Biomedical subjects

J K Chang

Publications and source records attributed to J K Chang.

At least 37 records · Page 2Linked to original sources

PubMed2000

Core decompression for osteonecrosis of the femoral head at pre-collapse stage.

Twenty-five patients (27 hips) were retrospectively studied for core decompression in the treatment of osteonecrosis of the femoral heads at pre-collapse stage, Ficat and Alert stages I and II, from Apr. 1984 to Jun. 1998 with follow-up period at least 1 yr (mean 28 months). Eleven hips (10 patients) were considered to have failed due to progressive collapsed more than 2 mm, severe pain or reoperation. We further analyzed the results with regard to the stages, the size of the necrotic area according to the Ohzono classification, the lateral head index (LHI) and the Kerboul combined necrotic angle. The survival rate according to the Ohzono classification was type 1B: 100%, 1C: 44%, 2: 25%, and 3B: 0%. Hips with Kerboul angle less than 250 degrees revealed satisfactory results in all except one hip. All hips with Kerboul angle more than 250 degrees collapsed. Fourteen of the 15 hips (93%) with lateral head index more than 20% did not collapse and all hips except one (7/8) with LHI less than 12% collapsed. We conclude core decompression yields satisfactory results in osteonecrotic femoral heads at pre-collapse stage and with small necrotic area or good lateral buttress.

Adult↗

PubMed2000

Postoperative evaluation for disseminated medulloblastoma involving the spine: contrast-enhanced MR findings, CSF cytologic analysis, timing of disease occurrence, and patient outcomes.

BACKGROUND AND PURPOSE: Postoperative MR imaging is routinely performed for staging of medulloblastoma because of frequent tumor dissemination along CSF pathways. The goals of this study were to: 1) determine the timing of disease occurrence and contrast-enhanced MR imaging features of disseminated medulloblastoma involving the spine and their relationship to patient outcomes; and 2) compare the diagnostic accuracy of MR imaging findings with CSF cytologic analysis. METHODS: Medical records, pathologic reports, and unenhanced and contrast-enhanced postoperative MR images of the spine and head from 112 patients who had resection of medulloblastoma were retrospectively reviewed. MR images of the spine were evaluated for abnormal contrast enhancement in the meninges and vertebral bone marrow. MR images of the head were evaluated for recurrent or residual intracranial tumor. Imaging data were correlated with available CSF cytologic results and patient outcomes. RESULTS: Twelve patients (11%) had tumor within the spinal leptomeninges depicted on MR images at the time of diagnosis. Twenty-five patients (22%) had disseminated disease in the spine (leptomeninges, n = 22; vertebral marrow, n = 1; or both locations, n = 2) on MR images 2 months to 5.5 years (mean, 2 years) after initial surgery and earlier negative imaging examinations. Eleven other patients (10%) had recurrent intracranial medulloblastoma without spinal involvement seen with MR imaging. Spinal MR imaging had a sensitivity of 83% in the detection of disseminated tumor, whereas contemporaneous CSF cytologic analysis had a sensitivity of 60%. The sensitivity of CSF cytologic analysis increased to 78% with acquisition of multiple subsequent samples, although diagnosis would have been delayed by more than 6 months compared with diagnosis by spinal MR imaging in six patients. Spinal MR imaging was found to have greater overall diagnostic accuracy than CSF cytologic analysis in the early detection of disseminated tumor (P = .03). Spinal MR imaging confirmed disseminated tumor when contemporaneous CSF cytologic findings were negative in 13 patients, whereas the opposite situation occurred in only two patients. False-positive results for spinal MR imaging and CSF cytologic analysis occurred when these examinations were obtained earlier than 2 weeks after surgery. The 5-year survival probability for patients with spinal tumor was 0.24 +/- 0.08 versus 0.68 +/- 0.05 for the entire study group. CONCLUSION: Spinal MR imaging was found to have greater diagnostic accuracy than CSF cytologic analysis in the early detection of disseminated medulloblastoma. CSF cytologic analysis infrequently confirmed disseminated tumor when spinal MR imaging results were negative. Delaying spinal MR imaging and CSF cytologic analysis by more than 2 weeks after surgery can reduce false-positive results for both methods. The presence of disseminated medulloblastoma in the spine seen with MR imaging is associated with a poor prognosis.

Adolescent↗

PubMed2000

Failure of the locking mechanism between the acetabular metal shell and the polyethylene liner after primary total hip arthroplasty--a case report.

The short and intermediate-term clinical and radiographic results associated with Harris-Galante II porous-coated acetabular modular cup without cementing have been excellent in most patients. Nevertheless, its modular design introduced the potential for failure of the locking mechanism. There are four pairs of locking ties on the rim of metal shell to fix the polyethylene liner within it. Failure of any locking tine would result in less rigid fixation between the metal shell and the polyethylene liner and potentially produce instability or even disassembling of the liner. Only nine cases have been reported previously about the fractures of the locking tine, but it has never been reported in literature in Taiwan. We report a case with fracture of one tine following minor trauma at five years after primary total hip arthroplasty. During reoperation, scratching injury on the outer surface of the polyethylene liner in contact with the inferior tines of the metal shell was noted. Although no disassembling of the liner was noted, the remaining locking mechanism was found to be less rigid when the liner was taken out of the shell. The locking mechanism of HG II cup may be mechanically weak and may fail without major trauma; therefore, its design ought to be improved in an attempt to prevent postoperative dissociation of the polyethylene liner.

Acetabulum↗

PubMed2000

Physical functioning and health-related quality of life: before and after total hip replacement.

Total hip replacement (THR) is a commonly adopted procedure for arthritis-related diseases. Although the THR efficacy in pain relief and restoration of physical functioning has been extensively studied, it remains unclear how health-related quality of life is affected by THR. The major purpose of this study was to examine and compare the differences in physical functioning and health-related quality of life for THR patients before and after operations. Based on a prospective study design, 46 THR patients at one medical center were reviewed and followed up (six months after operations) during the period from March 1997 to June 1998, with a follow-up rate of 88%. The THR subjects were interviewed and measured by the Modified Harris Hip Scale and the Chinese-version Short-form 36-item Health Survey (SF-36). Patient characteristics and the information related to procedures were derived from chart review. The results indicated that the THR patients had statistically significant improvements in physical functioning and health-related quality of life. In terms of the Harris Score, the mean Harris score was 91.6 (SD = 10.7) 6 months after THR, as compared to 45.2 (SD = 17.3) before THR. The eight ratings in the SF-36 measures were also statistically significantly improved (p < 0.001). Specifically, "role limitations due to physical functioning" demonstrated dramatic improvements after THR (15.2 vs. 63.5), followed by "role limitations due to emotional problems" (25.4 vs. 85.5). The findings confirm the effectiveness of THR outcomes in terms of physical functioning, pain relief, and health-related quality of life, which can be revealed by disease-specific (Harris Scale) and generic health measures (SF-36).

Adult↗

PubMed1999

Endomorphin-1 mediates 2 Hz but not 100 Hz electroacupuncture analgesia in the rat.

This work was designed to elucidate the possible involvement of endogenous endomorphin-I (EM1) in analgesia induced by electroacupuncture of low or high frequencies. Taking radiant heat tail flick latency (TFL) as an indication of nociception, rats were subjected to intrathecal (i.t.) injection of 10 microl antiserum against EM1 (EM1-AS) or normal rabbit serum (NRS, as control) and then followed by 2 or 100 Hz electroacupuncture stimulation for 30 min. The analgesia induced by 2 Hz electroacupuncture was attenuated by i.t. injection of EM1-AS at 1:10 and 1:100 but not at 1:1000 dilution. No such suppressive effect was observed for 100 Hz EA analgesia when EM1-AS was injected i.t. at any dilutions. These results indicate that EM1 is involved in 2 Hz but not 100 Hz electroacupuncture analgesia at spinal level.

Acupuncture Analgesia↗

PubMed1999

Hypothalamic orexin A-immunoreactive neurons project to the rat dorsal medulla.

Retrograde tract tracing combined with immunohistochemical techniques were used to identify the origin of orexin A-immunoreactive (OrA-ir) fibers in the rat medulla. One to 5 days following injection of the fluorescent dye Fluorogold into the dorsal medulla, labeled neurons were found in the lateral half of the lateral hypothalamus, paraventricular, perifornical, dorsomedial, dorsal and posterior hypothalamic nuclei. Labeling the same sections with OrA antisera revealed a concentration of OrA-ir neurons in the perifornical and dorsomedial regions of the tuberal hypothalamus. A maximum of 10% of Fluorogold-labeled hypothalamic neurons were OrA-ir and 15% of OrA-ir hypothalamic neurons contained Fluorogold. Our results demonstrate that a fraction of OrA-ir neurons in the tuberal hypothalamus project to areas of the medulla that are involved in autonomic functions.

Animals↗

PubMed1999

Effects of nonsteroidal anti-inflammatory drugs and prostaglandins on osteoblastic functions.

It has been reported that nonsteroidal anti-inflammatory drugs (NSAIDs) suppress bone repair and bone remodeling but only mildly inhibit bone mineralization at the earlier stage of the repair process. We proposed that the proliferation and/or the earlier stage of differentiation of osteoblasts may be affected by NSAIDs. This study was designed to investigate whether NSAIDs affect the proliferation and/or differentiation of osteoblasts and whether these effects are prostaglandin (PG) mediated. The effects of PGE1 and PGE2, indomethacin, and ketorolac on thymidine incorporation, cell count, intracellular alkaline phosphatase (ALP) activity, and Type I collagen content in osteoblast-enriched cultures derived from fetal calvaria were evaluated. The results showed that both PGs and NSAIDs inhibited DNA synthesis and cell mitosis in a time- and concentration-dependent manner. However, intracellular ALP activity and Type I collagen content were stimulated at an earlier stage of differentiation in osteoblasts. These results suggested that (i) the inhibitory effect of ketorolac on osteoblastic proliferation contributes to its suppressive effects on bone repair and remodeling in vivo; (ii) PGEs and NSAIDs may be involved in matrix maturation and biologic bone mineralization in the earlier stage of osteoblast differentiation; and (iii) the effects of ketorolac and indomethacin on cell proliferation and differentiation may not be through the inhibition of the synthesis of PGE1 or PGE2.

Alkaline Phosphatase↗

PubMed1999

Cardiovascular regulatory actions of the hypocretins in brain.

The hypocretins, also known as the orexins, are alternate translation products of a single gene. The recognition of their production in neurons of the rostral diencephalon, and their axonal localization in brain sites known to be important in the control of appetite, led to the demonstration of their orexogenic actions. However, these peptides are not as potent as other appetite stimulating neuropeptides and they have been localized in areas of brain more related to cardiovascular function. We verified the orexogenic actions of hypocretin-1 (Hcrt-1) and hypocretin-2 (Hcrt-2) in an ad libitum feeding model and identified the threshold dose to be 1 nmol when given into the lateral cerebroventricle (i.c. v.). Even at threshold doses for feeding, both Hcrt-1 and Hcrt-2 given i.c.v. into conscious, unrestrained rats stimulated significant elevations in mean arterial blood pressure, that appeared dose related. These elevations were relatively long lasting, mirroring the time course of a pressor dose of angiotensin II (0.1 nmol i.c.v.); however, the magnitude of blood pressure elevation to hypocretin did not equal that of A II. These data suggest an additional, non-appetitive action of the hypocretins and indicate that the peptide and receptor mapping studies may have predicted important roles for the peptides in the central nervous system control of cardiovascular function.

Amino Acid Sequence↗

PubMed1999

Accelerated release and production of orphanin FQ in brain of chronic morphine tolerant rats.

Orphanin FQ has been shown to possess anti-opioid activity at supraspinal level. Our previous work revealed that chronic morphine tolerance could be reversed by intracerebroventricular (i.c.v.) injection of OFQ IgG to rats. In this study, we used radioimmunoassay (RIA) to assess the changes of Orphanin FQ immunoreactivity (OFQ-ir) in cerebroventricular perfusate, periaqueductal gray (PAG) and amygdala of rats made tolerance to morphine (10-60 mg/kg, s.c., t.i.d., for 5 days). The results indicated that: (1) In rats administrated with morphine for 3 and 5 days, the content of OFQ-ir in cerebroventricular perfusate increased by 25% and 52% over the NS control group. (2) The content of OFQ-ir in PAG of rats receiving 1d, 3d and 5d injections of morphine showed an increase of 17%, 48% and 81% respectively over NS group. (3) The content of OFQ-ir in amygdala of rats given 3d and 5d of morphine showed a 36% and 55% increase compared with corresponding control group. It is suggested that continuous use of high doses of morphine accelerated the release and biosynthesis of OFQ in rat brain to antagonize the effect of opioids, which may play a role in the development of morphine tolerance, and that brain OFQ may serve as a delayed negative feedback control on opioid analgesia.

Amygdala↗

PubMed1999

Prolactin-releasing peptide-immunoreactivity in A1 and A2 noradrenergic neurons of the rat medulla.

Distribution of prolactin-releasing peptide-like immunoreactivity (PrRP-LI) was investigated in the rat medulla with the use of a rabbit polyclonal antiserum against the human PrRP-31 peptide. PrRP-positive neurons were noted mainly in two areas of the caudal medulla: ventrolateral reticular formation and commissural nucleus of the nucleus of the solitary tract (NTS), corresponding to the A1 and A2 areas. PrRP-LI neurons were absent in the medulla rostral to the area postrema. Double-labeling the sections with PrRP antisera and tyrosine hydroxylase (TH) monoclonal antibodies revealed extensive colocalization of PrRP- and TH-like immunoreactivity (TH-LI) in neurons of the A1 and A2 areas. Our results show that PrRP-LI is expressed in a population of A1 and A2 noradrenergic neurons of the rat caudal medulla.

Animals↗

PubMed1999

Orexin A-like immunoreactivity in the rat brain.

Distribution of orexin-A-like immunoreactivity (ORX-LI) in rat brains was investigated with the use of a rabbit polyclonal antibody against the full length peptide orexin A. Virtually all the ORX-LI cell bodies were observed in the lateral hypothalamus at the level of median eminence. The large majority of ORX-LI neurons appeared spherical or fusiform, 20-30 microm in diameter and issued two to five cell processes with few secondary branchings. Numerous ORX-LI fibers were observed in subregions of the hypothalamus. ORX-LI cell processes were sparsely distributed in the cortex, hippocampus and thalamus. Many varicose ORX-LI cell processes were situated close to the 3rd and lateral ventricles, some of which appeared to be protruding into the lumen. As a corollary, orexin A may be released into the ventricles and interact with neurons in distant targets, in addition to influencing the activity of neurons with which ORX-LI axons make synaptic contacts.

Animals↗

PubMed1999

Nocistatin reverses the effect of orphanin FQ/nociceptin in antagonizing morphine analgesia.

Nocistatin is a recently characterized neuropeptide derived from the preprohormone containing nociceptin (Orphanin FQ, OFQ). Nocistatin was reported to antagonize OFQ induced allodynia, hyperalgesia and prostaglandin E2-elicited pain responses. The aim of the present study was to determine whether nocistatin, injected intracerebroventricularly (i.c.v.), would reverse the anti-morphine effect of OFQ in rats using the tail-flick latency (TFL) as the nociceptive index. I.c.v. injection of nocistatin at doses of 0.005, 0.05, 0.5, 5, 50, and 500 ng produced no significant changes in the basal TFL, nor did it affect morphine analgesia. However, it significantly reversed the antagonistic effect of OFQ on morphine analgesia when co-injected i.c.v. at doses of 0.05, 0.5, 5, 50 and 500 ng per rat with OFQ. The dose-response curve was bell-shaped and the most effective dose was 0.5 ng. The results suggest that nocistatin can reverse the anti-morphine effect of OFQ in rat brain.

Analgesia↗

PubMed1999

Endomorphin-like immunoreactivity in the rat dorsal horn and inhibition of substantia gelatinosa neurons in vitro.

Endomorphin 1 and 2 are two tetrapeptides recently isolated from bovine as well as human brains and proposed to be the endogenous ligand for the mu-opiate receptor. Opioid compounds expressing mu-receptor preference are generally potent analgesics. The spinal cord dorsal horn is considered to be an important site for the processing of sensory information including pain. The discovery that endomorphins produced greater analgesia in mice upon intrathecal as compared to intracerebroventricular injections raises the possibility that dorsal horn neurons may represent the anatomic site upon which endomorphins exert their analgesic effects. We report here the detection of endomorphin 2-immunuoreactive fiber-like elements in superficial layers of the rat dorsal horn by immunohistochemical techniques. Whole-cell patch recordings from substantia gelatinosa neurons of cervical spinal cord slices revealed two conspicuous effects of exogenously applied endomorphin 1 and 2: (i) depression of excitatory postsynaptic potentials evoked by stimulation of dorsal root entry zone, and (ii) hyperpolarization of substantia gelatinosa neurons. These effects were reversed by the selective mu-opiate receptor antagonist beta-funaltrexamine. Collectively, the detection of endomorphin-like immunoreactivity in nerve fibers of the superficial layers and the inhibitory action of endomorphins on substantia gelatinosa neurons provide further support for a potential role of these two peptides in spinal nociception.

Animals↗

PubMed1999

Characterization of YS-27, an axenic Korean strain of Entamoeba histolytica.

Characterization of YS-27, an axenic Entamoeba strain, was performed by three different laboratory methods. Zymodeme analysis using starch gel electrophoresis and PCR with species-specific primers showed that YS-27 is a pathogenic Entamoeba which belongs to the group II zymodeme. Pathogenicity of YS-27 was further confirmed by observing the formation of liver abscess in Mongolian gerbils. These results showed that YS-27 is E. hisolytica.

Animals↗

PubMed1999

Central administration of [Phe1psi(CH2-NH)Gly2]nociceptin(1-13)-NH2 and orphanin FQ/nociceptin (OFQ/N) produce similar cardiovascular and renal responses in conscious rats.

In vitro studies have shown that [Phe1Psi(CH2-NH)Gly2]OFQ/N(1-13)-NH2 (referred to as [FG]OFQ/N(1-13)-NH2) is the first selective antagonist to prevent the binding of the endogenous ligand orphanin FQ/Nociceptin (OFQ/N) at the orphan opioid-like receptor. In the present study, we examined the potential changes in cardiovascular and renal function produced by the i.c.v. injection of [FG]OFQ/N(1-13)-NH2 in conscious Sprague-Dawley rats. In conscious rats, i.c.v. injection of [FG]OFQ/N(1-13)-NH2 produced a marked and sustained decrease in heart rate, mean arterial pressure, and urinary sodium excretion and a profound increase in urine flow rate (i.e., a water diuresis). The cardiovascular and renal excretory responses produced by i.c.v. [FG]OFQ/N(1-13)-NH2 were dose dependent and were similar in pattern but of longer duration than responses evoked by i.c.v. OFQ/N. In other animals, the i.c.v. injection of OFQ/N(1-13)-NH2, a potential metabolite of [FG]OFQ/N(1-13)-NH2, produced changes in cardiovascular and renal function that were comparable to those evoked by i.c.v. [FG]OFQ/N(1-13)-NH2. In contrast, OFQ/N(2-17), a fragment of OFQ/N [OFQ/N(1-17)], was inactive when administered centrally. Finally, studies were performed to determine whether [FG]OFQ/N(1-13)-NH2 may be an antagonist at the orphan opioid-like receptor receptor when administered centrally at a dose that alone was inactive. In these studies, i.c.v. pretreatment of animals with low-dose [FG]OFQ/N(1-13)-NH2 failed to prevent the cardiovascular and renal excretory response to i.c.v. OFQ/N. Although [FG]OFQ/N(1-13)-NH2 is reported to be an antagonist of the OFQ/N receptor in vitro, these findings indicate that this compound has agonist activity similar to that of the endogenous ligand OFQ/N when administered centrally in vivo.

Animals↗

PubMed1999

Characteristics of primary osteoblast culture derived from rat fetal calvaria.

Primary osteoblast cultures, which reflect more phenotypic properties of normal osteoblasts than osteoblastic cell lines, can be used as an experimental tool for investigating the osteoblastic functions in vitro. Primary osteoblast cultures were obtained from the parietal bones of calvaria of fetal rats in this study. Differential characteristics of osteoblasts in our culture system were examined and fibroblast cultures were also tested for comparison. We tested the alkaline phosphatase (ALP) and von Kossa stains on osteoblast and fibroblast cultures to examine the expression of ALP and the subsequent matrix mineralization occurred at 2 and 3 weeks after cell confluence respectively. The results showed that osteoblast cultures revealed obvious positive stains of ALP and von Kossa, while fibroblast cultures revealed negative stains, suggesting the osteoblast culture system used in this study reflects the typical phenotypes of primary osteoblasts but not fibroblasts. We tested the ALP activities following various doses of PGE2 or ketorolac treatments in primary osteoblast and fibroblast cultures. The results showed that PGE2 and ketorolac stimulated intracellular ALP activities of osteoblasts in dose dependent fashions, while very low ALP activities were detected in either the control or agents treated cultures of fibroblast. These results suggest that PGE2 may be involved in osteoblastic differentiation and the stimulatory effect of ketorolac on osteoblastic ALP activity may not be PGE2 mediated. The responses of osteoblasts to both agents can be as the characteristics of primary osteoblast derived from rat calvaria.

Alkaline Phosphatase↗

PubMed1999

Hip arthroplasty for osteonecrosis in patients with systemic lupus erythematosus.

Thirty-seven hip arthroplasties including 19 bipolar hemiarthroplasties (BH) and 18 total hip arthroplasties (THA) were performed in our hospital in 23 patients with systemic lupus erythematosus (SLE) for femoral head osteonecrosis between July 1984 and July 1996. These patients were followed up retrospectively to compare the results of BH and THA. One case with right side BH and left side THA expired about 1 year after operation and was excluded from this study. In both groups, these hips with pre-operative osteonecrosis were subclassified in Ficat and Arlet classification. The mean duration of follow-up was 44.5 months (24-85 months) for THA was 70.2 months (24-119 months) for BH. The mean Harris scores pre-operatively were 56.7 +/- 1.09 points in the BH group and 50.7 +/- 1.29 points in the THA group. The mean post-operative scores were 81.9 +/- 4.37 points in the BH group and 95.5 +/- 0.80 points in the THA group at final follow up. The clinical results of the THA group were better than those of the BH group. However, at an early stage before collapse of the femoral head (Ficat stage II), the results of BH were as good as those of THA. Five BH were converted to THA at the time ranging from 39 months to 113 months (mean 63.2 months) after primary operation due to acetabular cartilage wearing or severe groin pain. The failure rate of BH group was 27.8% (5/18). There was no loosening or revision in the THA group. Although the follow-up durations were different in these two groups, the clinical result was obviously superior in the THA group, particularly after the femoral heads had collapsed. Considering the relatively short life span of SLE patients, we prefer THA over BH in the treatment of the femoral head osteonecrosis in SLE patients. However, based on our results, BH is still a very good choice of treatment before the collapse of the femoral head.

Adolescent↗

PubMed1998

A synthetic human Agouti-related protein-(83-132)-NH2 fragment is a potent inhibitor of melanocortin receptor function.

Chemical synthesis of Agouti proteins - Agouti and Agouti-related proteins - is complicated by their large size and by multiple cysteine residues located in the carboxyl terminal regions. Three human Agouti-related protein (AGRP) fragments, two of which correspond to a proposed endoprotease cleavage site between amino acids 82 and 83, were synthesized and tested for anti-melanotropic activity using Xenopus laevis dermal melanophores. Amino-terminal fragments AGRP(25-51) and (54-82) were devoid of significant antagonist activity, whereas the amidated carboxyl-terminal AGRP fragment (83-132)-NH2 was potently active with an inhibitory equilibrium dissociation constant (Ki) of 0.7 nM. The ability to synthesize functionally active AGRP should help unravel its role in the central nervous system and its unusual properties with respect to interaction with the melanocortin family of G-protein coupled receptors.

Agouti Signaling Protein↗