastia showed improvement of clinical symptoms after the operation. Two patients with residual growth hormone-secreting macroadenomas in the cavernous sinus needed Sandostatin treatment. Three patients with nonfunctional macroadenomas underwent nearly total resection leaving residual tumor in the cavernous sinus, which then required adjuvant radiotherapy. No complications related to this approach were encountered in the patients during the follow-up period. CONCLUSIONS: Endonasal transsphenoidal endoscopic surgery can be employed for treating pituitary tumors without septal or sublabial complications. Postoperative suffering was reduced and hospitalization was shortened by this mini-invasive procedure. This surgical procedure can be used for both microadenomas and macroadenomas.

Adenoma↗

PubMed2000

Establishment and characterization of a cell line (HCDB-1) derived from a hamster buccal pouch carcinoma induced by DMBA and Taiwanese betel quid extract.

This study identified that the carcinogenesis of hamster buccal pouch (HBP) induced by 7,12-dimethylbenz[a]anthracene (DMBA) was greatly enhanced (18 folds) by a combination treatment with Taiwanese betel quid (BQ) extract. A new cell line, HCDB-1, has been established from induced carcinomas. The cultured monolayer cells were epithelioid in shape with irregular nuclei. They demonstrated abundant cytokeratin and tonofilaments; however, ultrastructural well-organized desmosomes were lacking. The HCDB-1 cell exhibited population doubling in 19 h and was highly tumorigenic in nude mice. A C-->T transition at codon 141 (Ala to Val) of the p53 gene was detected in this cell. This mutation is equivalent to a specific temperature-sensitive mouse p53Ala135Val mutant that causes transformation by shifting to 37.5 degrees C. HCDB-1 is the first cell line established from the HBP model of oral carcinogenesis induced by DMBA/Taiwanese BQ extract. It might be valuable for exploring the molecular pathogenesis of oral cancer.

9,10-Dimethyl-1,2-benzanthracene↗

PubMed2000

Alterations of adenomatous polyposis Coli (APC) gene in oral squamous cell carcinoma.

The present study assessed the roles of Adenomatous Polyposis Coli (APC) tumor suppressor gene during oral carcinogenesis. Reduction of APC transcript levels and APC loss of heterozygosity (LOH) were found in 39% (7/18) and 29% (10/34) cases of oral squamous cell carcinoma (OSCC), respectively. The apparent APC heterozygosity (27%) in non-cancerous matched oral tissue (NCMOT) adjacent to OSCC at an exon 11 locus was significantly lower than normally found in the Taiwanese population (49%). These findings suggest that the allelic status of APC could indicate a cancer risk. No polymorphism of 11307 allele of APC was identified in NCMOT or OSCC. Our data indicated that alterations of APC are frequent molecular changes of OSCC. Advances in understanding of the APC alterations that accompany OSCC development might provide a means for early diagnosis and possibly new therapeutic strategies.

Carcinoma, Squamous Cell↗

PubMed1999

Copper(II)-induced self-oligomerization of alpha-synuclein.

alpha-Synuclein is a component of the abnormal protein depositions in senile plaques and Lewy bodies of Alzheimer's disease (AD) and Parkinson's disease respectively. The protein was suggested to provide a possible nucleation centre for plaque formation in AD via selective interaction with amyloid beta/A4 protein (Abeta). We have shown previously that alpha-synuclein has experienced self-oligomerization when Abeta25-35 was present in an orientation-specific manner in the sequence. Here we examine this biochemically specific self-oligomerization with the use of various metals. Strikingly, copper(II) was the most effective metal ion affecting alpha-synuclein to form self-oligomers in the presence of coupling reagents such as dicyclohexylcarbodi-imide or N-(ethoxycarbonyl)-2-ethoxy-1,2-dihydroquinoline. The size distribution of the oligomers indicated that monomeric alpha-synuclein was oligomerized sequentially. The copper-induced oligomerization was shown to be suppressed as the acidic C-terminus of alpha-synuclein was truncated by treatment with endoproteinase Asp-N. In contrast, the Abeta25-35-induced oligomerizations of the intact and truncated forms of alpha-synuclein were not affected. This clearly indicated that the copper-induced oligomerization was dependent on the acidic C-terminal region and that its underlying biochemical mechanism was distinct from that of the Abeta25-35-induced oligomerization. Although the physiological or pathological relevance of the oligomerization remains currently elusive, the common outcome of alpha-synuclein on treatment with copper or Abeta25-35 might be useful in understanding neurodegenerative disorders in molecular terms. In addition, abnormal copper homoeostasis could be considered as one of the risk factors for the development of disorders such as AD or Parkinson's disease.

Alzheimer Disease↗

PubMed1999

The murine nonclassical class I major histocompatibility complex-like CD1.1 molecule protects target cells from lymphokine-activated killer cell cytolysis.

Classical class I major histocompatibility complex (MHC) molecules, as well as the nonclassical class I histocompatibility leukocyte antigen (HLA)-E molecule, can negatively regulate natural killer (NK) cell cytotoxicity through engagement of NK inhibitory receptors. We show that expression of murine (m)CD1.1, a nonpolymorphic nonclassical MHC class I-like molecule encoded outside the MHC, protects NK-sensitive RMA/S target cells from adherent lymphokine-activated killer cell (A-LAK) cytotoxicity. Passage of effector cells in recombinant interleukin (rIL)-2 enhanced protection by mCD1.1, suggesting an expansion of relevant A-LAK population(s) or modulation of A-LAK receptor expression. Murine CD1. 1 conferred protection from lysis by rIL-2-activated spleen cells of recombination activating gene (Rag)-1(-/-) mice, which lack B and T cells, demonstrating that mCD1.1 can protect RMA/S cells from lysis by NK cells. An antibody specific for mCD1.1 partially restored A-LAK lysis of RMA/S.CD1.1 transfectants, indicating that cell surface mCD1.1 can confer protection from lysis; therefore, mCD1.1 possibly acts through interaction with an NK inhibitory receptor. CD1.1 is by far the most divergent class I molecule capable of regulating NK cell activity. Finally, mCD1.1 expression rendered RMA/S cells resistant to lysis by A-LAK of multiple mouse strains. The conserved structure of mCD1.1 and pattern of mCD1.1 resistance from A-LAK lysis suggest that mCD1.1 may be a ligand for a conserved NK inhibitory receptor.

Animals↗

PubMed1999

Scanning electron microscopy observation of vascularization around hydroxyapatite using vascular corrosion casts.

An intimate relationship exists between the regenerative response of the vascular and osseous elements following hydroxyapatite (HA) implantation. In order to fully comprehend the 3-dimensional vascular architecture around HA, dense HA particles were implanted into the tibiae of dogs. Following healing periods of 2 weeks, 1 month, and 3 months, the tibiae were prepared by the corrosion cast technique. Under scanning electron microscopy (SEM) observation, the characteristic vascular morphology of the HA-implanted cavity was successfully demonstrated. The initial vascularization began in the form of loose sinusoidal capillaries. Many sinusoids formed a complex network by anastomosing with each other. The newly formed vessels extended centripetally from the peripheral cavity wall and from the periosteal surface. Under greater magnification, the tapered vascular sprouting was shown to project into the space that was previously occupied by an HA particle. The presence of vascular sprouting is clearly an important indicator of angiogenesis. Increasing vascularization was demonstrated with time. The presence of vessels in the Haversian's canal indicated the more established vascularization. Almost full vascularization of the HA-implanted cavity was seen 3 months after implantation. The vascular organizational layout of the cavity was also clearly shown in the fractured transverse-sectioned sample. In the control without HA implantation, the central region of the cavity showed a hollow pattern in the initial stage. The vascularization looked like it was collapsing and not fully filling the cavity. However, remarkable differences of the final vascular pattern could not be found between the study and control group after 3-month implantation. The study provides the time-lapsed 3-dimensional vascular changes of the HA-implanted cavity, as well as the value of the corrosion cast technique in examining the bony circulation.

Animals↗

PubMed1999

Isolation of a Helicobacter pylori protein, FldA, associated with mucosa-associated lymphoid tissue lymphoma of the stomach.

BACKGROUND & AIMS: The growth of gastric mucosa-associated lymphoid tissue lymphoma (MALToma) seems to depend on the stimulation of Helicobacter pylori. We attempted to identify specific antigen(s) from H. pylori strains associated with MALToma. METHODS: Membranous and secreted proteins of H. pylori were compared on sodium dodecyl sulfate-polyacrylamide gel electrophoresis by Western blot using sera from patients with MALToma. RESULTS: A 19-kilodalton protein was seen in all strains isolated from patients with MALToma but uncommonly in other strains. The protein was purified and sequenced. Amino acid sequence comparison showed it was an FldA homologue, a putative flavodoxin protein. DNA sequencing in 26 strains revealed that a nucleotide G insertion at position 481 of the fldA gene was more frequently observed in strains associated with MALToma than other strains (9/9 vs. 6/17; P = 0.002). The mutation caused a short truncation. A recombinant protein with this truncation was expressed and tested. Sera of 12 (70.6%) of 17 patients with MALToma were positive for the antibody to the recombinant protein, and 7 (16.7%) of 42 control patients were positive (12/17 vs. 7/42; P < 0.0001). CONCLUSIONS: Truncated FldA of H. pylori is associated with gastric MALToma. It may be involved in the pathogenesis of gastric MALToma. Antibody to this antigen could be used as a serological marker of the disease.

Adult↗

PubMed1999

Interaction between Helicobacter pylori and non-steroidal anti-inflammatory drugs in peptic ulcer bleeding.

BACKGROUND: Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs) are the two primary causes of peptic ulcer disease. How H. pylori and NSAIDs interact and influence the development of ulcer bleeding is still not clear. METHODS: A hospital-based, age- and sex-matched case-control study was conducted. Multivariate and stratified analyses were performed for further evaluation of the interaction between H. pylori and NSAIDs. RESULTS: Ninety-seven patients (52 gastric ulcers, 45 duodenal ulcers) and 97 non-ulcer controls were enrolled in the study. H. pylori and NSAIDs were both found to be independent risk factors for ulcer bleeding (H. pylori odds ratio, 2.22; 95% confidence interval (CI), 1.23-4.01; NSAIDs odds ratio, 4.57; 95% CI, 2.50-8.35). There was no synergistic effect. In contrast, a negative interaction was observed in the logistic regression and stratified analysis, although the difference was not significant (H. pylori adjusted odds ratio, 3.47; 95% CI, 1.73-6.95; NSAID adjusted odds ratio, 6.16; 95% CI, 3.14-12.09). CONCLUSION: H. pylori increases the risk of peptic ulcer bleeding but may play a protective role in NSAID users.

Aged↗

PubMed1999

Heterogeneous Helicobacter pylori isolates from H. pylori-infected couples in Taiwan.

Helicobacter pylori strain diversity was investigated in 55 H. pylori seropositive couples in Taiwan in biopsy samples from the antrum and corpus. Two DNA typing methods were used to characterize 90 isolates from 25 couples. In only 1 of the 25 couples was the same strain colonized from both partners. Comparison of isolates from 2 sites in each of 40 patients showed that 9 pairs were distinct but might be related. Peptic ulcer occurred in 77.8% of these 9 patients compared with 29% of 31 patients with the same predominant strain in 2 biopsies (P=.025). Random amplified polymorphic DNA and sequence analyses of 2 closely related isolates from 1 patient support the hypothesis that development of genetic diversity of H. pylori results from horizontal genetic exchange during long-term colonization of mixed bacterial populations.

Adult↗

PubMed1999

Generation of a monoclonal antibody that recognizes a polymorphic epitope of C57BL/6 Ly-49G2.

To facilitate the study of natural killer (NK) cell functions, we have generated a panel of hybridomas that secrete antibodies recognizing B6 NK cell surface markers. One of these hybridomas, Cwy-3, secretes a mouse IgG1 specific for the B6 allele of Ly-49G2 (Ly-49G2B6). In addition, this monoclonal antibody (MAb) fails to stain A-LAKs derived from all other mouse strains tested. This suggests that Cwy-3 recognizes a polymorphic epitope of Ly-49G2B6. More importantly, this MAb exhibits no cross-reactivity to other known B6 Ly-49 family members. Therefore, Cwy-3 is in sharp contrast to the two known anti-Ly-49G2 MAbs, which are reported to recognize a nonpolymorphic epitope of Ly-49G2, and react with other Ly-49 members. In this regard, Cwy-3 will offer significant advantages over the cross-reactive anti-Ly-49G2 MAbs in fully defining the specificity and function of the Ly-49G2B6 NK cell receptor. With this novel Ly-49G2-specific MAb, we have isolated an EL-4 subline expressing a significant density of Ly-49G2 receptors.

Animals↗

PubMed1999

Telomerase activity and in situ telomerase RNA expression in oral carcinogenesis.

To investigate the role of telomerase in oral carcinogenesis, we assayed telomerase activity in various oral tissues by a modified telomeric repeat amplification protocol (TRAP) analysis. Also, using digoxigenin-labeled probes, we measured the in situ expression of human telomerase RNA component (hTR) in paired oral squamous cell carcinomas (OSCC) and adjacent non-cancerous matched tissue (NCMT). We detected telomerase activity in three OSCC cell lines, but not in primary oral keratinocytes. In patient samples, most OSCC (36/42, 86%) and oral premalignant lesions (8/12, 67%) possessed telomerase activity. In addition, 6 of 27 (22%) NCMT contained weak telomerase activity. In situ hybridization showed that hTR was expressed in almost all OSCC (23/27, 85%) as well as in the majority of NCMT (20/25, 80%). In most cases, accumulation of hTR was observed both in the nucleus and cytoplasm of epithelial cells. A correlation between hTR expression and more advanced tumor grade was observed. The appearance of telomerase activation and hTR expression during oral carcinogenesis was different. This study indicates that the activation of telomerase is an early and frequent event in OSCC.

Adult↗

PubMed1999

Lipase-catalyzed synthesis of (S)-naproxen ester prodrug by transesterification in organic solvents.

A lipase-catalyzed enantioselective transesterification process was developed for the synthesis of (S)-naproxen 2-N-morpholinoethyl ester prodrug from racemic 2,2,2-trifluoroethyl naproxen ester in organic solvents. By selecting isooctane and 37 degrees C as the best solvent and temperature, the apparent fits of the initial conversion rates for transesterification and hydrolysis side reaction suggest a ping-pong Bi-Bi enzymatic mechanism with the alcohol as a competitive enzyme inhibitor. Improvements in the initial conversion rate and the productivity for the desired (S)-ester product were obtained after comparing with the result of an enantioselective esterification process. Studies of water content in isooctane and alcohol containing various N,N-dialkylamino groups on the enzyme activity and enantioselectivity, as well as the recovery of (S)-ester product by using extraction, were also reported.

Alcohols↗

PubMed1999

Differentiation characteristics of cholesteatoma epithelium determined by expression of transglutaminase isoenzymes.

Transglutaminase (TGase) isoenzymes are involved in the process of the differentiation and cornification of keratinocytes in the epidermis. This study investigates the presence and localization of three TGase isoenzymes to elucidate the nature and differentiation status of the squamous epithelium in human aural cholesteatoma. Twenty cholesteatoma specimens were used. The presence and localization of three TGase isoenzymes were studied by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry. mRNA expression of three TGase isoenzymes were detected in the tested cholesteatomas with variable levels. The immunohistochemical staining patterns of three TGase isoenzymes showed variations within specimens, relating to keratinizing activity. TGase K is the most abundant among three isoenzymes. Keratinizing epithelium of cholesteatoma have similar expression profiles of TGase isoenzymes with those of epidermis of the skin. Other areas, particularly those showing non-keratinizing epithelium, showed weak immunostaining of TGase E and C, suggesting its different maturation status from keratinizing epithelium. The results of this study indicate that epithelium of cholesteatoma undergoes same direction of maturation and differentiation characteristics as the epidermis of skin, evidenced by similar expressions of TGases both in mRNA level and immunohistochemistry.

Cell Differentiation↗

PubMed1999

Allogeneic bone marrow transplantation of chronic myeloid leukemia from an HLA-matched unrelated donor with the beta-thalassemic trait.

We report a chronic myeloid leukemia patient who underwent allogeneic bone marrow transplantation from an HLA-matched unrelated donor with the beta-thalassemic trait. The donor was a heterozygote for the -28 A-->G mutation. We examined the recipient's bone marrow and peripheral blood using the polymerase chain reaction (PCR) method to detect the -28 G-->A mutation of the donor type and monitored the sustained engraftment. This case suggests that a donor with the thalassemic trait can be a candidate for matched unrelated bone marrow transplantation for hematological malignancies and that PCR based genetic examination of the thalassemic mutation is a useful tool to detect early engraftment.

Adult↗

PubMed1999

Gastric emptying rate assessment based on the proportion of intra-abdominal radioactivity in the stomach.

UNLABELLED: Using scintigraphic techniques, the rate of gastric emptying is calculated by quantifying the absolute radioactivity within a gastric region of interest (intragastric method) with the time of meal completion considered 100% retention. However, this technique has significant limitations arising from subject movement and radionuclide gamma-ray attenuation, which may render curve fitting difficult, particularly in patients with gastroparesis. In an attempt to minimize these limitations, we have expressed the intragastric content as a percentage of the total abdominal radioactivity (abdominal method) and compared these two methods. METHODS: Forty-five subjects in a sitting position consumed a meal consisting of two fried eggs labeled with 99mTc, two slices of toast and 300 mL 5% glucose water (412 kcal). Data were acquired at a rate of one frame every 5 min from the left anterior oblique view. Using the two methods, the intragastric retention ratios at 30, 60, 90, 120 and 240 min and the 50% emptying time (T50) were obtained from both observation and calculation by power exponential fit. R2, representing goodness of fit of the nonlinear curve fitting, was calculated. RESULTS: There were no differences in the calculated values of T50 between the two methods. Quantitative estimates of T50 by extrapolation of a power exponential fit were feasible in 42 of the 45 subjects when the abdominal method was used, compared with only 29 of the 45 subjects when the intragastric method was used. In the 23 subjects with delayed emptying, quantitative estimates of T50 were feasible in 20 subjects when the abdominal method was used, compared with 7 subjects when the intragastric method was used. Using the abdominal method as opposed to the intragastric method also significantly improved R2. The difference between observed values and estimated values of T50 and intragastric retention ratios at 30, 90 and 120 min was smaller using the abdominal method. CONCLUSION: Scintigraphic measurement of gastric emptying calculated using the proportion of the abdominal radioactivity in the stomach offers substantial advantages over conventional methods, particularly in patients with gastroparesis.

Adult↗