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Biomedical subjects

H J Lin

Publications and source records attributed to H J Lin.

At least 145 records · Page 8Linked to original sources
PubMed1993

Aspergillosis complicating the grafted skin and free muscle flap in a diabetic.

A case of infected diabetic foot ulcer was reconstructed by a free muscle flap overlaid with a skin graft. Primary cutaneous aspergillosis involving the grafted skin and the transplanted muscle was described. The patient presented with an indurated grey-yellow plaque or black eschar in the wound without purulent discharge. Biopsies and cultures demonstrated A. flavus as the etiologic agent without evidence of systemic dissemination. Early diagnosis necessitates a high index of suspicion in immunocompromised patients with unusual cutaneous manifestation. Treatment consisted of aggressive debridement, systemic and local antifungal therapy, and delayed grafting. We concluded that primary cutaneous aspergillosis may occur at the reconstructed wound in an immunocompromised diabetic, and that it is a rare complication requiring prompt diagnosis and treatment.

Aspergillosis↗
PubMed1993

Establishment of a quality assurance program for human immunodeficiency virus type 1 DNA polymerase chain reaction assays by the AIDS Clinical Trials Group. ACTG PCR Working Group, and the ACTG PCR Virology Laboratories.

An independent quality assurance program has been established by the Virology Committee of the AIDS Clinical Trials Group in the Division of AIDS, National Institute of Allergy and Infectious Diseases, for monitoring polymerase chain reaction (PCR) assays for human immunodeficiency virus type 1 (HIV-1) DNA that are performed by 11 laboratories participating in multicenter clinical trials in the United States. To perform HIV-1 DNA PCR for patients in AIDS Clinical Trials Group protocols, each laboratory was initially certified by correctly testing a coded certification panel consisting of eight well-defined clinical whole-blood specimens and 30 cell pellets containing 0, 2, 5, 10, 20, or 50 8E5/LAV cells per 125,000 uninfected peripheral blood mononuclear cells. PCR was performed by one of two standardized commercial assays for amplification and nonisotopic detection of HIV-1 proviral DNA. For continuing certification, each laboratory must correctly test eight coded whole-blood samples per quarter and run three or four coded cell pellets and HIV-1 DNA copy standards with every PCR assay in real time. The PCR results for the coded pellets on each run are entered into an encrypted computer file, which immediately assesses the validity of the run. To date, 10 of 11 laboratories have correctly tested all HIV-1-positive and -negative samples in the initial certification panel on their first or second attempt. Subsequently, 9 of these 11 laboratories have continued to maintain their certified status. The use of commercial HIV-1 DNA PCR assays and an external quality assurance program have ensured that results from different laboratories are comparable and that problems with sensitivity and specificity are quickly identified.

Certification↗
PubMed1993

Is sclerosant injection mandatory after an epinephrine injection for arrest of peptic ulcer haemorrhage? A prospective, randomised, comparative study.

A prospective, randomised, comparative study was performed to assess the need for a pure alcohol injection after an epinephrine injection in the arrest of active peptic ulcer bleeding. Sixty four patients with active ulcer bleeding were enrolled in the study. The two groups (epinephrine and epinephrine plus pure alcohol) were matched for sex, age, site of bleed, endoscopic findings, shock, haemoglobin, and concomitant illness at randomisation. The volume of injected epinephrine in the epinephrine and the epinephrine plus pure alcohol groups mean (SD) was 6.0 (3.0) ml and 5.5 (3.0) ml respectively (p > 0.05). The volume of injected pure alcohol in the epinephrine plus pure alcohol group was 1.9 (1.1) ml. Bleeding was initially controlled in 31 (97%) of the epinephrine group and all of the epinephrine plus pure alcohol group. Rebleeding occurred in 11 (36%) of the epinephrine group and in five (16%) of the epinephrine plus pure alcohol group (p > 0.05). Rebleeding was successfully controlled in some patients with treatment by a second injection. Other patients had heat probe thermocoagulation or surgery. Ultimate haemostatic rates were 69% (22/32) and 88% (28/32) for the epinephrine and the epinephrine plus pure alcohol groups respectively (p > 0.05). The epinephrine plus pure alcohol group achieved a better haemostatic effect for spurting haemorrhage (9/10 v 5/11, p < 0.05). The need for emergency operations and blood transfusions were comparable in both groups. The stay in hospital were less in the epinephrine plus pure alcohol group (mean 4.3 v 7.1, p < 0.05). It is concluded that pure alcohol injection after an epinephrine injection can improve the haemostatic rate in patients with spurting haemorrhage and shorten the hospital stay for patients with active bleeding.

Combined Modality Therapy↗
PubMed1993

[Congenital nasopharyngeal teratoma: report of a case and review of the literature].

Teratomas are the most common congenital tumors, but teratomas of the nasopharynx are rare and seen almost exclusively in infants, usually in neonates. An unusual case of a neonate with respiratory distress is presented and a nasopharyngeal mass protruding into the oral cavity. After successful removal of the mass, pathological examination revealed a mature teratoma. The management and differential diagnosis are discussed, accompanied by a review of the literature.

Female↗
PubMed1993

Adenomyoma of the papilla of Vater: a case report.

Adenomyoma of the papilla of Vater is exceedingly rare. Histologically, the adenomyoma is characterized by locules of ducts with interlacing bundles of smooth muscle. A 63-year-old male patient is presented who had developed abdominal pain, progressively darker urine and light color stool, jaundice and dyspepsia over the past two-month period. Impression from radiologic study was neoplasm of the papilla of Vater, pathologic findings proved adenomyoma. This case, and review of the literature, suggest that local excision is the treatment-of-choice.

Ampulla of Vater↗
PubMed1993

[Value of fine needle aspiration cytology in the diagnosis and management of fibroadenoma of the breast].

Cytological and histopathological biopsies were obtained from 121 breast lumps clinically diagnosed as fibroadenomas. Of these 98.3 percent of the lesions were benign. The cytological diagnosis was benign in 95.1 percent of 101 (83.4% of total) cases confirmed as fibroadenomas, histopathologically, but inadequate for diagnosis in 4.9 percent. The remaining 20 lesions included one breast cancer and one primary malignant lymphoma. In this group aspiration cytology was inadequate for diagnosis in 20 percent of the cases (P < 0.05). The cytological reports cast suspicion in the two malignant cases. No lesion with benign cytology was subsequently shown to be malignant. Ninety-five (78.5%) cases of the lesions, representing 72 women under 35 years of age, which has been clinically diagnosed as fibroadenomas, showed fibroadenoma, histopathologically, in 89.5% of these cases. The other 26 (21.5%) lesions in 21 patients, who were over 35 years in age, had 61.5 percent fibroadenomas, cytological results cast suspicion of fibroadenoma in 87.1 percent of these cases. The other 16 histopathologically diagnosed fibroadenomas in patients over 35 years of age showed 62.5% were cytologically suspected of being fibroadenomas (P < 0.025). As a result of this study it is reasonable to suggest that a typical clinical fibroadenoma can be treated conservatively in women under 35 years, but only if an adequate cytological smear obtained by fine needle aspiration does not show malignant of suspicious cells.

Adenofibroma↗
PubMed1993

Recombinant interferon-alpha in inoperable hepatocellular carcinoma: a randomized controlled trial.

To evaluate the clinical efficacy of interferon-alpha in hepatocellular carcinoma, 71 adult Chinese patients with histologically proven inoperable hepatocellular carcinoma were randomized to receive recombinant interferon-alpha 2a (50 x 10(6) IU/m2) intramuscularly three times a week (n = 35) or no antitumor therapy (n = 36). The survival of interferon-alpha-treated patients was significantly better than that of patients who received no antitumor therapy (p = 0.0471); median lengths of survival were 14.5 and 7.5 wk, respectively. Objective tumor regression greater than 50% was observed in 31.4% (11 of 35) of patients receiving interferon-alpha. Interferon-alpha induced tumor regression greater than 50% in 11 (31.4%) patients. Compared with the group receiving no antitumor therapy, the interferon-alpha therapy group had more tumor regression (p < 0.0001) and less tumor progression (p = 0.001). This high-dose interferon-alpha therapy was relatively well tolerated; only 34.3% of patients required reduction of dosage by one third or one half because of persistent fatigue. Two patients with diabetes mellitus (one also had tabes dorsalis) exhibited mental deterioration that might have been partially attributable to interferon-alpha therapy. We conclude that interferon-alpha is useful in a proportion of Chinese patients with inoperable hepatocellular carcinoma, both in prolonging survival and in inducing tumor regression.

Adult↗
PubMed1993

Slow acetylator mutations in the human polymorphic N-acetyltransferase gene in 786 Asians, blacks, Hispanics, and whites: application to metabolic epidemiology.

Our aim was to determine the population frequencies of the major slow acetylator alleles of the polymorphic N-acetyltransferase (NAT2) gene, whose locus maps to chromosome 8. We used allele-specific PCR amplification on 786 dried blood spots obtained from Hong Kong Chinese, U.S. Koreans, U.S. blacks, U.S. Hispanics, Germans, and U.S. whites. Our results show that four slow acetylator alleles can be detected as mutations at positions 481, 590, and 857 in the NAT2 gene. Recognized base substitutions at positions 341 and 803 need not be determined, because they were almost always associated with the 481T mutation. The known mutation at position 282 was strongly associated with the 590A mutation. The 481T, 590A, and 857A mutations accounted for virtually all of the slow acetylator alleles in Asian and white populations. The 857A mutation proved to be an Asiatic allele. The results will be useful in large-scale epidemiologic studies of cancer and other conditions potentially associated with the acetylator polymorphism.

Acetylation↗
PubMed1992

Significance of isolated anti-HBc seropositivity by ELISA: implications and the role of radioimmunoassay.

Hepatitis B virus (HBV) surface antigen (HBsAg) and antibody to HBsAg (anti-HBs) are excellent markers for HBV infection and its immunity. The significance of isolated antibody to HBV core antigen (anti-HBc) seropositivity is not certain. To elucidate this, sera from 638 Chinese adult subjects, aged 18-52 years, seronegative for both HBsAg and anti-HBs, were tested for anti-HBc. Fifty-one (8%) were found to have an isolated anti-HBc seropositivity by ELISA, and all were negative for IgM-anti-HBc. The anti-HBc persisted in all subjects who attended follow-up for hepatitis B vaccination (n = 48) for a period of 8 months. These 48 subjects received 3 doses of hepatitis B vaccine (HB-VAX, 10 micrograms or 20 micrograms) at 0, 1, and 6 months: 72.9% developed a primary anti-HBs response (suggestive of a false-positive anti-HBc seropositivity), 4.2% developed an anamnestic or secondary anti-HBs response, and 22.9% did not develop an anti-HBs response. Increasing the cutoff point of the ELISA or reconfirmation with radioimmunoassay (RIA) reduced only a minor half of the false positives. This low specificity of anti-HBc ELISA/RIA, together with the high rate of anti-HBs response to hepatitis B vaccine, indicates that subjects with isolated anti-HBc seropositivity should be included in vaccination programs.

Adolescent↗
PubMed1992

Polymerase chain reaction assay for hepatitis C virus RNA using a single tube for reverse transcription and serial rounds of amplification with nested primer pairs.

A procedure is described for the detection of hepatitis C virus (HCV) RNA in blood by means of the polymerase chain reaction (PCR) in which the reverse transcription step and two rounds of amplification are carried out in a single tube. This results in fewer manipulations, reduced risk of contamination, and economy of time. The procedures are generally applicable to other assays based on the PCR. We describe the preparation (from 100 microL serum) of test samples that remain stable for at least 6 days under specified conditions and an assay that employs nested primer pairs homologous to conserved sequences in the 5' noncoding region. The method was tested on 107 sera from the United States and Japan. Correlation with first-generation anti-HCV was 77%. Two sets of nested primer pairs homologous to sequences in the 5' noncoding region and one set based on structural region sequences showed differences in their reactivities with serum HCV RNA. The recommended single tube procedure specified a primer for reverse transcription that was conserved in all reported HCV genomes but absent from pestivirus genomic sequences. The effects of preanalytical factors on the detection of HCV RNA were studied. Qualitatively, there was no change in the HCV RNA-positivity of sera that were exposed to room temperature for 24 hours. Quantitative studies showed a decrease in titer in some specimens. Three cycles of freeze-thawing had no detectable effects on the titers of HCV RNA.

Base Sequence↗
PubMed1992

Nonspecific DNA binding activity of simian virus 40 large T antigen: evidence for the cooperation of two regions for full activity.

We generated a series of COOH-terminal truncated simian virus 40 large tumor (T) antigens by using oligonucleotide-directed site-specific mutagenesis. The mutant proteins [T(1-650) to T(1-516)] were expressed in insect cells infected with recombinant baculoviruses. T(1-623) and shorter proteins [T(1-621) to T(1-516)] appeared to be structurally changed in a region between residues 269 and 522, as determined by increased sensitivities to trypsin digestion and by altered reactivities to several monoclonal antibodies. These same mutant proteins bound significantly less nonorigin plasmid DNA (15%) and calf thymus DNA (25%) than longer proteins [T(1-625) to T(1-708)]. However, all mutant T antigens exhibited a nearly wild-type level of viral origin-specific DNA binding and binding to a helicase substrate DNA. This indicated that binding to origin and helicase substrate DNAs is separable from about 85% of nonspecific binding to double-stranded DNA. As an independent confirmation that a region distinct from the origin-binding domain (amino acids 147 to 247) is involved in nonspecific DNA binding, we found that up to 96% of this latter activity was specifically inhibited in wild-type T antigen by several monoclonal antibodies which collectively bind to the region between residues 269 and 522. In order to investigate the relationship between the origin-binding domain and the second region, we performed origin-specific DNA binding assays with increasing amounts of calf thymus DNA as competitor. The results suggest that this second region is not an independent nonspecific DNA binding domain. Rather, it most likely cooperates with the origin-binding domain to give rise to wild-type levels of nonspecific DNA binding. Our results further suggest that most of the nonspecific binding to double-stranded DNA is involved in a function other than direct recognition and binding to the pentanucleotides at the replication origin on simian virus 40 DNA.

Animals↗
PubMed1992

Pyrrolizidine alkaloid composition of three Chinese medicinal herbs, Eupatorium cannabinum, E. japonicum and Crotalaria assamica.

The pyrrolizidine alkaloid composition of three Chinese herbs, "pei lan", "cheng gan cao" and "zi xiao rong," identified respectively as Eupatorium cannabinum, Eupatorium japonicum (Compositae) and Crotalaria assamica (Leguminosae), were studied by fast atom bombardment mass spectrometry and gas chromatography-electron impact mass spectrometry. Viridiflorine, cynaustraline, amabiline, supinine, echinatine, rinderine and isomers of these alkaloids were found in the Eupatorium species. Monocrotaline was the only pyrrolizidine alkaloid detected in the Crotalaria species.

Drugs, Chinese Herbal↗
PubMed1992

Subclinical hepatocellular carcinoma in Hong Kong Chinese.

Of the 208 Chinese patients with histologically proven hepatocellular carcinoma (HCC) seen during a 5-year period, 191 patients presented with symptomatic HCC and 17 patients with asymptomatic HCC (subclinical HCC, SCHCC) being picked up by alpha-fetoprotein (AFP) screening. Compared with the patients with symptomatic HCC, patients with SCHCC had a better performance status (p less than 0.01), higher serum albumin levels (p less than 0.05) and lower alkaline phosphatase levels (p less than 0.01). In those patients with symptomatic HCC, 4.7% were operable and only 2 patients had a tumour diameter of less than 5 cm. In contrast, patients with SCHCC had a higher operability rate (76.5%, p less than 0.0001) and all had a tumour of less than 5 cm in diameter (p less than 0.0001). Patients with SCHCC, most of whom had their tumour resected, had a better long-term survival (p less than 0.0001). We conclude that patients with SCHCC picked up by AFP serosurveillance have a better performance status, higher operability and better prognosis.

Actuarial Analysis↗
PubMed1992

Evidence of genetic heterogeneity in five kindreds with familial hypertrophic cardiomyopathy.

BACKGROUND: Recently, two families with hypertrophic cardiomyopathy have been shown to have mutations in the cardiac beta-myosin heavy chain gene (beta-MHC) located on the long arm of chromosome 14. METHODS AND RESULTS: We have performed linkage analysis of five newly ascertained pedigrees with more than 50 chromosomal markers detecting polymorphisms. Our findings confirm the linkage to beta-MHC gene locus on chromosome 14 in one family (LOD score, 4.50) and suggest linkage to the same gene in another kindred. Chromosome 14 markers were not linked to the disease gene in the other three kindreds, however, and a test for genetic heterogeneity was statistically significant. Moreover, markers for the beta-MHC gene identified affected individuals who were recombinants with respect to this gene and the disease phenotype in these three kindreds. CONCLUSIONS: These results provide conclusive evidence that hypertrophic cardiomyopathy in separate families is caused by mutations in disease genes at two or more locations in the genome.

Adolescent↗
PubMed1992

[Flow cytometric analysis of DNA in esophageal cancer].

Malignancy is the first of the ten leading causes of death in Taiwan area, however, since 1978, esophageal cancer is on the first ten causes of malignancy. Esophageal cancer is an aggressive neoplasm with a generally poor prognosis. This is usually related to the advanced stages of the neoplasm at presentation and at diagnosis. In this study, the DNA content in tumor was analyzed by flow cytometry, and compared it with clinical- pathological data, especially the survival time. All thirty seven cases (36 male, 1 female, mean age: 56.5 +/- 10.3 y/o) received operation at Kaohsiung Medical College Hospital in the past 11 years and 29 cases (27 male, 2 female, mean age: 62.2 +/- 9.6 y/o) proved to be esophageal cancer by endoscopic biopsy were assayed in this study. The formalin fixed-paraffin embedded block is used to analyze DNA content by flow cytometry. After comparing these results with clinical-pathological data, there were no significant difference in sex, age, duration, tumor location and length. However, there is a significant correlation between ploidy and tumor cell differentiation, that is, most of the diploid cells were well differentiated while most of the aneuploid cells were poorly differentiated. The median survival time of diploid cases was 325 days which was longer than the 277 days in aneuploid group, but there was no significant difference between these two groups. The same result was noticed in DNA index. Multiple variables analysis of prognostic factors disclosed that there were significant difference in correation with age tumor location tumor length, and whether there was combined radiotherapy and operation. But there were no significant relationship between survival and DNA ploidy DNA index distant metastasis surrounding tissue invasion sex duration and tumor cell differentiation. These data suggest that DNA folw cytometry analysis alone, may not provide a sueful biologic basis for the variable prognosis seen with esophageal tumors.

Aged↗
PubMed1992

[Ileal inflammatory fibroid polyp: case report].

The inflammatory fibroid polyp is a rare, polypoid lesion in the gastrointestinal tract. It occurs in the stomach, small intestine, and large intestine in descending order of frequency. This case report shows an ileal inflammatory fibroid polyp that causes ileoileal intussusception. So far, the histogenesis and pathogenesis of these kinds of polyps are still uncertain. Under the microscopic examination, the lesion appears to be made up of spindle-shaped or stellate cells that are morphologically identical to proliferating fibroblasts. Immunostaining results are strongly positive for vimentin and focally positive for S100 protein. However, epithelial membrane antigen, factor VIII R Ag, smooth muscle actin, and lysozyme test are all negative. This favors the view that the inflammatory fibroid polyp is fibroblastic in origin.

Aged↗