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Biomedical subjects

H J Lin

Publications and source records attributed to H J Lin.

At least 127 records · Page 7Linked to original sources

Ethnic distribution of slow acetylator mutations in the polymorphic N-acetyltransferase (NAT2) gene.

The acetylation polymorphism may affect rates of activation or detoxification of common carcinogens, thereby influencing cancer risk. Our aim was to define the ethnic distribution of the major slow acetylator mutations in the polymorphic N-acetyltransferase gene, in order to provide background data for epidemiological studies. Our results contain new analyses on 803 individuals, including 365 new specimens and 438 specimens that had been partly characterized in an earlier study. Tests were done to establish the specificity and reproducibility (98%) of our PCR assays. The recognized slow acetylator mutations, 191A, 481T, 590A, and 857A (which correspond to alleles M4 and M4b; M1 and r3; M2/r2; and M3 and S3, respectively), accounted for nearly all slow acetylator alleles among blacks, whites, Asian Indians, Hispanics, Koreans, Japanese, Hong Kong Chinese, Taiwanese, Filipinos and Samoans. The ethnic distribution supports an interpretation that the acetylation polymorphism existed before Paleolithic splitting of human populations from Africa. We identified two additional NAT2 mutations, suggesting that other rare alleles are likely to be found.

Acetylation↗

Clinical courses and predictors for rebleeding in patients with peptic ulcers and non-bleeding visible vessels: a prospective study.

Detailed characterisation of non-bleeding visible vessels in terms of colour, size evolution, and time of rebleeding is important in determining the natural history of these lesions. The colour and size of non-bleeding visible vessels were observed endoscopically every day for three days and then every other day until rebleeding or flattening of visible vessels occurred in 140 patients. Rebleeding happened in 61 (44%) patients. Of them, 59 (97%) rebled within 72 hours. Flattening of visible vessels happened in 79 (56%) patients and 77 of 79 (98%) had flattening of visible vessels within 72 hours. Rebleeding rate increased with increasing length of exposed vessels (r = 0.96, p < 0.001). Coffee ground fluid or blood retention in the stomach and ulcer size > or = 2.0 cm were independent predictors for rebleeding using multivariate analysis. It is suggested that patients with non-bleeding visible vessels and independent predictors for rebleeding may need early aggressive treatment.

Adult↗

Noninvasive hemodynamic classification of carotid-cavernous sinus fistulas by duplex carotid sonography.

The hemodynamic classification of the CCF has important implications for prognosis and therapy, but satisfactory criteria for such a differentiation are still lacking. We studied the application of extracranial duplex sonography in 14 cases of CCF with emphasis on the hemodynamic parameters of the RI and flow volume and made a correlation with the angiographic findings. We conclude with proposed duplex sonographic criteria for hemodynamic classification: (1) small RI with increased flow volume in the ICA: direct ICA-cavernous sinus fistulas (type A); (2) normal RI and flow volume in the ICA and ECA: dural branch of ICA-cavernous sinus fistulas (type B); (3) small RI with or without increased flow volume in the ECA: dural branch of ECA-cavernous sinus fistulas (type C) or dural branches of ICA- and ECA-cavernous sinus fistulas (type D). Application for assessment of the therapeutic effectiveness was also demonstrated.

Arteriovenous Fistula↗

Serum c-erbB-2 oncoprotein in the diagnosis of gastric cancer in comparison with CA 19-9, CEA, TPA, CA 125 and AFP.

BACKGROUND: Although many tumor markers can detect gastric cancer, they are still far from perfect. The aim of this study was to evaluate the role of a new tumor marker, serum c-erbB-2 oncoprotein, in patients with gastric cancer. METHODS: We tested this tumor marker in 35 patients of gastric cancer, 13 patients of hepatoma, 13 patients of colon cancer, 8 patients of lung cancer, and 22 patients without malignancy (4 of acute pancreatitis, 10 of benign gastric ulcer and 8 normal subjects) between July and December 1991. A newly developed enzyme immunoassay kit was used to assay serum c-erbB-2 oncoprotein. RESULTS: Abnormal level of c-erbB-2 oncoprotein was found in 11/32 (34.4%) of gastric cancer, 4/13 (30.8%) of hepatoma, 2/8 (25%) of lung cancer, 3/13 (23.1%) of colon cancer, 0/3 (0%) of gastric lymphoma, and 4 of non-malignant conditions (18.2%). Six tumor markers were assessed at the same time in 32 patients of gastric cancer. The abnormal level for CA 19-9 was found in 13/32 patients (40.6%); for TPA: 9/32 (28.1%); for c-erbB-2 oncoprotein: 11/32 (34.4%); for CEA: 8/32 (25%); for CA 125: 2/32 (6.3%); and for AFP: 1/32 (3.1%). CONCLUSIONS: C-erbB-2 oncoprotein is a new tumor marker. Practical application needs further mass survey.

Biomarkers, Tumor↗

The influence of sham feeding on gastric acid and pepsin secretion in the Chinese with duodenal ulcer and liver cirrhosis.

BACKGROUND: This study was conducted to evaluate gastric acid and pepsin output in the Chinese patients with liver cirrhosis and duodenal ulcers. METHODS: In a period of one year and three months, we prospectively assayed the acid and pepsin responses to sham feeding in 10 healthy males, 20 males with duodenal ulcers, and 11 males with liver cirrhosis. RESULTS: Although basal and sham feeding stimulated acid outputs were higher in duodenal ulcer patients (2.7 +/- 0.3 and 3.7 +/- 0.3 mEq/h, mean +/- SEM) than in normal subjects (1.6 +/- 0.4 and 2.9 +/- 0.6 mEq/h) and in patients with liver cirrhosis (1.8 +/- 0.4 and 2.1 +/- 0.7 mEq/h), it did not reach statistical significance. Both basal and sham feeding stimulated pepsin outputs were significantly higher in duodenal ulcer patients (11.2 +/- 2.1 and 9.5 +/- 2.2 mg/h) than in normal subjects (2.4 +/- 0.5 and 4.3 +/- 1.2 mg/h) and in patients with liver cirrhosis (3.6 +/- 1.4 and 3.9 +/- 1.2 mg/h) (p < 0.05). The serum gastrin and pepsinogen I concentration in basal and sham feeding conditions demonstrated no statistically significant difference among three groups. CONCLUSIONS: Basal and sham feeding stimulated acid outputs in the Chinese were lower in normal subjects and duodenal ulcer patients as compared with those in the Occidentals. High basal pepsin output may play an important role in the pathogenesis of duodenal ulcers in the Chinese.

Analysis of Variance↗

Characteristics of patients with bleeding peptic ulcer requiring emergency endoscopy and aggressive treatment.

OBJECTIVES: Patients with an ulcer and active bleeding or a nonbleeding, visible vessel are high-risk for further bleeding and should receive aggressive therapy. In this study, we tried to identify clinical parameters that predict these high-risk groups. METHODS: Over a 7-month period, 16 clinical parameters were analyzed prospectively in 316 patients with bleeding peptic ulcer. A multivariate analysis was used to find the independent predictors for the high-risk patients. RESULTS: A total of 114 patients (36%) was found to have a spurting hemorrhage (eight patients), oozing hemorrhage (27 patients), or a nonbleeding visible vessel (79 patients). Using an univariate analysis, a statistically significant predictor was the appearance of coffee ground fluid or blood from the nasogastric tube. This predictor also emerged as an independent factor (odds ratio, 0.4333; 95% confidence interval, 0.263-0.714). CONCLUSIONS: Patients with bleeding peptic ulcer who have coffee ground fluid or blood from the nasogastric tube should receive an emergency endoscopy and aggressive treatment.

Emergencies↗

Thoracic epidural anesthesia for major abdominal surgery: a retrospective study.

In 1986-1988, the authors had experiences with thoracic epidural anesthesia for a variety of major abdominal operations in 303 patients. It is proved to be reliable and effective. The puncture levels were between T8 to T12. 2% lidocaine, in plain form or with 1:200,000 epinephrine, was used as anesthetic agent. Perioperative complications were carefully managed with satisfactory results. Post-operative conditions were evaluated and seemed to be superior to those of general anesthesia in many aspects. No patient had neurologic deficit as a result of the epidural anesthesia. We concluded that thoracic epidural anesthesia is an excellent alternative technique in major abdominal surgeries.

Abdomen↗

Non-A, non-B fulminant hepatitis is also non-E and non-C.

OBJECTIVES: to define the roles of the hepatitis C and E viruses (HCV and HEV) in non-A, non-B (NANB) fulminant hepatitis. METHODS: we utilized the polymerase chain reaction to amplify HCV and HEV RNA sequences and assays to detect antibodies to HCV and HEV in the acute phase sera of eight presumed viral NANB and seven nonviral NANB fulminant hepatic failure (FHF) patients. RESULTS: none of the 15 patients had detectable HCV or HEV RNA or elevated HCV and IgM-HEV antibody titers in their acute phase sera. Three patients, all with features of autoimmune hepatitis, had raised IgG-HEV antibody titers. Due to the possibility of serologically undetectable hepatitis B virus (HBV) infection in fulminant hepatitis patients, we performed polymerase chain reaction amplification of HBV genomic DNA in acute phase sera of the presumed viral NANB FHF patients and subsequently found no evidence of HBV DNA. CONCLUSIONS: we did not find evidence implicating HCV or HEV in presumed viral NANB FHF or as agents contributing to or causing the liver failure in nonviral NANB FHF patients with autoimmune hepatitis, drug-induced hepatotoxicity, or halothane hepatotoxicity.

Adolescent↗

Soft x-ray magnetic circular dichroism: a probe for studying paramagnetic bioinorganic systems.

Soft x-ray magnetic circular dichroism was used to study a paramagnetic bioinogranic system. We measured the Fe L edges of Pyrococcus furiosus rubredoxin, using circularly polarized synchrotron radiation, a split-coil super-conducting magnet, low sample temperatures, and fluorescence detection. The observed dichroism effect is strong (30%) and in general agreement with the calculation. The method is element- and oxidation state-specific, and the data can be interpreted by established theoretical procedures. Soft x-ray magnetic circular dichroism demonstrates enormous potential as a probe for studying paramagnetic systems in biology, chemistry, and material science.

Bacteria↗

DOOR syndrome (deafness, onycho-osteodystrophy, and mental retardation): a new patient and delineation of neurologic variability among recessive cases.

We report the seventeenth case of the recessive form of the DOOR syndrome. The parents were Guatemalan and not known to be consanguineous. The patient had developmental delay, severe sensorineural deafness, and abnormal nails and phalanges in the hands and feet. Urinary 2-oxoglutarate excretion was normal. The patient was among a subset of DOOR syndrome patients without seizures in infancy. This observation may be useful in discussing the prognosis for newly identified cases.

Abnormalities, Multiple↗

Exstrophy of the cloaca in a 47,XXX child: review of genitourinary malformations in triple-X patients.

Cloacal exstrophy, unilateral renal agenesis, and Müllerian anomalies occurred in a liveborn infant with a 47,XXX chromosome constitution. The patient extends the range of genitourinary anomalies reported in triple-X patients. Screening asymptomatic patients for urinary tract abnormalities may be useful in searching for silent malformations potentially associated with this karyotype.

Abnormalities, Multiple↗

Five-year follow-up of a prospective randomized trial of hepatitis B recombinant DNA yeast vaccine vs. plasma-derived vaccine in children: immunogenicity and anamnestic responses.

In a prospective randomized trial, 318 children aged between 3 mo and 11 yr who were negative for all hepatitis B markers were randomized to receive two 5-micrograms doses of hepatitis B recombinant DNA yeast vaccine at 0 and 1 mo (group 1), three 5-micrograms doses of hepatitis B recombinant DNA yeast vaccine at 0, 1 and 6 mo (group 2) or three 10-micrograms doses of plasma-derived hepatitis B vaccine (group 3). The HBs antibody response rate at 8 mo was between 93% and 99%; it was still 75% to 87% at 5 yr in all three groups. Geometric mean titers at 1 yr were 83, 1,085 and 858 mIU/ml in groups 1, 2 and 3, respectively. These values had decreased after 5 yr to 47, 131 and 250 mIU/ml. Subjects in group 1 showed a significantly less proportional drop in geometric mean titer at the fifth year than did subjects in group 2 (p = 0.05) or group 3 (p = 0.015). None of the children developed HBc antibody, even after 5 yr of follow-up. We noted 42 episodes of significantly increased HBs antibody titers, probably due to anamnestic response, even when the titers had dropped to low levels. The mean age at which anamnestic response occurred was 8.7 yr.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

Randomized controlled trial of recombinant alpha-2a-interferon for chronic hepatitis C. Comparison of alanine aminotransferase normalization versus loss of HCV RNA and anti-HCV IgM.

We enrolled 32 patients with chronic hepatitis C into a randomized, controlled trial to evaluate the efficacy of recombinant alpha-2a-interferon treatment. Sixteen patients were randomized to receive 1.5 million units of recombinant alpha-2a-interferon subcutaneously, thrice weekly, for six months while the remaining 16 patients were randomized to a control group that received no treatment. The mean serum alanine aminotransferase (ALT) level during the six-month study period, expressed as a percentage of the prestudy baseline value, was 82% for the control group compared to 56% for the treatment group (P = 0.014). One fourth of the treatment group normalized their serum ALT level compared to only 6% of the controls (P = 0.05). During posttherapy follow-up, 86% of responders clinically relapsed. Loss of anti-HCV IgM and HCV RNA occurred exclusively in interferon-treated responders. Anti-interferon antibodies developed in 32% of all treated patients. Forty percent of nonresponders developed anti-interferon antibodies compared to only 14% of responders (P = NS). We conclude that recombinant alpha-2a-interferon is clinically effective in patients with chronic hepatitis C. However, most responders in this trial of low-dose interferon relapsed upon cessation of treatment.

Adult↗

Refractoriness of neuromuscular transmission: determination by computer subtraction of neurally evoked compound electromyograms.

Shortly after elicitation of a muscle response by supramaximal stimulation of its motor nerve, there exists a period of refractoriness of neuromuscular transmission when a second stimulation elicits only a submaximal response or no response at all. Many anaesthetics and neuromuscular blocking and facilitatory drugs change the refractoriness of neuromuscular transmission. Measurement of this refractoriness may improve our understanding of the neuromuscular actions of these drugs and be useful in differential diagnosis. However, the neuromuscular refractory periods (RP) are difficult to measure, and the unavailability of normal values renders accurate determination of drug effects impossible. Based on an existing technique of digitization and time expansion of the neurally evoked compound electromyogram (ncEMG), we developed a computer programme of waveform subtraction, and determined in nine normal awake volunteers the various interstimulus intervals when neuromuscular transmission was refractory (RP0), 3/4 refractory (RP.25), half refractory (RP.5), 1/4 refractory (RP.75) or non-refractory (RP1). We confirmed our hypotheses that computer-based waveform subtraction of the digitized ncEMG is a feasible and necessary technique for the accurate determination of the RPs of neuromuscular transmission, and report that the normal values in humans are: RP0 = 1.0 +/- 0.1, RP.25 = 1.3 +/- 0.3, RP.5 = 1.9 +/- 0.3, RP.75 = 2.9 +/- 0.5, and RP1 = 6.6 +/- 1.9 ms (mean +/- SD), respectively, in the ulnar nerve-first dorsal interosseous muscle model.

Adult↗

The hepatitis C virus genome: a guide to its conserved sequences and candidate epitopes.

A comprehensive analysis of reported hepatitis C virus genomic sequences comprising 151 partial or complete nucleotide sequences and 159 partial or complete amino acid sequences revealed an irregular composition of conserved and variable regions. There were but eight conserved nucleotide sequences, none outside the 5' noncoding and structural regions. A search among conserved amino acid sequences revealed 14 candidate B-cell epitopes, which were chosen mainly on the basis of their hydrophilicity profiles. Twenty five candidate T-cell epitopes were selected according to the criteria of absolute conservation of amino acid sequence, together with characteristic sequence motifs, amphipathic helical structure, or both. Conserved peptide sequences, with the characteristics of both B- and T-cell epitopes, were identified in the nonstructural 5 (NS5) region of the genome.

Amino Acid Sequence↗

Hepatitis C virus infection in kidney transplant recipients.

To determine the prevalence and significance of hepatitis C virus infection in kidney transplant recipients, paired serum samples collected from 100 renal allograft recipients on admission for kidney transplantation and 1 yr after transplantation were tested for antibody to hepatitis C virus with second-generation enzyme immunoassay and recombinant immunoblot assay and for hepatitis C virus RNA with reverse transcription-polymerase chain reaction. Before kidney transplantation, hepatitis C virus antibody was detected with second-generation enzyme immunoassay in 18 patients (12 second-generation recombinant immunoblot assay-positive, 6 second-generation recombinant immunoblot assay-indeterminate). Nine of 12 second-generation recombinant immunoblot assay-positive and 2 of 6 second-generation recombinant immunoblot assay-indeterminate samples were hepatitis C virus RNA positive. In addition, 7 of 82 patients who had no detectable antibody on second-generation enzyme immunoassay or second-generation recombinant immunoblot assay were hepatitis C virus RNA positive. After kidney transplantation, hepatitis C virus antibody was detected in 19 patients (12 second-generation recombinant immunoblot assay-positive, 7 second-generation recombinant immunoblot assay-indeterminate, 14 seropositive for hepatitis C virus antibody). Eleven of 12 patients with second-generation recombinant immunoblot assay-positive results and 4 of 7 with second-generation recombinant immunoblot assay-indeterminate results were positive for hepatitis C virus RNA. Hepatitis C virus RNA was present in 28 patients 1 yr after kidney transplantation. Six patients appeared to have acquired active hepatitis C virus infection 1 yr after kidney transplantation (seroconverted to hepatitis C virus RNA positivity).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The variability of the hepatitis B virus genome: statistical analysis and biological implications.

A statistical analysis of the nucleotide sequence variability in 14 published hepatitis B virus (HBV) genomes was carried out using parametric and nonparametric methods. A parametric statistical model revealed that the different regions of the genome differed significantly in their variability. The conclusion was supported by a nonparametric kernel-density model of the HBV genome. Genes S, C, and P, region X, the precore region, and the pre-S2/pre-S1 regions were ranked in order of increasing variability. In many instances, conserved regions of the genome identified with sequences of known function in HBV biology. However, other characterized regions (such as pre-S) showed much variability despite the involvement of their encoded peptides in specific functions. Point mutations that may result in the formation of stop codons and amino acid changes may affect the clinical picture of HBV infection and may be reflected in atypical serological patterns.

Consensus Sequence↗