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Biomedical subjects

J C Hwang

Publications and source records attributed to J C Hwang.

At least 19 recordsLinked to original sources

Heat shock protein 70 and tumor necrosis factor alpha in Taiwanese patients with dementia.

This study was to determine whether polymorphisms of heat shock protein 70-1 (HSP70-1) and tumor necrosis factor alpha (TNF-alpha) are associated with the risk of Alzheimer's disease (AD) and vascular dementia (VaD). Using the criteria of the NINCDS-ADRDA and NINDS-AIREN, 125 AD patients, 57 VaD patients and 109 ethnically matched nondemented controls were enrolled. The HSP70-1 -110 A/C and TNF-alpha -1031 T/C, -863 C/A and -857 C/T polymorphisms were analyzed by means of genotype or haplotype association methods. None of the four genotypes examined showed a statistically significant difference in genotype distribution between the AD cases and controls. However, the HSP70-1 -110 CC genotype occurred more frequently among AD cases (p=0.0821; odds ratio: 2.08; 95% confidence interval, CI: 0.92-4.98). The overall genotype distribution among the VaD cases tended to be different at the HSP70-1 -110 and TNF-alpha -1031 sites (p=0.0604 and 0.0316, respectively). The HSP70-1 -110 CC genotype was more frequent (p=0.0459), and the association of the -110 CC genotype with VaD was evident (p=0.0207; odds ratio: 3.22; 95% CI: 1.20-8.87). The more frequent TNF-alpha -1031 TC genotype (p=0.0614) was also evidently associated with VaD (p=0.0209; odds ratio: 2.32; 95% CI: 1.14-4.78). Multivariate analysis demonstrated the synergistic effect of the HSP70-1 -110 CC and TNF-alpha -1031 TC/CC genotypes on VaD (p=0.0091; odds ratio: 10.09; 95% CI: 2.01-75.97). Haplotype analysis among TNF-alpha -1031, -863, -857 sites revealed that -1031C-857C may act as a risk haplotype among VaD cases (p=0.0132, odds ratio: 2.26; 95% CI: 1.19-4.33). Our results suggest a potential protective role for HSP70 in both VaD and AD, whereas TNF-alpha may act as a risk factor only for VaD, and not for AD.

Aged↗

Genetic testing in spinocerebellar ataxia in Taiwan: expansions of trinucleotide repeats in SCA8 and SCA17 are associated with typical Parkinson's disease.

DNA tests in normal subjects and patients with ataxia and Parkinson's disease (PD) were carried out to assess the frequency of spinocerebellar ataxia (SCA) and to document the distribution of SCA mutations underlying ethnic Chinese in Taiwan. MJD/SCA3 (46%) was the most common autosomal dominant SCA in the Taiwanese cohort, followed by SCA6 (18%) and SCA1 (3%). No expansions of SCA types 2, 10, 12, or dentatorubropallidoluysian atrophy (DRPLA) were detected. The clinical phenotypes of these affected SCA patients were very heterogeneous. All of them showed clinical symptoms of cerebellar ataxia, with or without other associated features. The frequencies of large normal alleles are closely associated with the prevalence of SCA1, SCA2, MJD/SCA3, SCA6, and DRPLA among Taiwanese, Japanese, and Caucasians. Interestingly, abnormal expansions of SCA8 and SCA17 genes were detected in patients with PD. The clinical presentation for these patients is typical of idiopathic PD with the following characteristics: late onset of disease, resting tremor in the limbs, rigidity, bradykinesia, and a good response to levodopa. This study appears to be the first report describing the PD phenotype in association with an expanded allele in the TATA-binding protein gene and suggests that SCA8 may also be a cause of typical PD.

Age of Onset↗

Covered retrievable tracheobronchial hinged stent: an experimental study in dogs.

PURPOSE: To evaluate the safety and technical feasibility of the use of a covered retrievable tracheobronchial hinged stent and investigate the histopathologic airway changes after placement and removal of the stent in dogs. MATERIALS AND METHODS: The experimental stent was composed of tracheal and bronchial stents that were connected together at their ends. Each stent was woven from a single thread of 0.2-mm-diameter nitinol wire filament in a tubular configuration and covered with polyurethane solution by a dipping method. Drawstrings were attached at the upper end of the tracheal stent for stent removal. Under fluoroscopic guidance, 20 stents were placed at the lower trachea and left main bronchus in 20 dogs and were electively removed 4 weeks (n = 10) or 8 weeks (n = 10) after placement. Ten dogs were killed just after stent removal and the remaining 10 were killed 2 weeks after stent removal. RESULT: Stents were successfully placed in all dogs. Pneumonia was observed in three dogs. Stent migration occurred in seven dogs (35%). Except for two cases of stent expectoration, 18 stents were easily removed within a few minutes. There was considerable granulation tissue proliferation and inflammatory reaction in the airways of the dogs that were killed just after stent removal. The pathologic changes of the airways returned to almost-normal conditions 2 weeks after stent removal. CONCLUSION: Placement and removal of a covered retrievable tracheobronchial hinged stent seems to be feasible, and histopathologic changes of the airway related to the stents returned to normal 2 weeks after stent removal.

Animals↗

Cardiac and pulmonary vagal neurons receive excitatory chemoreceptor input.

The effects of hypercapnia and hypocapnia on the activities of the cardiac and pulmonary vagal single fibers were examined in the decerebrated, unanesthetized, paralyzed, and vagotomized cats. The animals breathed 100% O2. Fractional end tidal CO2 concentration was raised to 9% by adding CO2 into the O2 inlet. Average discharge rate of efferent cardiac vagal units (n=10) increased from 1.0+/-0.3 to 2.2+/-0.3 Hz. Hypocapnia apnea was produced by hyperventilation. Activities of cardiac vagal units tested (n = 4) showed dramatic decrease (0.1+/-0.0 Hz). Mean arterial blood pressure did not change significantly under these conditions. In contrast, only instantaneous firing rate during inspiration was significantly increased for efferent pulmonary vagal units (n = 11) during hypercapnia. The activities of the 3 pulmonary vagal units tested with hypocapnia decreased significantly. We concluded that cardiac and pulmonary vagal neurons were excited by chemoreceptor input.

Animals↗

The removal of beta-2-microglobulin by an immunoadsorption wall.

The accumulation of beta-2-microglobulin (beta2M) in collagen-rich tissues has been proven to be the main cause of dialysis related amyloidosis. However, it remains uncertain which technique for the removal of beta2M can be used without compromising the advantages of other dialysis strategies. A new concept, an immunoadsorption wall, which combines the principles of immunoisolation and immunoadsorption is proposed to remove beta2M. The present investigations suggested that the application of the concept to clinical use is feasible and worthwhile. The concept, if validated, will help shape a novel multitask type of artificial kidney based on the combination of different separation technologies.

Antibodies↗

A single minute lesion around the ventral respiratory group in medulla produces fatal apnea in cats.

In 35 adult cats anesthetized with intraperitoneal chloralose and urethane, the ventrolateral medulla was explored by microinjection of kainic acid (KA, 24 mM, 200 nl) with metal electrode-tubing or glass micropipette to determine regions which elicit persistent apnea. Persistent apnea is defined as: (1) In spontaneously breathing cats, termination of respiration over 3 min with a decrease of the mean systemic arterial pressure (MSAP) to 25 mm Hg. (2) In animals under artificial ventilation and paralyzed by gallamine, cessation of bilateral phrenic nerve (PNA) activities over 25 min. The apnea producing area was located dorsal to the rostral pole of the lateral reticular nucleus, ventromedial to the ambiguous nucleus and immediately caudal to the retrofacial nucleus. Functionally, this region includes the rostral part of the ventral respiratory group (rVRG) encompassing the pre-BOtzinger area. We define this region as the VRG apnea producing area (VRG-Apa). Fatal apneusis was observed under following conditions: (1) Persistent apnea was produced after a single KA microinjection in one side of the VRG-Apa (5 animals). Microinjection of sodium glutamate (0.25 M, 70-200 nl) in the same area produced only brief apnea, while microinjection of kynurenic acid (0.1 M, 200 nl) showed little effect on the respiration but slightly increased the SAP. (2) Positioning an electrode nearby but not in the VRG-Apa with or without KA injection did not produce apnea. But when a second electrode insertion to the opposite VRG-Apa immediately produced persistent apnea even without KA injection (6 animals). (3) Midsagittal division of the medulla 0-5 mm rostral to the obex produced persistent silence of PNA on both sides in artificial ventilated animals (7 animals), while similar division 0-5 mm caudal to the obex (4 animals) produced a brief but reversible quiescence of PNA. In conclusion, findings of the present study support the existence of a restricted region of VRG-Apa. VRG-Apa on both sides are closely connected, and integrity of both VRG-Apa is essential for normal respiration.

Animals↗

Pharmacological properties of ACh receptors on the heart of the marine bivalve Meretrix lusoria.

The cholinergic receptors on the heart of the marine bivalve Meretrix lusoria were used as a model to investigate their pharmacological properties in bivalves. By recording method, we measured the contractile force (CF) and the heart rate (HR) of the heart to examine the characteristics of cholinergic receptors of a marine bivalve. The known ACh receptor agonists or antagonists in vertebrate nervous system were then introduced into the heart by perfusion, to monitor their effects upon heart activities. Of the six tested agonists, two mAChR agonists (OXA-22, bethanechol) and two nAChR agonists (methylcarbachol, nicotine) mimicked the response induced by ACh. Among the seven tested antagonists, three mAChR antagonists (trihexyphenidy1, atropine and scopolamine) and three nAChR antagonists (TEA, curare and hexamethonium bromide) showed the antagonistic effects on the inhibition induced by ACh. However, there was one mAChR agonist, metoclopramide, that behaved like an ACh antagonist. Both APE (mAChR agonist) and PTMA (nAChR antagonist) showed no significant effects. This differences suggest that the pharmacological characteristics of ACh receptors on the heart of bivalve are different from those in vertebrates. It may be a novel type of ACh receptors.

Acetylcholine↗

Respiratory-related facial nerve activity in response to activation of the rostral ventrolateral medulla in the cat.

The effects of electrical and chemical activation of the rostral ventrolateral medulla (rVLM) on respiratory-related facial nerve activity were investigated in decerebrated, paralyzed, vagotomized and ventilated cats. The animal was maintained at normocapnia and hypercapnia in hyperoxia. Phrenic and facial nerve activities were simultaneously recorded. Excitation of the rVLM either by electrical current (12.5 to 50 microA, 80 Hz and 0.5 ms pulse duration) or glutamate microinjection (50 mM, 20 to 200 nl) inhibited both phrenic and facial nerve discharges. Although inhibition of the rVLM upon both nerves was attenuated by hypercapnia, this inhibition remained significant during hypercapnia. These results suggest that the rVLM may be involved in the modulation of upper airway patency by controlling respiratory-related facial nerve activity.

Animals↗

Frostbite of the face after recreational misuse of nitrous oxide.

Exposure of the skin to nitrous oxide, a liquified gas stored under pressure in a cylinder, can occur in anaesthesiologists and in those involved in recreational misuse of the gas. A case is reported of a man who presented to the emergency department after sniffing nitrous oxide and sustaining frostbite injury to his left cheek. Conservative management of this injury allowed spontaneous separation of the necrotic tissue and healing of the granulating wound by contraction.

Facial Injuries↗

Hemodialysis alternative with ascites ultrafiltration for an end-stage renal failure patient associated with tense ascites secondary to decompensated liver cirrhosis.

Patients with end-stage renal disease combined with tense ascites caused by decompensated liver cirrhosis are sometimes encountered in a hemodialysis center. A big problem for the management of these patients is the tendency of hypotension during ultrafiltration. Subsequent fluid accumulation, especially in the abdominal cavity, causes breathing difficulty and abdominal discomfort. We present a new technique, ascites ultrafiltration, to solve this problem. Using the same equipment as for ordinary hemodialysis, and incurring the same cost, we removed directly approximately 8 L of ascites fluid during each nearly 4-hour session. No hemodynamic instability was noted. We proved this technique to be an effective and safe alternative method for this group of patients.

Ascites↗

Severe burn injury from recreational gasoline use.

This report describes the case of a 13-year-old boy who suffered severe burns with inhalation injury during the recreational use of gasoline. Gasoline sniffing is a popular form of solvent abuse for young children and adolescents in isolated, rural communities. In addition to the neurological and physiological complications of gasoline inhalation, gasoline sniffers face the significant threat of severe burn injury or death resulting from ignition of the gasoline vapor as well as from extensive physical contact with the constituents of liquid gasoline.

Adolescent↗

Investigation of upper gastrointestinal hemorrhage in chronic renal failure.

The role of specific pathological findings in the upper gastrointestinal tract in chronic renal failure remains uncertain. Most of the studies were conducted in the West, and the number of subjects was small. We have tried to look at that problem in Taiwan. Endoscopy to evaluate the source of upper gastrointestinal hemorrhage was performed in 698 patients over a 37-month period; that represents 4.4% of all patients undergoing upper gastrointestinal endoscopy for miscellaneous reasons in that time span. Fifty-eight patients (8.3%) who had been hemodialyzed for chronic renal failure were selected, as were 640 control patients who did not have renal failure. Patients with renal transplant were not included. Endoscopic diagnoses, contributing factors of bleeding, and the course and outcome of the hospitalization were analyzed. chi 2 Test with or without Yates' correction and Student's t test were used as appropriate. Erosive gastritis was the most frequent source of bleeding in patients with chronic renal failure. Erosive gastritis (p < 0.005), erosive esophagitis (p < 0.001), and esophageal ulcer (p < 0.005) were significantly more common causes of bleeding in the renal failure population than in the group without renal failure. The two groups did not differ significantly (p > 0.05) in smoking, heavy alcohol intake, or use of ulcerogenic medications. The age was older (64.1 +/- 11.4 vs. 55.7 +/- 16.2 years) and the mortality rate higher (13% vs. 2%) in patients with renal failure than in those without. The differential diagnoses of upper gastrointestinal bleeding sites differ in patients with and without chronic renal failure; they are diverse. However, erosive gastritis, rather than gastric ulcer or duodenal ulcer, is the most common cause in the patients with renal failure. The mortality rate is significantly higher in these patients than in the general population.

Acute Disease↗

Bilateral amputations following hydrotherapy tank burns in a paraplegic patient.

Hydrotherapy is an important part of wound care and physical therapy. The benefits of hydrotherapy are derived from water's cleansing ability, buoyancy, drag, inertia and temperature. If the temperature of the water is not adequately controlled, an immersion scald burn can occur. A paraplegic patient who was receiving hydrotherapy for treatment of his malleolar ulcers sustained immersion scald burns that ultimately necessitated below-the-knee amputations.

Adult↗

Changes in phrenic, hypoglossal and recurrent laryngeal nerve activities after intravenous infusions of aminophylline in cats.

Aminophylline is known to have respiratory stimulant properties, and it has been suggested that it may also be effective in sleep apnoea. However, its role in this disorder remains uncertain. Theoretically, increasing upper airway motoneural activity in order to maintain airway patency might alleviate obstructive sleep apnoea. On the other hand, increasing the respiratory drive may also prove beneficial in treating central sleep apnoea. In these studies, we attempted to determine the effect of aminophylline on neural activities of the upper airway and diaphragm. We administered intravenously either a low dose (4 mg.kg-1) or a high dose (16 mg.kg-1) of aminophylline to decerebrated, vagotomized and paralysed cats, and continuously recorded the phrenic hypoglossal and recurrent laryngeal nerve activities for 3 h. Results showed that a high dose of aminophylline induced a marked increase in phrenic nerve activity, but not hypoglossal or recurrent laryngeal nerve activity. In a group treated with a low dosage of aminophylline, a significant increase of activity was found in all three nerves. Furthermore, phrenic nerve activity increased more with a high dose than with a low dose. We confirmed that aminophylline has dose-dependent and selective effects on respiratory neural activity. A low dose acts on the upper airway and diaphragm, but a high dose induces a marked increase in central respiratory drive. According to our results, low dose aminophylline might be beneficial in obstructive sleep apnoea, whereas, a high or low dose might improve some cases of central sleep apnoea.

Aminophylline↗

Plasma luteinizing hormone and progesterone concentrations after prostaglandin F2 alpha in Taiwan yellow cows (Bos indicus).

A luteolytic dose (500 micrograms) of cloprostenol was given four days before expected estrus to five mature cyclic cows of native Taiwan Yellow cattle. Blood samples were collected at hourly intervals for 60 hours and then twice daily (0800 h and 1600 h) until onset of the following estrus or Day 29 after prostaglandin (PG) injection. Plasma progesterone levels were quite low in the follicular phase and elevated over an 11-13 day period during the luteal phase for every animal. Two cows showed peak luteinizing hormone (LH) levels of 19.97 and 23.77 ng/ml of plasma at 120 and 127 h after PG injection. One cow did not show peak LH level during the 60-h sampling period, but had its highest concentration of 18.02 ng/ml at 0800 h on Day 8. Two cows showed no detectable peak LH during the 60-h sampling period or on subsequent days. But these two cows had increased concentrations of progesterone beginning on Day 6 and Day 12. All animals came back into estrus 23-28 days after PG treatment.

Animals↗

Responses of respiratory-modulated facial nerve activity to activation of the ventrolateral subarea of the nucleus of the tractus solitarius.

The purpose of the present study was to examine respiratory-modulated facial nerve activity (FNA) in response to activation of the ventrolateral subarea of the nucleus of the tractus solitarius (vlNTS). The cat was anesthetized with sodium pentobarbital and then vagotomized bilaterally, paralyzed and ventilated artificially. End-tidal fractional concentration of CO2 was maintained at hyperoxic normocapnia. Partial occipital craniotomy was performed to expose the obex. Activities of the phrenic and the facial nerves were simultaneously recorded. The vlNTS was excited by electrical current (80 Hz frequency, 0.5 ms pulse duration and a variety of current from 12.5 to 50 microA) and glutamate (30-100 nl, 0.5 M). Three responsive patterns for both nerves were observed in response to vlNTS activation. First, inspiratory facial nerve activity (iFNA) and phrenic nerve activity (PNA) were decreased (p < 0.01), while expiratory facial nerve activity (eFNA) was not changed. Second, iFNA and PNA were diminished (p < 0.01) but eFNA was enhanced. Third, iFNA was decreased whereas PNA was enhanced. These results suggest that there might be a neural pathway projecting from the vlNTS to the facial nuclei to modulate respiratory-modulated facial nerve activities.

Animals↗

Facilitation and inhibition of phrenic motoneuronal activities by lung inflation.

The purpose was to evaluate the facilitatory influence of pulmonary inflations on phrenic activity. In decerebrate cats, activities of phrenic motoneurons and nerve were recorded during ventilatory cycles in which the lungs were inflated to different levels and inflations were withheld. Motoneuronal activities were divided into "early" and "late" populations depending on their onset of activity. In normocapnia, facilitation was manifested by an increase in the rate of rise of phrenic activity. Facilitation increased with an increased level of inflations and fell when inflations were withheld. This facilitation was largely due to an increased rate of change and earlier onset of late motoneuronal activities. These variables for early motoneuronal activities were little altered by changes in inflations. Peak discharge frequencies of both early and late motoneurons increased during noninflation cycles. Facilitation was still evident during hypercapnia and in anesthetized animals; however, under these conditions, the earlier onset of late motoneuronal activities was no longer observed. We conclude that facilitation by pulmonary stretch receptor discharge is a constant determinant of phrenic neuronal and neural activities.

Anesthesia↗