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Biomedical subjects

J K Chang

Publications and source records attributed to J K Chang.

At least 19 recordsLinked to original sources

Portable microscopic cell counter for the determination of residual leucocytes in blood components.

BACKGROUND AND OBJECTIVES: The accurate determination of residual white blood cell (WBC) in blood components is of considerable clinical importance, and a variety of methods have been devised for the counting of low levels of residual WBC. In this study, we evaluated the performance of microscopic cell counter with microchannel plastic chip (C-reader) with regard to its ability to quantify WBC in WBC-reduced red cell concentrates. MATERIALS AND METHODS: In order to quantify residual WBC with the microscopic cell counter, WBC-reduced red cell concentrate was stained using propidium iodide. Three studies were performed: linearity, precision and correlation compared to those of manual Nageotte chamber counting and automatic flow cytometric methods. RESULTS: Dilution experiments, conducted over a range of 0.7-712 WBC/microl, showed a linearity of r(2) > 0.999, with coefficient of variation values of < or = 15.6% and accuracy of 93.8% over all tested ranges. In comparison with the Nageotte chamber counting and flow cytometric methods, the correlation coefficients were r(2) > 0.995. The detection limit of this method was 0.24 WBC/microl. Total analysis time per sample was approximately 5 min. CONCLUSION: The microscopic cell counter for residual WBC counting was determined to be efficient at the level of currently defined standards, with acceptable precision and accuracy. This method may prove useful for the quality assurance and control of WBC-depleted blood products.

Blood Component Transfusion↗

Beacon immunoreactivity in the rat hypothalamus.

Beacon (BC) is a peptide of 73 amino acids, whose gene expression was first reported in the hypothalamus of Psammomys obesus (or Israeli sand rat). To appreciate better the functional role of BC in normal rats and sand rats, the distribution of BC immunoreactivity (irBC) and its subcellular localization were studied in the brain of Sprague-Dawley rats. In the hypothalamus, intense staining was present in neurons of the supraoptic (SO), paraventricular (PVH), and accessory neurosecretory nuclei and in cell processes of median eminence. Double labeling of the hypothalamic sections with mouse monoclonal oxytocin (OT) antibody and rabbit polyclonal BC antiserum revealed that nearly all OT-immunoreactive cells from SO, PVH, and accessory neurosecretory nuclei were irBC. Double labeling of the sections with guinea pig vasopressin (VP) antiserum and BC antiserum showed that a population of VP-immunoreactive neurons was irBC. By immunoelectron microscopy, immunoreactive product was associated with mitochondrial membranes or appeared as electron-dense bodies in many PVH and SO neurons. Most of the neurosecretory granules were unstained for BC. Taken together, our results indicate the presence of beacon in the OT-containing neurons and a population of VP-containing neurons, mostly associated with mitochondrial membrane. Insofar as the amino acids sequence of beacon is identical to that of ubiquitin-like 5, it is possible that the distribution of BC immunoreactivity noted in our study is that of ubiquitin-like 5 peptide in the rat hypothalamus.

Animals↗

Total synthesis of human and rat coupling factor-6 amide and pressor effects in the rat.

Mitochondrial coupling factor-6 (CF-6) is a component of the ATP synthase complex essential for energy transduction. CF-6, which is localized to the surface of endothelial cells (ECs) and released by shear stress, has been implicated as an endogenous vasoconstrictor. Previous methods of obtaining CF-6 through purification and recombinant methods were laborious and inefficient. Here, we describe the chemical synthesis of human CF-6, (33-108)-NH(2), its C-terminal fragment (55-108)-NH(2), which is termed pCF-6; the rat CF-6, (33-108)-NH(2), its C-terminal fragment pCF-6, (55-108)-NH(2); and two N-terminal fragments of the rat pro-coupling factor-6, (24-52)-NH(2) and (33-52)-NH(2). Biological activities of each peptide were initially screened with bioassays and verified by in vivo studies. Accordingly, intravenous administration of CF-6, pCF-6, rat CF-6, and rat pCF-6 produced a modest but statistically significant increase in blood pressure and heart rate in urethane anesthetized rats, whereas the N-terminal rat pro-coupling factor-6, (24-52)-NH(2) and (33-52)-NH(2) caused no significant pressor response. Thus, the biologically active site probably resides at the C-terminal portion of CF-6 peptides.

Amino Acid Sequence↗

Cocaine- and amphetamine-regulated transcript peptide-immunoreactivity in dorsal motor nucleus of the vagus neurons of immature rats.

Cocaine- and amphetamine-regulated transcript (CART) peptide, a family of neuropeptides, is shown to inhibit food intake upon intracerebroventricular injection to the rat. CART peptide-immunoreactivity (irCART) was detected in neurons of the dorsal motor nucleus of the vagus (DMNV) of postnatal day one (P1) rats, the earliest day examined. The number of labeled DMNV neurons reached the peak between P5 and P8 rats and gradually declined thereafter. Few irCART neurons were noted in the DMNV between P22 and P90 rats. Double-labeling the medullary sections from P5 and P8 rats with CART-antiserum and choline acetyltransferase (ChAT)-antiserum revealed that irCART neurons in the DMNV were ChAT-immunoreactive (irChAT), but not all irChAT neurons were irCART. Intraperitoneal injection of the retrograde tracer Fluorogold to P3 and P5 rats labeled DMNV neurons, the majority of which were also irCART. The number of irCART neurons in other regions of the brain and spinal cord generally showed an increase in adult rats as compared to that of the same regions in immature rats. Our result suggests that expression of irCART in DMNV neurons undergoes developmental changes such that few neurons appear to contain irCART in mature rats. As a corollary, CART may be a signaling molecule to the gastrointestinal tract during the critical period of early development.

Age Factors↗

Changes in brain content of nociceptin/orphanin FQ and endomorphin 2 in a rat model of neuropathic pain.

Orphanin FQ (OFQ) and endomorphins (EM) are newly characterized members of opioid peptide family. OFQ has been shown to antagonize morphine analgesia at supraspinal level, whereas endomorphins are highly selective endogenous ligands for mu receptor, showing analgesic effect at both spinal and supraspinal level. OFQ and EM-2 (EM2) immunoreactivity (ir) was measured by radioimmunoassay in nociception-related brain areas of rats subjected to L5/L6 spinal nerve ligation, using sham operated rats as control. It was found that: (1) the content of EM2-ir of spinal nerve ligated rats showed a significant increase (778%) in periaqueductal gray (PAG), and a significant decrease (43%) in striatum, compared with the control group. (2) a significant increase of the content of OFQ-ir was found in amygdala (+841%) and PAG (+459%), respectively in spinal nerve ligated rats. High pressure liquid chromatography showed that the EM2-ir and OFQ-ir were both heterogeneous with the major part eluting at the position of EM2 and OFQ standard, respectively. These results suggest that spinal nerve ligation induces significant changes in the content of EM2-ir and OFQ-ir in some discrete brain areas, which may play a role in nociceptive modulation.

Amygdala↗

Nocistatin, a peptide reversing acute and chronic morphine tolerance.

It has been reported that intracerebroventricular (i.c.v.) injection of nociception/orphanin FQ (OFQ) can antagonize morphine analgesia, whereas i.c.v. OFQ antibody can reverse morphine tolerance. Nocistatin (NST) is a recently characterized neuropeptide possessing an antagonizing effect on OFQ. Here we examine whether i.c.v. NST would result in a reversal of morphine tolerance. The results showed that: (1) i.c.v. NST at doses of 0.005, 0.05, 0.5, 5 or 50 ng per rat produced a bell-shaped dose-dependent reversal of chronic morphine tolerance, with maximum response at 0.5 ng. (2) Acute morphine tolerance could also be reversed, albeit partially, by i.c.v. NST at 0.5 ng. (3) The reversal of acute and chronic morphine tolerance by NST was completely abolished when NST (0.5 ng) was co-injected with (8 microg) OFQ. Since OFQ and NST are derived from the same preprohormone, the profile of its splicing in the CNS may play an important role in determining the effectiveness of morphine analgesia.

Analgesics, Opioid↗

Urotensin II-immunoreactivity in the brainstem and spinal cord of the rat.

The distribution of urotensin-II-immunoreactivity (irU-II) was studied in the rat brainstem and spinal cord with the use of an antiserum against the human urotensin II (U-II) peptide. A population of ventral horn neurons in the spinal cord, hypoglossal nucleus, dorsal motor nucleus of the vagus, facial motor nucleus, nucleus ambiguus, abducens nucleus and trigeminal motor nucleus exhibited irU-II of varying intensities. The number of irU-II motor neurons was higher in the lumbar segments as compared to that of cervical, thoracic and sacral segments. Double-labeling the sections with U-II- and choline acetyltransferase (ChAT)-antisera revealed that nearly all irU-II ventral horn and brainstem neurons were ChAT-positive. The result provides the first immunohistochemical evidence of the presence of irU-II in cholinergic motoneurons of the rat spinal cord and brainstem.

Animals↗

Comparative strength of three methods of fixation of transverse acetabular fractures.

With the advent of percutaneously placed lag screws for fixation of acetabular fractures, this study evaluated the strength of lag screw fixation compared with traditional fixation techniques of transverse acetabular fractures. Ten formalin-treated human, cadaveric pelvic specimens with bilateral, transtectal transverse acetabular fractures were used for this study. The right acetabular fractures were fixed with a five-hole plate and four screws with the central hole spanning the posterior fracture site. The left acetabular fractures were fixed with two lag screws, one each in the anterior and posterior columns, or with a screw and wire construct stabilizing both columns. The specimens were loaded to implant failure. Stiffness, yield strength, maximum load at failure, and site of failure was recorded. The plate and screw construct showed significantly greater yield and maximum strength when compared with the two lag screws. The stiffness of the lag screw method was 39% higher than that of the plating method, but this result was not statistically significant. In addition, the plate and screw method provided significantly greater maximum strength than the screw and wire technique. The quadrilateral plate seemed to be the weakest area of fixation because 83% of the implant failures occurred in this region. In patients in whom the risks of formal open reduction and internal fixation of acetabular fractures outweigh the possible benefits, such as in patients with burns or degloved skin, the advent of computer-assisted and fluoroscopically guided percutaneous surgical techniques have been instrumental. This study showed there is greater strength of fixation with a plate and screw construct, possibly secondary to supplementary fixation distal to the quadrilateral plate. However, lag screw fixation provided relatively greater stiffness, which may account for its clinical success. Percutaneous lag screw fixation of appropriate transverse acetabular fractures is a viable option.

Acetabulum↗

Surgical treatment for concomitant fractures of the femoral neck and diaphysis: a treatment protocol.

Concomitant ipsilateral femoral shaft and neck fractures are difficult to treat. The standard protocol in our hospital is plates for diaphyseal fractures and lag screws or dynamic hip screws (DHS) fixations for the femoral neck fractures. We treated 21 patients with these complex fractures between 1988 and 1998 with this protocol. All patients were injured from high-energy trauma. There were 15 males and 6 females with an average age of 44 years. The average follow-up period is 50 months. All except one patient united well. During the follow-up period, neither non-union of the femoral neck fracture nor osteonecrosis of the femoral head was noted. There was also no malunion. There were twenty good results and one poor functional result. We conclude that plate on the shaft and sliding hip screws or separate screws in the hip are a reliable method for concomitant ipsilateral femoral neck and shaft fractures.

Adult↗

Postoperative 6-month and 1-year evaluation of health-related quality of life in total hip replacement patients.

BACKGROUND AND PURPOSE: During the last decade, health-related quality of life (HRQOL) has been recognized as a principal outcome measure for total hip replacement (THR). However, most THR outcome studies in Taiwan have limited their assessments to the areas of pain relief and physical function. This study examined the effects of THR on quality of life. METHODS: A longitudinal prospective study design was adopted. A total of 76 THR patients were enrolled. Disease specific (Harris Hip Score) and generic measures (SF-36) were determined before and after surgery. Postoperative evaluations were completed at 6 months and 1 year. Patient characteristics and related medical information were derived from chart data. RESULTS: Significant improvement was found in HRQOL. This improvement was maintained at both 6-month and 1-year follow-up. Specifically, the mean Harris Hip Score improved from 44.7 to 88.9 at the 6-month postoperative evaluation, and further improved to 91.3 at the 1-year evaluation. In the SF-36, each domain of health status showed a significant improvement at 6-month and 1-year evaluations (p < 0.05 or p < 0.01). CONCLUSIONS: The results of the Harris Hip Score and the SF-36 showed that THR not only relieved physical pain but also enhanced all aspects of quality of life. In addition to pain relief and improved physical function, improvements in role limitations due to physical or emotional problems were also significant. These findings indicate that a general health survey should be combined with a disease-specific scoring system to assess THR outcome.

Adult↗

Spontaneous femoral neck fracture complicating a healed subtrochanteric fracture--a case report.

A rare case of spontaneous femoral neck fracture complicating a healed subtrochanteric fracture was encountered in an 85-year-old female. The subtrochanteric fracture was caused by a minor trauma with no other combined injury. Patient received close reduction and internal fixation two days later and the fracture healed in three months. Six months after operation, spontaneous ispilateral femoral neck fracture occurred without trauma. Although there were some reports about subcapital fracture or femur neck fracture complication after operation, this is the first case of spontaneous femoral neck fracture after healed subtrochanteric fracture which was treated with a 95 degrees dynamic condylar screw (DCS) and side plate previously without technical error.

Aged↗

Orexins: a role in medullary sympathetic outflow.

Orexin A and B, also known as hypocretin 1 and 2, are two recently isolated hypothalamic peptides. As orexin-containing neurons are strategically located in the lateral hypothalamus, which has long been suspected to play an important role in feeding behaviors, initial studies were focused on the involvement of orexins in positive food intake and energy metabolism. Recent studies implicate a more diverse biological role of orexins, which can be manifested at different level of the neuraxis. For example, canine narcolepsy, a disorder with close phenotypic similarity to human narcolepsy, is caused by a mutation of hypocretin receptor 2 gene. Results from our immunohistochemical and functional studies, which will be summarized here, suggest that the peptide acting on neurons in the rostral ventrolateral medulla augment sympathoexcitatory outflow to the spinal cord. This finding is discussed in the context of increased sympathetic activity frequently associated with obesity.

Animals↗

Endomorphin and mu-opioid receptors in mouse brain mediate the analgesic effect induced by 2 Hz but not 100 Hz electroacupuncture stimulation.

This work was designed to examine whether brain endomorphins (EM1 and EM2), the endogenous mu-opioid ligands, are involved in electroacupuncture (EA)-induced analgesia in the mice. C57BL/6J mice were given EA for 30 min and the effect of EA-induced analgesia was assessed by radiant heat tail flick latency (TFL). Intracerebroventricular (i.c.v.) injection of mu-opioid receptor antagonist D-Phe-Cys-Tyr-D-Tyr-Orn-Thr-Pen-Thr-NH(2) (CTOP), or antiserum against EM1 or EM2 was performed to see whether EA analgesia could be blocked. The results showed that: (1) i.c.v. injection of CTOP at 25-100 ng dose-dependently antagonized the analgesia induced by EA of 2 Hz, but not 100 Hz. (2) Intracerebroventricular injection of EM1 antiserum (5 ml, 1:1 or 1:10 dilution) dose-dependently antagonized 2 Hz, but not 100 Hz EA analgesia. (3) EM2 antiserum showed similar effect at 1:1 dilution. The results are interpreted to mean that endogenously released EM1 and EM2 and the cerebral mu-receptors are involved in mediating 2 Hz but not 100 Hz EA analgesia in the mice.

Animals↗

Differential expression of cocaine- and amphetamine-regulated transcript-immunoreactivity in the rat spinal preganglionic nuclei.

The distribution of cocaine- and amphetamine-regulated transcript-like immunoreactivity (CART-LI) was investigated in the rat spinal cords with the use of an antiserum against the CART peptide fragment 55-102. CART-LI fibers were concentrated in the superficial layers of the dorsal horn of all segments. In addition to CART-LI fibers, intensely labeled somata were detected in the intermediolateral cell column (IML) and other sympathetic preganglionic nuclei of the thoracolumbar segments. In the lumbosacral segments, CART-LI fibers but not somata were seen in the sacral parasympathetic nucleus. Double-labeling the spinal sections with choline acetyltransferase (ChAT)-antisera and CART-antisera revealed that the large majority of ChAT-positive somata in the sympathetic preganglionic nuclei were CART-positive, whereas ChAT-positive somata in the parasympathetic preganglionic nuclei were CART-negative. Our results show that CART-LI is selectively expressed in a population of sympathetic preganglionic neurons (SPNs), but not in parasympathetic preganglionic neurons (PPNs) of the rat.

Animals↗

Epidemiology of cervical and trochanteric fractures of the proximal femur in 1996 in Kaohsiung City, Taiwan.

The goal of this study was to determine the incidence of cervical and trochanteric fractures of the proximal femur in 1996 in Kaohsiung City, Taiwan. Kaohsiung City is the industrial and commercial center of southern Taiwan, with a population of 1,433,621 in 1996. The number of individuals over 65 years of age accounted for 6.2% of the total population. Data from the archives of reimbursement of the National Health Insurance program were used to investigate the incidence of fractures of the proximal femur. This study detected 580 cervical and trochanteric fractures (40.5 fractures per 100,000 population per year) in 261 males (35.8 fractures per 100,000 men per year) and 319 females (45.3 fractures per 100,000 women per year), with 420 (72%) of these fractures occurring in individuals over 65 years of age. The age-specific incidences of cervical and trochanteric fractures increased exponentially with age in both genders. The overall ratio of cervical to trochanteric fractures was 1:1.04. The mean ages of women with cervical or trochanteric fractures (71.6 and 74.0 years, respectively) were significantly higher than those of males (59.9 and 64.8 years, respectively; P < 0.01). The age-adjusted incidences of fractures of the proximal femur in Kaohsiung City were higher than in other Asian countries, but were lower than in Western countries such as the United States and Norway. The urban lifestyle and low daily calcium intake may be responsible for this increased incidence of proximal femoral fractures in Kaohsiung City.

Adult↗

Ipsilateral fractures of the femoral neck and shaft.

Ipsilateral femoral shaft and neck fractures are difficult to treat. From 1989 to 1998, we treated 18 patients with these complex fractures. There were 14 male and 4 female with an average age of 40 years. Most resulted from high-energy trauma. The average follow-up period is 41 months. All but one of the fractures united well. The mean time to union is 5.2+/-2.3 months in the diaphysis and 4.16+/-2 months in the neck. No cases of the femoral neck fracture or osteonecrosis of the femoral head were observed during the follow-up period. Fourteen cases were treated with a standard protocol of plates for diaphyseal fractures and lag screws or dynamic hip screws (DHS) fixations for the femoral neck fractures. There were 13 good and 1 fair functional results. Two neglected neck fractures were treated with interlocking nailing for diaphyseal fracture with fair results. We conclude that a plate on the shaft and sliding hip screws or separate screws in the hip is a reliable method for ipsilateral femoral neck and shaft fractures.

Activities of Daily Living↗

Pressor effects of orexins injected intracisternally and to rostral ventrolateral medulla of anesthetized rats.

Orexin A and B, two recently isolated hypothalamic peptides, have been reported to increase food consumption upon intracerebroventricular injections in rats. In addition to the hypothalamus, orexin A-immunoreactive fibers have been observed in several areas of the medulla that are associated with cardiovascular functions. The present study was undertaken to evaluate the hypothesis that orexins may influence cardiovascular response by interacting with neurons in the medulla. Intracisternal injections of orexins A (0.0056-7.0 nmol) or B (0.028-0.28 nmol) dose dependently increased mean arterial pressure (MAP) by 4-27 mmHg and heart rate (HR) by 26-80 beats/min in urethan-anesthetized rats, with orexin A being more effective in this regard. MAP and HR were not changed by intravenous injection of orexins at higher concentrations. Microinjection of orexin A (14 pmol/50.6 nl) to the rostral ventrolateral medulla, which was confirmed by histological examination, increased MAP and HR. Our results indicate that, in addition to a role in positive feeding behavior, orexins may enhance cardiovascular response via an action on medullary neurons.

Animals↗