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Biomedical subjects

C S Lai

Publications and source records attributed to C S Lai.

At least 19 recordsLinked to original sources
PubMed2003

Effects of a beverage containing an enzymatically induced-viscosity dietary fiber, with or without fructose, on the postprandial glycemic response to a high glycemic index food in humans.

OBJECTIVE: Dietary supplementation with guar gum or fructose has been reported to reduce the postprandial glycemic response to an oral glucose challenge. As a result of the poor palatability of most foods containing guar gum, a novel low-viscosity beverage with guar gum was developed that becomes viscous in vivo through an enzymatic induction. The primary study objective was to determine the effect of an amylase-induced viscosity (I-V) product, with or without supplemental fructose, on the postprandial glycemic response to a high glycemic index test meal in healthy nondiabetic subjects. DESIGN: The study was a four-treatment, placebo-controlled, double-blind, randomized block protocol. SETTING: The study was performed at Glycaemic Index Testing, Inc., Toronto, Ontario, Canada. SUBJECTS: A total of 30 healthy nondiabetic volunteers (13 male, 17 female, mean+/-s.e.m. age of 51+/-3 y and body mass index of 24.2+/-0.4 kg/m(2)) participated in the study. INTERVENTION: In the morning after an overnight fast, subjects participated in four 3-h meal glucose tolerance tests on separate occasions. The test meals contained 50 g of available carbohydrate from maltodextrin and white bread (control) or the same meal with either 5 g of guar gum (3.6 g galactomannan), 5 g of fructose, or 5 g of guar gum +5 g of fructose. RESULTS: Treatments containing guar gum had a reduced (P<0.01) baseline-adjusted peak glucose response and incremental area under the glucose curve. In contrast to previous studies, fructose increased (P<0.05) the baseline-adjusted peak glucose concentration. CONCLUSIONS: Guar gum incorporated into an amylase I-V product provided a means to stabilize blood glucose levels by reducing the early phase excursion and then by appropriately maintaining the later phase excursion in healthy nondiabetic humans.

Adolescent↗
PubMed2001

A forkhead-domain gene is mutated in a severe speech and language disorder.

Individuals affected with developmental disorders of speech and language have substantial difficulty acquiring expressive and/or receptive language in the absence of any profound sensory or neurological impairment and despite adequate intelligence and opportunity. Although studies of twins consistently indicate that a significant genetic component is involved, most families segregating speech and language deficits show complex patterns of inheritance, and a gene that predisposes individuals to such disorders has not been identified. We have studied a unique three-generation pedigree, KE, in which a severe speech and language disorder is transmitted as an autosomal-dominant monogenic trait. Our previous work mapped the locus responsible, SPCH1, to a 5.6-cM interval of region 7q31 on chromosome 7 (ref. 5). We also identified an unrelated individual, CS, in whom speech and language impairment is associated with a chromosomal translocation involving the SPCH1 interval. Here we show that the gene FOXP2, which encodes a putative transcription factor containing a polyglutamine tract and a forkhead DNA-binding domain, is directly disrupted by the translocation breakpoint in CS. In addition, we identify a point mutation in affected members of the KE family that alters an invariant amino-acid residue in the forkhead domain. Our findings suggest that FOXP2 is involved in the developmental process that culminates in speech and language.

Amino Acid Sequence↗
PubMed2001

An alternative dressing for skin graft immobilization: negative pressure dressing.

The key difficulty of skin grafting is keeping the graft immobilized on uneven surfaces involved with motion, such as the nuchal area, axilla, web spaces, and the perineal area. This study reports the development of a new idea of negative pressure dressing (NPD) to maintain good immobilization of the skin graft and, at the same time, not cause any significant distress in the patient's daily life. Furthermore, the components of this dressing are available in ordinary hospitals. In this report, there are eight cases of skin grafts which were applied by this method, and the average success rate was approximately 97%. Therefore, use of negative pressure dressings to safeguard immobilization of the skin graft is an appropriate alternative method for grafts on uneven or mobile surfaces.

Adolescent↗
PubMed2001

Nonendoscopic harvest of the gastrocnemius muscle flap through a small incision.

Traditional gastrocnemius flap harvest requires a long skin incision, starting from the popliteal fossa to the mid leg. The authors designed three instruments to facilitate harvest of this flap through a small incision without the help of an endoscope in 10 patients. All 10 gastrocnemius muscle flaps survived with a 100% success rate.

Adolescent↗
PubMed2001

Tarsal tunnel syndrome secondary to neurilemoma--a case report.

Peripheral nerve entrapment syndromes in the foot include those symptom complexes that are primarily neurologic in origin and result from embarrassment to any of the peripheral nerve trunks or branches of the foot. Tarsal tunnel syndrome usually is precipitated by compression of the tibial nerve posterior and distal to the medial malleolus. A neurilemoma is relatively uncommon in the foot. It is usually a solitary tumor that is almost exclusively benign and can be removed without jeopardizing the integrity of the nerve. Diagnosis is based on a thorough history and clinical pictures. Certain diagnostic modalities, ultrasound and MRI, have been employed to aid in diagnosis. Surgical excision of the tumor remains the treatment of choice.

Female↗
PubMed2001

Congenital multiple plaque-like glomangiomyoma in trunk--a case report.

Congenital glomus tumor is a rare variant of glomus tumor, and glomangiomyoma is the least frequent histological type of glomus tumor. We present a case of congenital multiple plaque-like glomangiomyoma in an 11-year-old child with multiple diffuse plaques on his right lateral trunk. Histopathologic study showed a picture of typical glomus cell undergoing transition to smooth muscle cell. After literature review, this might be the first case report of congenital multiple plaque-like glomus tumor in trunk with histological appearance of a glomangiomyoma.

Child↗
PubMed2001

Endometrioma in a cesarean section scar--a case report.

Scar endometriosis remains quite rare and there is only one case report in the literature of plastic surgery. We present a case of endometrioma appearing on the cesarean section scar. The classic symptom was a painful scar that became swollen and more tender during menstruation. The cause of surgical scar endometriosis is believed to be iatrogenic transplantation of endometrium to the surgical wound. Surgical excision remains the treatment of choice. This entity must be kept in mind by plastic surgeons evaluating patients who present with soft-tissue masses of the abdominal wall in the setting of previous combined hysterectomy and abdominoplasty.

Adult↗
PubMed2000

The SPCH1 region on human 7q31: genomic characterization of the critical interval and localization of translocations associated with speech and language disorder.

The KE family is a large three-generation pedigree in which half the members are affected with a severe speech and language disorder that is transmitted as an autosomal dominant monogenic trait. In previously published work, we localized the gene responsible (SPCH1) to a 5.6-cM region of 7q31 between D7S2459 and D7S643. In the present study, we have employed bioinformatic analyses to assemble a detailed BAC-/PAC-based sequence map of this interval, containing 152 sequence tagged sites (STSs), 20 known genes, and >7.75 Mb of completed genomic sequence. We screened the affected chromosome 7 from the KE family with 120 of these STSs (average spacing <100 kb), but we did not detect any evidence of a microdeletion. Novel polymorphic markers were generated from the sequence and were used to further localize critical recombination breakpoints in the KE family. This allowed refinement of the SPCH1 interval to a region between new markers 013A and 330B, containing approximately 6.1 Mb of completed sequence. In addition, we have studied two unrelated patients with a similar speech and language disorder, who have de novo translocations involving 7q31. Fluorescence in situ hybridization analyses with BACs/PACs from the sequence map localized the t(5;7)(q22;q31.2) breakpoint in the first patient (CS) to a single clone within the newly refined SPCH1 interval. This clone contains the CAGH44 gene, which encodes a brain-expressed protein containing a large polyglutamine stretch. However, we found that the t(2;7)(p23;q31.3) breakpoint in the second patient (BRD) resides within a BAC clone mapping >3.7 Mb distal to this, outside the current SPCH1 critical interval. Finally, we investigated the CAGH44 gene in affected individuals of the KE family, but we found no mutations in the currently known coding sequence. These studies represent further steps toward the isolation of the first gene to be implicated in the development of speech and language.

Base Sequence↗
PubMed2000

NOX 100, a nitric oxide scavenger, enhances cardiac allograft survival and promotes long-term graft acceptance.

BACKGROUND: We examined the role of nitrosative stress in allograft destruction. METHODS: Rats undergoing cardiac transplants received NOX-100, a water-soluble nitric oxide (NO) scavenger with antioxidant properties, with or without low-dose cyclosporine (CsA). Graft survival, NO production, and nuclear factor kappa B (NF-kappaB) activity were studied. RESULT: Using NOX-100 daily until rejection prolonged graft survival (11.6+/-0.6 vs. 7.4+/-0.2 days; P<0.05). Daily low-dose CsA (2.5 mg/kg im) for 7 days or until rejection also prolonged survival (12.6+/-0.5 and 21.6+/-1.6 days, respectively; P<0.01 vs. Controls). Low-dose CsA for 7 days and NOX-100 for 30 days prolonged graft survival (45.0+/-4.7 days; P<0.01 vs. all groups.). NOX-100 had no effect on whole blood CsA levels. Combination therapy until Day 100 resulted in 1 graft loss at Day 116 and indefinite survival in 3 animals (>300 days), which accepted a second WF strain heart without further immunosuppressive therapy but promptly rejected a third party (ACI) cardiac allograft. NOX-100 and CsA reduced nitrate and nitrite, and combination therapy completely normalized NO through to Day 30. Electron paramagnetic resonance spectroscopic analysis demonstrated reduction of signals for nitrosylmyoglobin and nitrosyl-heme with NOX-100 and elimination of signals with CsA alone or combination therapy. Activity of myocardial NF-kappaB decreased with monotherapy vs. untreated allografts. Combination therapy resulted in further inhibition of NF-kappaB up to Day 30. The extent of graft survival correlated with the extent of NO scavenging and NF-kappaB inhibition. Short-term combination therapy had no effect on graft lymphocytic infiltrate on Days 15, 20, and 30. CONCLUSION: These data support a role for both oxidative and nitrosative stress in rejection and the immunoregulatory potential of antioxidant therapy after transplantation.

Animals↗
PubMed2000

An easy method for preparation of postage stamp autografts.

A modified technique of postage stamp autografting is studied. By using quick cutting plates, chessboard tray, skiing technique and petrolatum gauze, skin islands can be uniformly located and correctly oriented on the gauze. Moving the skin squares on the stainless steel tray is relatively easy, and the expansion ratio can be predicted by means of the chessboard diagram. The skin island grafts adhere to the petrolatum gauze when the gauze is applied to the tray. Then, as in the modified Meek technique, the "autografting carrier" can be used to cover the burn wound. In comparison with the modified Meek technique, this method does not require expensive equipment. The quick cutting plates can take over the function of the modified Meek-Wall dermatome. The stainless steel trays and the petrolatum gauze are easily available. The advantages of this method include: (1) the expansion ratio can reach up to 1:9, (2) the preparation procedures are not time consuming, (3) regular distribution of these skin islands shortens the healing time, and (4) the cost of this method is relative low. The results of this technique are comparable to that of the modified Meek technique. This preliminary study reveals that this technique is an easy and economic alternative for the treatment of extensive burn patients.

Adult↗
PubMed2000

Endoscope-assisted correction of primary varicose veins.

The purpose of this study is to evaluate the possibilities and results of application of endoscopic surgery in the operation of primary varicose veins. With good illumination and magnified viewing, the varicosities, incompetent perforating veins, and healthy veins were clearly visualized. The incompetent perforating veins were clipped and divided securely. The varicose veins and tributaries were dissected and removed completely after being clipped and divided. The healthy veins were preserved if possible. Primary varicose veins in 43 limbs of 37 patients were operated. The operation was conducted through one access incision in 31 limbs (72%), two incisions in 11 limbs (25%), and three incisions in 1 limb. The mean number of incisions was 1.3 in each limb. Hematoma formation occurred in 1 patient due to the slipping of one clip on the third postoperative day. The other patients had uneventful postoperative courses. All 37 patients were reviewed 4 to 30 months postoperatively. Only one limb had recurrent varices at a new site. Ninety-seven percent of limbs (42 of 43) had no recurrence of varicose veins. Seventy-eight percent of patients (29 of 37) were extremely pleased with this operation. Although the other 22% of patients (8 of 37) appreciated this operation, they were not completely satisfied because some preoperative complaints persisted. In this series, the recurrent rate of varicose veins was low (1 in 43 limbs) and postoperative scarring was minimized, in addition to the advantages of endoscopic surgery. These results demonstrate that endoscopic surgery is a worthy alternative procedure for correcting primary varicose veins.

Adult↗
PubMed2000

Endoscope-assisted parotidectomy for benign parotid tumors.

Sixteen cases of parotidectomy of benign tumors were performed by means of a short incision with the assistance of endoscopic surgery. The average length of the preauricular and retromandibular incision was 6.9 cm (range, 6.0-8.1 cm). This incision provided safe dissection of the facial nerve trunk and exposed a major part of the gland to direct vision. Identification and separation of the facial nerve branches in peripheral glandular tissue was performed by means of endoscopic surgery instead of wide exposure with a long incision. Because endoscopic surgery provided good illumination and magnification on the monitor, the operation could proceed clearly and sharply in a bloodless field. Therefore, the incidence of facial nerve injury and perioperative morbidity was minimized. In this series, tumors were removed completely, without injury to the facial nerve. Patients were also satisfied with the short and inconspicuous postoperative scars.

Adult↗
PubMed2000

Extensor digitorum brevis rotational muscle flap for lower leg and ankle coverage.

BACKGROUND: Soft tissue reconstruction around the ankle has been a challenging problem. This article reports our experience using the extensor digitorum brevis muscle flap; some technical variations are discussed. METHODS: The extensor digitorum brevis muscle flap is vascularized by the well-defined lateral tarsal artery, a branch of the dorsalis pedis artery originating at the level of the inferior extensor retinaculum. This flap was used for coverage of soft tissue defects in the lower leg and the ankle in 10 patients with various injuries. RESULTS: All flaps survived completely. Complications included delayed healing of donor skin in two cases. Flap elevation was possible even in the traumatized donor foot. CONCLUSION: The advantages of this flap include constant and reliable blood supply, easy and rapid flap dissection, adequate bulk, and one-stage procedure. However, disadvantages include the small size of the flap and the sacrifice of the dorsalis pedis artery.

Adolescent↗
PubMed2000

Continuous intra-arterial infusion therapy in hydrofluoric acid burns.

To determine the effect of continuous intra-arterial calcium gluconate infusion therapy on patients suffering from hydrofluoric acid dermal burns of the digits, clinical treatment was performed prospectively on 10 patients from January 1997 to December 1998 at the burn care unit of Kaohsiung Medical University Hospital. An arterial catheter was inserted transcutaneously through the radial artery of the involved hand. After confirmation of the proper position of the catheter, calcium gluconate was infused continuously with an ambulatory infusion pump. Rapid pain relief was achieved immediately after infusion. The rate of infusion was then tapered down gradually, and treatment was completed with no major therapeutic complication. All injured digits of these 10 patients were successfully salvaged with good cosmetic appearance and complete functional preservation. Compared with other conventional therapies, continuous intra-arterial calcium gluconate infusion therapy proved to be a safe, rapid, simple, portable, and effective method for treating hydrofluoric acid dermal burns.

Adult↗
PubMed1999

Apparent digestibility and glycaemic responses to an experimental induced viscosity dietary fibre incorporated into an enteral formula fed to dogs cannulated in the ileum.

The purpose of this study was to evaluate the apparent digestibility and postprandial glycaemic responses of ileal-cannulated dogs when fed an experimental induced viscosity dietary fibre (IVF) incorporated into a liquid enteral formula. Dietary treatments were: (1) control; (2) Glucerna; (3) Glytrol; (4) IVF; and (5) Jevity. Diets varied in concentrations of crude protein (CP), fat, starch and total dietary fibre (TDF). Dry matter and starch intakes by dogs fed the Glucerna and Glytrol treatments were lower (P<0.05) than for those consuming the other diets. However, daily intakes of CP and fat followed a reverse trend. Digestibility of nutrients at the ileum was high (>80%) for all dietary treatments. Mineral absorption proximal to the ileum and from the total tract was not significantly different among treatments. Mean incremental area under the serum glucose response curves for dogs fed Glytrol, Glucerna, and IVF treatments were lower (P<0.05) than the control treatment. Induced viscosity fibre appears to have no negative effects on nutrient digestion throughout the gastrointestinal tract. Its ability to moderate serum glucose concentrations would make it a potentially good choice for a diabetic liquid formula.

Animals↗
PubMed1999

Biological evaluation of the nitric oxide-trapping agent, N-methyl-D-glucamine dithiocarbamate-Fe2+, as a probe of nitric oxide activity released from control and diabetic rat endothelium.

We utilized the nitric oxide (NO) scavenger N-methyl-D-glucamine dithiocarbamate-Fe2+ (MGD-Fe) to characterize the role of NO in basal and acetylcholine (ACh)-stimulated relaxation arising from the endothelium of control vs diabetic rat aortic rings. In phenylephrine-contracted rings, MGD-Fe produced an additional increment in tension that was indomethacin-insensitive (i.e., excluding a role of prostanoids in this action). This MGD-Fe-sensitive component was more pronounced in control rings than diabetic rings and of the same magnitude achieved in rings without MGD-Fe treatment after removal of endothelium or treatment with the NO synthase inhibitor L-nitroarginine (L-NA). This suggests complete scavenging of basal NO by MGD-Fe and supports reduced basal NO in diabetic rings. ACh fully relaxed both control and diabetic rings. This relaxation was abolished by removal of the endothelium and was inhibited by L-NA (by 100% and 90% in control and diabetic rings, respectively). In contrast, MGD-Fe only partially inhibited ACh-induced relaxation in control (65+/-5% inhibition) and diabetic (41+/-11% inhibition) rings. The MGD-Fe-resistant component was not further modified by indomethacin. Addition of L-arginine (L-ARG) (but not D-arginine (D-ARG) enhanced the ACh-induced relaxation of MGD-Fe-treated diabetic (but not control) rings. These data provide evidence about endothelium-dependent relaxation in control and diabetic rings which cannot be discerned by use of L-NA alone. This study suggests that ACh produces a NO synthase-dependent vasodilation, a portion of which is due to free NO radical (*NO) or due to NO in a form or location that is unavailable for scavenging by MGD-Fe.

Acetylcholine↗
PubMed1999

The use of composite acellular allodermis-ultrathin autograft on joint area in major burn patients--one year follow-up.

Scar contracture is a major long-term sequelae of meshed split-thickness skin grafts in the case of full-thickness burn injuries, and especially in joint areas. Severe contracture around joints may lead to loss of mobility. The thickness of the dermis in the autograft plays a major role in the functional and cosmetic outcomes of the third degree burn. How to replace lost dermis is a major problem in skin restoration following severe burns. The human allograft skin (AlloDerm) is an acellular dermal matrix with normal collagen bundling organization and intact basement membrane complex. We present 12 cases of clinical application of a composite grafting technique in which the allogeneic skin (AlloDerm) provided source of dermis, and an ultrathin autograft (0.004-0.006 inch in thickness) provided epidermis. In these patients, The composite grafts were applied to full-thickness burn wounds over various articular skin surfaces. The average skin graft take rate was 91.5%. These ultrathin autografts allow the donor sites to heal faster. The mean time of donor site reepithelization was 6 days. All patients had a nearly normal range of joint motion (average 95% of normal) after one year's follow up. Wound assessment over time has shown supple skin that has been resistant to trauma and infection. The cosmetic results were judged to be fair to good by surgeons and patients after one year's follow up.

Adult↗