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Biomedical subjects

C S Wu

Publications and source records attributed to C S Wu.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Endoscopic diagnosis and clinical experience of colonic tuberculosis].

From February 1979 to May 1994, 18 cases of colonic tuberculosis were detected by colonscopy at Chang Gung Momorial Hospital, Linkou Medical Center. There were 10 males and 8 females, with mean age of 43.6. In ten, the diagnosis was confirmed histologically or bacteriologically in colonic biopsy material and post-operated lymph nodes. The remaining 8 patients was suspected on colonoscopy, and had good response to antituberculous therapy. The major symptoms were abdominal pain (83%), diarrhea (67%), and body weight loss (61%). Average duration from symptoms to diagnosis was 4.1 months. Chest X-ray revealed active pulmonary tuberculosis in 14 of 18 patients (78%), 4 of 14 patients were military type. The colonic tuberculosis involved in ileocecal area in 6, ileocecum and contiguous colonic regions in 7, segmental colonic involvement in 4, and pancolitis in 1 patient. Multiple ulceration and ulcerohypertrophic lesions were the major colonoscopic findings. Typical caseating granuloma were found in 5 cases (36%) from colonoscopic biopsy, the other 5 from surgical resected specimens. Antituberculous therapy produced remarkable symptomatic improvement in all patients except 2 cases complicated with intestinal obstruction necessitating laparotomy. Colonoscopy with biopsy is a useful diagnostic tool in early diagnosis and avoiding unnecessary laparotomy in colonic tuberculosis.

Adolescent↗
PubMed1995

Specific staining of iododeoxyuridine and bromodeoxyuridine in tumors double labelled in vivo: a cell kinetic analysis.

The simultaneous and specific staining of iododeoxyuridine (IdUrd) and chlorodeoxyuridine (CldUrd) allows for more accurate estimates of potential doubling time (Tpot). Because CldUrd is not approved for human use, the procedure was adapted for the staining of IdUrd and bromodeoxy-uridine (BrdUrd). The fluorescein isothiocyanate-conjugated B44 antibody (B44-FITC) stained both IdUrd and BrdUrd in tumor nuclei labelled singly with one or the other pyrimidine analogue. However, when MCaK tumors in exponential growth in vivo were pulse labelled with both IdUrd and BrdUrd, the staining of BrdUrd was not seen, and the labelling pattern reflected specificity to IdUrd. These observations were confirmed using tumors pulse labelled with IdUrd and/or BrdUrd at 6 h and/or 0.3 h prior to tumor removal in all possible combinations. Simultaneous specific staining of BrdUrd by Br3 and of IdUrd by B44-FITC was documented by quantification of labelling indices (LIs) from double-labelled tumors. The specificity of B44-FITC for IdUrd in double-labelled tumors was due to a greater affinity of this antibody for IdUrd than for BrdUrd. This technique allowed for two independent estimates of LI and Tpot when tumors were double labelled for 3.0 and 5.5 h. Both IdUrd and BrdUrd are approved for clinical use, and this double-labelling technique should prove to be valuable for measuring the cell kinetics of solid tumors in vivo.

Animals↗
PubMed1995

Detection and partial sequence analysis of Helicobacter pylori DNA in the bile samples.

The existence of Helicobacter pylori in the biliary tract was investigated. Seven bile samples were included in this study. Among them, six bile samples were collected by percutaneous transhepatic cholangiodrainage and the other by needle aspiration during cholecystectomy. Using nested PCR with two sets of primers homologous to the urease A gene, Helicobacter pylori DNA was detected. Three samples, one from a patient with advanced gastric cancer involving the pancreatic head and two from patients with pancreatic head tumor, were found to be positive for Helicobacter pylori DNA. On the other hand, three samples from patients with cholangiocarcinoma and one from a patient with chronic cholecystitis were all negative. To further verify the specificity of our PCR analysis, partial sequences of the PCR products from the three positive samples were analyzed by direct sequencing. Several silent mutations and a missense mutation (AAA to AGA; Lys-164 to Arg-164) were identified in the urease A gene. We conclude that Helicobacter pylori DNA can be easily detected in the bile samples. The possibility of asymptomatic cholangitis caused by this organism requires further investigation.

Adult↗
PubMed1995

Helicobacter pylori in cirrhotic patients with peptic ulcer disease: a prospective, case controlled study.

BACKGROUND: There is an increased prevalence of peptic ulcer disease in patients with liver cirrhosis, but the role of Helicobacter pylori is unclear. METHODS: lgG antibodies against H. pylori were measured in 60 patients with compensated liver cirrhosis, in 60 sex- and age-matched patients with compensated liver cirrhosis, and in 60 normal controls. All patients received panendoscopic examinations to search for the evidence of esophageal varices, congestive gastropathy, and peptic ulcers. RESULTS: Duodenal ulcers were more common in compensated and decompensated cirrhotic patients (16.7% and 13.3%, respectively) than in normal controls (3.3%, p < 0.05). Gastric ulcers were more frequent in decompensated (15.0%) than compensated cirrhotic patients and normal controls (3.3% and 1.7%, respectively, p < 0.05). The prevalence of H. pylori was not statistically different among the three groups (normal 60.0%, compensated 61.7%, and decompensated, 75.0%; p > 0.05). The prevalence of H. pylori also showed no statistical differences in respect to duodenal ulceration (100%, 80%, and 87.5%, respectively, p > 0.05). The prevalence of H. pylori did not differ significantly in relation to the presence or absence of esophageal varices (68.4% vs 100% if no varices, p = 0.04) and in the presence of congestive gastropathy (50.0 vs 94.7%, p = 0.03). CONCLUSIONS: The prevalence of peptic ulcer was increased in cirrhotic patients, but the prevalence of H. pylori was similar in compensated cirrhotic patients, decompensated cirrhotic patients, and normal controls. The frequency of non-H. pylori-associated peptic ulcers in cirrhotic patients was increased in the presence of esophageal varices or congestive gastropathy.

Case-Control Studies↗
PubMed1995

A prospective study of fungal infection of gastric ulcers: clinical significance and correlation with medical treatment.

A prospective study was performed to evaluate the prevalence of fungal infection in gastric ulceration and its effect on ulcer healing in 178 benign and 97 malignant gastric ulcers. Fungal infection was defined as presence of fungal hyphae or spores in the biopsy forceps specimen. For patients with benign gastric ulcers, sucralfate 1 g q.i.d. was prescribed and a second panendoscopy examination was carried out after 6 weeks to evaluate ulcer healing. Fungal colonization was found in 36 (20.2%) patients with benign gastric ulcers and 26 (26.8%) patients with gastric cancers (p > 0.2). The mean age of patients with benign gastric ulcer with fungal infection (group I) was 64.2 +/- 11.4 years, whereas the mean age of those without fungal infection (group II) was 56.2 +/- 13.1 years (p < 0.01). Follow-up panendoscopy after 6 weeks of sucralfate therapy revealed 6 of 24 patients (25%) in group I and 19 of 81 patients (23%) in group II with unsatisfactory healing (difference not significant). Comparison of confounding factors such as smoking, daily tea or coffee intake, underlying disease, ulcer location, and endoscopic appearance between these two groups revealed no significant differences. In conclusion, the presence of fungus in gastric ulcers is a secondary phenomenon and it does not affect ulcer healing.

Anti-Ulcer Agents↗
PubMed1995

Early gastric cancer--a clinicopathological study.

From 1983 to 1991. 981 cases with gastric cancer underwent gastric resection in Chang Gung Memorial Hospital. Ninety-two cases (9.4%) had early gastric cancer with a mean age of 54.5 years. The most commonly present symptoms were epigastralgia and abdominal fullness (79.3%). Most lesions were located in the lower third of stomach (64.0%). Type IIc was the most common macroscopic type (31.5%). The tumor was confined to the mucosa layer in 40 (43.5%) cases; submucosa invasion was noted in the remaining 52 (56.5%) patients. Lymph node involvement was found in 5 (5.4%) cases. No statistical correlation between the depth of tumor invasion and the size of the tumor was noticed. Three patients died of tumor recurrence on the 11th, 13th and 36th months after operation. The Kaplan-Meier estimate for five year survival was 96.4% in these 92 cases. 96.6% in mucosa cancer and 95.6% in submucosa cancer. The risk factor for mortality was lymph node metastasis which had a positive correlation with the depth of tumor invasion. There were four (4.3%) cases of minute early gastric cancer. However, there was neither mortality nor lymph node metastasis in these four cases. Retrospectively, the review of original histological slides in 40 cases, the intestinal type of early gastric cancer had a higher association with intestinal metaplasia, had more frequency of submucosa invasion (70% vs 35%, p = 0.026), and were older in age (61 vs 50.4 years old) than the diffuse type. Although statistically insignificant, the intestinal type had the tendency to involve the lymph node.

Adolescent↗
PubMed1995

Acute hepatitis A with coexistent hepatitis C virus infection presenting as a virus-associated hemophagocytic syndrome: a case report.

A 23-yr-old male with acute hepatitis A and coexistent hepatitis C became critically ill 3 wk after the onset of fever and jaundice with progressive anemia, thrombocytopenia, and hepatosplenomegaly. Bone marrow biopsy revealed hemophagocytosis. Despite aggressive supportive treatment with parenteral steroids, the patient died of disseminated intravascular coagulopathy with gastrointestinal bleeding. Necropsy of the liver showed histiocyte aggregation in the portal area with hemophagocytosis.

Acute Disease↗
PubMed1994

Conformation of bilirubin oxidase in native and denatured states.

The conformation of bilirubin oxidase (EC 1.3.3.5) from Myrothecium verrucaria was studied by circular dichroism (CD). The far-UV CD spectrum showed a single minimum at 215 nm and a maximum near 198 nm, suggesting the dominance of beta-sheets. There was another negative band at 187 nm that is absent from the spectra of model alpha-helix or beta-sheet. CD analysis by the method of Chang et al. agreed well with the estimates based on the Chou and Fasman sequence-predictive method, but the Provencher-Glöckner method of CD analysis agreed well with the sequence-predictive method of Garnier et al. At pH 12 the 215- and 187-nm bands completely disappeared and the protein was denatured. This denaturation was accompanied by the appearance of a large positive band at 250 nm, probably due to ionization of tyrosine residues. In 20 mM sodium dodecyl sulfate the magnitude of the 215-nm band increased, but the spectrum transformed to that of partial helices after heating at 100 degrees C. In 6 M guanidine hydrochloride the far-UV CD spectrum was monotonic and became more negative at the lower wavelength limit (near 212 nm), suggesting that the secondary structure of the protein was disrupted. However, the near-UV CD spectrum retained residual aromatic bands even after heating at 100 degrees C. Thus, our denaturation studies suggest that bilirubin oxidase has a rigid tertiary structure.

Amino Acid Sequence↗
PubMed1994

Role of endoscopic retrograde pancreatography in pancreatic ascites.

We present a case of pancreatic ascites. The diagnosis was strongly suspected on the basis of ascitic fluid analysis and was confirmed by observation of pancreatic duct contrast leakage at endoscopic retrograde pancreatography (ERP). Computed tomography was not helpful in this case. For localization and final confirmation of the lesion, ERP is the most valuable investigative method.

Adult↗
PubMed1994

Henoch-Schönlein purpura complicated by upper gastrointestinal bleeding with an unusual endoscopic picture.

In the course of Henoch-Schönlein purpura, diverse gastrointestinal manifestations are common. We report a patient with Henoch-Schönlein purpura complicated by upper gastrointestinal bleeding. A peculiar endoscopic picture not previously described is presented and articles about the endoscopic findings in this disease are reviewed. It is concluded that endoscopy can be useful in the diagnosis of Henoch-Schönlein purpura, especially for those patients without typical skin rash.

Adult↗
PubMed1994

Cholangiography of icteric type hepatoma.

OBJECTIVES: Icteric type hepatoma caused by floating tumor debris in the major bile duct was rare. Such cases were often incorrectly identified as biliary carcinoma or choledocholithiasis until pathological proof. The goal of this study was to analyze the cholangiograms of icteric type hepatomas, and to identify the characteristic cholangiographic features of this rare disease. METHODS: A retrospective analysis of 20 cholangiographies of icteric type hepatomas during a 10-yr period was carried out. RESULTS: There were 15 males and five females in this series. Seventeen (85%) patients were hepatitis B virus carriers, and liver cirrhosis was detected in 16 (80%) patients. Serum alpha-fetoprotein levels in 13 (65%) of the patients were over 400 ng/ml. The cholangiographic findings included: 1) intraductal filling defects resulting in partial or complete obstruction and ductal dilation in 14 cases (70%), 2) abrupt complete obstruction of the common hepatic duct with an irregular cut surface in three cases (15%), and 3) tumor encasement and stricture of the biliary system in three cases (15%). Management of these patients included hepatic resection, choledochotomies with T tube stenting, or PTCD. Most of them died within one-half year after diagnosis, but one patient in our series, who received hepatic resection, survived more than 70 months. CONCLUSIONS: It is important to recognize this group of patients. Because with proper management, good palliation or cure is possible. The cholangiographic appearances, when taken alone, are not diagnostic of icteric type hepatomas. Once these cholangiograms are seen in patients with associated risks of developing a hepatoma, such as liver cirrhosis, chronic viral hepatitis, and elevated serum alpha-fetoprotein, however, an icteric type hepatoma should be suspected.

Adult↗
PubMed1994

Vibrio vulnificus infection--report of 8 cases and review of cases in Taiwan.

Vibrio vulnificus infection, which is a rare and fatal disease, can be categorized clinically as either primary septicemia or wound infection. The clinical presentation of patients with primary septicemia can vary from fever alone to a more severe illness including high-grade bullous lesions, hypotension, and shock. Wound infection typically results from either injury to the skin in a marine environment or contact of a preexisting wound with sea water. We reported eight cases with Vibrio vulnificus infection in Chang gung Memorial Hospital and reviewed ten other cases previously reported with details in Taiwan. Fourteen patients presented with primary septicemia, and four with wound infection. Thirteen patients had alcoholism or chronic liver disease, two had peptic ulcer disease, one was steroids abuser, and one patient had thalassemia and chronic liver disease. Overall mortality was 55.6% (ten patients). Patients with hypotension within 48 hours of admission had higher mortality than normotensive patients (77% vs. 0%, P = 0.007). Patients with chronic liver disease or liver cirrhosis also had tendency to a higher mortality than not (64% vs. 25%, P = 0.274). Chronic liver diseases and liver cirrhosis are common disease in Taiwan. They take a high risk for Vibrio vulnificus infection. Clinician should keep in mind of this potentially fatal infection in these patients reporting a history of recent raw oyster consumption and presented with sepsis and characterized skin lesions. Prompt empirical antibiotics treatment and aggressive surgical treatment may be lifesaving for this acute and fatal disease.

Adult↗
PubMed1994

[Clinical observation of Henoch-Schonlein purpura-focus on gastrointestinal manifestation and endoscopic findings].

During the 5.5-year period from January 1988 to June 1993, there were 40 cases of Henoch-Schonlein purpura diagnosed in Chang Gung Memorial Hospital, Taipei. The diagnosis criteria is defined as a typical skin rash, which pathologic examination shows leukocytoclastic vasculitis, accompanied by any two of these major manifestations of the disease, namely gastrointestinal, renal and joint involvement. Their medical records were reviewed with respect to the clinical symptoms, laboratory findings, roentogenologic findings, endoscopic findings, and morbidity. There are 21 women and 19 men with age raging from 10 to 63 years old (mean age 35.9 years old). The male to female ratio was 1:1.1 and about 80% of the patients were at the age of fifteen or older. There was no special season distribution in this series. The main clinical features were purpuric skin rashes, 40 cases (100%), followed by gastrointestinal symptoms, 25 cases (62.5%), renal involvement, 21 cases (52.5%) and joint involvement, 19 cases (47.5%). The major gastrointestinal symptoms were abdominal pain (25 case) and bleeding from gastrointestinal tract (10 cases), and minor symptoms included vomiting (7 cases), diarrhea (1 cases) and acute pancreatitis (2 cases). Gastrointestinal endoscopy was performed in 5 cases and all had hyperemic mucosa and scattered hemorrhagic purpura in the stomach and duodenum. The characteristic hemorrhagic erosive duodenitis were observed in 3 cases. These findings may alert the gastroenterologists to take into consideration of this disease earily and thus avoid unnecessary laparotomy and complications.

Adult↗
PubMed1994

Rheumatoid factor in hepatitis B virus surface antigen positive patients.

Rheumatoid factor (RF) is often found in the sera of patients with nonrheumatic diseases in comparison with normal individuals. We collected 95 healthy HBs antigen positive adults and 98 healthy HBs antigen negative adults. RF was present in 14.74% (14/95) of the HBs antigen positive group while it was present in 3.06% (3/98) of the HBs antigen negative group (p < 0.05). RF was positive in 15.38% (2/13) of the HBe antigen positive patients whereas it was positive in 14.63% (12/82) of the HBe antigen negative patients (p > 0.05). RF was found positive in 16.90% (12/71) of the anti-HBe antibody positive group while it was positive in 8.33% (2/24) of the anti-HBe antibody negative group (p > 0.05). We conclude that the positive rate of RF in HBs antigen positive patients is significantly higher than in that of HBs antigen negative patients. The incidence of RF positivity of the HBe antigen positive group is not higher than that of the HBe antigen negative group. The positive rate of RF in anti-HBe antibody positive group has a tendency to be higher than in that of their negative counterparts though there was no significant difference between them.

Adult↗
PubMed1993

Comparing the human and schistosomal hypoxanthine-guanine phosphoribosyltransferases by circular dichroism.

The hypoxanthine-guanine phosphoribosyltransferases (HGPRTases) of human and the parasitic trematode, Schistosoma mansoni, are of biomedical importance. The conformations of these two enzymes were studied by circular dichroism (CD). The schistosomal HGPRTase is estimated to contain 27% alpha-helix and 30% beta-structure. This result is consistent with what is predicted from a tertiary model (Craig, S.P., Cohen, F.E., Yuan, L., McKerrow, J.H. and Wang, C.C. (1991) in Molecular & Immunological Aspects of Parasitism (Wang, C.C., ed.), pp. 122-138, Am. Assoc. Adv. Sci., Washington DC, USA), which proposes that the enzyme is an alpha/beta barrel protein. The human enzyme is estimated to contain 21% alpha-helix and 53% beta-form. The two enzymes are different in their thermostability. The human enzyme remains active after being heated to 85 degrees C for 15 min, while the schistosomal enzyme only retains its activity at temperature below 65 degrees C. The transition temperature (T1/2) of the schistosomal HGPRTase was determined by CD measurement to be 57.5 degrees C. One of the enzyme substrates, phosphoribose pyrophosphate (PRPP), stabilizes the HGPRTases by preventing the human enzyme from unfolding at 85 degrees C and partially protecting the schistosomal enzyme from unfolding at 65 degrees C. It is suggested that the amino-acid substitutions in the human enzyme improve the spatial structure and stability of its alpha-helices, which may lead to an enhanced thermostability.

Amino Acid Sequence↗
PubMed1993

Collisionally activated dissociation and tandem mass spectrometry of intact hemoglobin beta-chain variant proteins with electrospray ionization.

Electrospray ionization collisionally activated dissociation (CAD) mass spectra of multiply charged human hemoglobin beta-chain variant proteins (146 amino acid residues, 15.9 kDa), generated in the atmospheric pressure/vacuum interface and in the collision quadrupole of a triple-quadrupole mass spectrometer, are shown and compared. Several series of structurally informative singly and multiply charged b- and y-mode product ions are observed, with cleavage of the Thr 50-Pro 51 CO-NH bond to produce the complementary y96 and b50 sequence ions as the most favored fragmentation pathway. The eight different beta-globin variants studied differ by a single amino acid substitution and can be differentiated from the observed m/z shifts of the assigned product ions. The overall fragmentation patterns for the variant polypeptides are very similar, with the exception of the Willamette form, in which Arg is substituted for Pro- 51, and multiply charged y96 product ions are not observed. Circular dichroism spectra of normal beta A and beta Willamette show very little difference under a variety of solvent conditions, indicating that fragmentation differences in their respective CAD mass spectra are substantially governed by primary rather than secondary structure.

Adult↗
PubMed1993

Circular dichroic analysis of denatured proteins: inclusion of denatured proteins in the reference set.

We hypothesize that inclusion of denatured proteins in the set of reference native proteins may better represent the unordered form in the current circular dichroism (CD) analyses of proteins involving unfolding ones. Adding three denatured-protein spectra and one oligopeptide spectrum to 16 reference protein spectra markedly improved the correlation coefficients (r) between CD calculations and X-ray determinations for the unordered form and, to a lesser extent, for beta-turn, but the r-values for alpha-helix and beta-sheet decreased slightly. With 20 reference proteins the estimates of the unordered form of denatured proteins were significantly improved. Thus, we suggest that as a compromise the new set of reference proteins be used for estimating the changes in conformation for unfolding proteins. However, the current use of 16 reference native proteins appears to be adequate for CD analysis of native proteins and the expansion to 20 reference proteins including denatured ones may not enhance the analysis of native proteins.

Amino Acid Sequence↗