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Biomedical subjects

J L Lin

Publications and source records attributed to J L Lin.

At least 19 recordsLinked to original sources

Gout in systemic lupus erythematosus and overlap syndrome - a hospital-based study.

The negative association between gout and rheumatoid arthritis is widely accepted, and gout is also speculated to be rare in systemic lupus erythematosus (SLE), as only a few sporadic cases have been reported. From 1985 to 2001 we encountered 15 lupus patients at Chang-Gung Memorial Hospital, including two with lupus-scleroderma and one with lupus-scleroderma-polymyositis overlap syndrome coexisting with gout. This study retrospectively analyses the clinical and laboratory characteristics of these patients. A lower female predominance is found, and most patients developed gout after the onset of SLE, although gout preceded SLE in two cases. Measurement of serum uric acid and 24-h urine uric acid found all of the patients to be hyperuricaemic and underexcretors of uric acid. Furthermore, most of the patients (14/15) were receiving diuretics. Also, many had hypertension and serious cardiovascular diseases. Renal impairment during gouty attacks seemed to be a predisposing factor for developing end-stage renal disease. Gouty arthritis usually occurred during relative SLE inactivity, podagra was frequent, and tophi were found in a few patients. Compared with the unselected population of SLE patients, the cases studied here had a higher incidence of chronic arthritis, malar rash, haematologic disorder, photosensitivity, serositis and neurologic disorder. Renal disease in the patients sampled was frequently membranous nephropathy.

Adult↗

Nuclear beta-catenin expression is closely related to ulcerative growth of colorectal carcinoma.

Although most colorectal cancer develops based on the adenoma-adenocarcinoma sequence, morphologically, colorectal cancer is not a homogeneous disease entity. Generally, there are two distinct morphological types: polypoid and ulcerative colorectal tumours. Previous studies have demonstrated that K-ras codon 12 mutations are preferentially associated with polypoid growth of colorectal cancer; however, little is known about the molecular mechanism that determines ulcerative growth of colorectal cancer. beta-catenin complex plays a critical role both in tumorigenesis and morphogenesis. We examined the differential expression of beta-catenin and its related factors among different types of colorectal cancer in order to determine any relationship with gross tumour morphology. Immunohistochemical staining of beta-catenin, E-cadherin and MMP-7 was performed on 51 tumours, including 26 polypoid tumours and 25 ulcerative tumours. Protein truncation tests and single-strand conformational polymorphism for mutation of the adenomatous polyposis coli tumour suppressor gene, as well as single-strand conformational polymorphism for the mutation of beta-catenin exon 3 were also done. Nuclear expression of beta-catenin was observed in 18 out of 25 (72%) cases of ulcerative colorectal cancer and seven out of 26 (26.9%) cases of polypoid colorectal cancer. A significant relationship of nuclear beta-catenin expression with ulcerative colorectal cancer was found (P<0.001). However, this finding was independent of adenomatous polyposis coli tumour suppressor gene mutation and E-cadherin expression. Together with previous data, we propose that different combinations of genetic alterations may underlie different morphological types of colorectal cancer. These findings should be taken into consideration whenever developing a new genetic diagnosis or therapy for colorectal cancer.

Adenomatous Polyposis Coli↗

Self-organized nanoscale pattern formation on vicinal Si(111) surfaces via a two-stage faceting transition.

We demonstrate a self-organized pattern formation on vicinal Si(111) surfaces that are miscut toward the [2;11] direction. All the patterns, consisting of a periodic array of alternating (7 x 7) reconstructed terraces and step-bunched facets, have the same periodicity and facet structure, independent of the miscut angle, while the width of the facets increases linearly with miscut angle. We attribute such unique pattern formation to a surface faceting transition that involves two transition stages: the first stage forms a stress-domain structure defining the universal periodicity; the second stage forms the low-energy facets controlling the facet width.

Journal Article↗

Metabolism of territrem a in liver microsomes from wistar rats: 2. Sex differences and regulation with gonadal hormones and phenobarbital.

The aim of the present study was to assess the effects of sex difference on metabolism of territrem A (TRA) by liver microsomes from 7-wk-old Wistar rats. Metabolism of TRA to 2-dihydro-4beta-demethylterritrem A (MA2) through 4beta-hydroxymethyl-4beta-demethylterritrem A (MA1) and 4beta-oxo-4beta-demethylterritrem A (MAX) was observed in intact male rats. However, in intact female rats only MA1 was formed, although the amount of MA, formed in females was much less than in males. Phenobarbital pretreatment enhanced this step and was not affected by gonadectomy. In the gonadectomized rats of both sexes, MA2 was formed from TRA when the animals were further treated by testosterone and was significantly enhanced by treatment with phenobarbital. However, estradiol treatment or estradiol in combination with phenobarbital treatment did not affect MA2 formation from TRA in gonadectomized rats.

Animals↗

A defect in the Kv channel-interacting protein 2 (KChIP2) gene leads to a complete loss of I(to) and confers susceptibility to ventricular tachycardia.

KChIP2, a gene encoding three auxiliary subunits of Kv4.2 and Kv4.3, is preferentially expressed in the adult heart, and its expression is downregulated in cardiac hypertrophy. Mice deficient for KChIP2 exhibit normal cardiac structure and function but display a prolonged elevation in the ST segment on the electrocardiogram. The KChIP2(-/-) mice are highly susceptible to the induction of cardiac arrhythmias. Single-cell analysis revealed a substrate for arrhythmogenesis, including a complete absence of transient outward potassium current, I(to), and a marked increase in action potential duration. These studies demonstrate that a defect in KChIP2 is sufficient to confer a marked genetic susceptibility to arrhythmias, establishing a novel genetic pathway for ventricular tachycardia via a loss of the transmural gradient of I(to).

Action Potentials↗

MST4, a new Ste20-related kinase that mediates cell growth and transformation via modulating ERK pathway.

In this study, we report the cloning and characterization of a novel human Ste20-related kinase that we designated MST4. The 416 amino acid full-length MST4 contains an amino-terminal kinase domain, which is highly homologous to MST3 and SOK, and a unique carboxy-terminal domain. Northern blot analysis indicated that MST4 is highly expressed in placenta, thymus, and peripheral blood leukocytes. Wild-type but not kinase-dead MST4 can phosphorylate myelin basic protein in an in vitro kinase assay. MST4 specifically activates ERK but not JNK or p38 MAPK in transient transfected cells or in stable cell lines. Overexpression of dominant negative MEK1 or treatment with PD98059 abolishes MST4-induced ERK activity, whereas dominant-negative Ras or c-Raf-1 mutants failed to do so, indicating MST4 activates MEK1/ERK via a Ras/Raf-1 independent pathway. HeLa and Phoenix cell lines overexpressing wild-type, but not kinase-dead, MST4 exhibit increased growth rate and form aggressive soft-agar colonies. These phenotypes can be inhibited by PD98059. These results provide the first evidence that MST4 is biologically active in the activation of MEK/ERK pathway and in mediating cell growth and transformation.

Amino Acid Sequence↗

Dual-site atrial pacing for atrial fibrillation in patients without bradycardia.

Atrial pacing has been shown to delay the onset of atrial fibrillation (AF) when compared with ventricular pacing in patients with sick sinus syndrome. The role for pacing in the control of AF in patients without bradycardia is uncertain. We performed a randomized, crossover, single-blinded study in 22 patients (14 women, aged 63 +/- 10 years) with paroxysmal AF refractory to treatment with oral sotalol (202 +/- 68 mg/day) and no bradycardic indication for pacing. All patients received a dual-chamber pacemaker with 2 atrial pacing leads positioned at the high right atrium and coronary sinus ostium, respectively. Patients were randomized in a crossover fashion to be paced for 12 weeks, either with high right atrial (RA) pacing at 30 beats/min ("Off") or dual-site RA pacing with an overdrive algorithm that maintained atrial pacing at a rate slightly above the sinus rate ("On"). Treatment on resulted in a significantly higher percentage of atrial pacing and a reduction in atrial ectopic frequency than the treatment off period. The time to the first clinical AF recurrence was prolonged (15 +/- 17 to 50 +/- 35 days, p = 0.006), and total AF burden was reduced (45 +/- 34% vs 22 +/- 29%, p = 0.04) in the on-treatment phase. However, there was no difference in AF checklist symptom scores or overall quality-of-life measures. Dual-site RA pacing with continued sinus overdrive prolonged the time to AF recurrence and decreased AF burden in patients with paroxysmal AF. The absence of a major impact on symptom control suggests that pacing should be used as an adjunctive therapy with other treatment modalities for AF.

Adolescent↗

Band splitting for Si(557)-Au: is it spin-charge separation?

It has been proposed that the Si(557)-Au surface exhibits spin-charge separation in a one-dimensional electron liquid. Two narrowly spaced bands are found which exhibit a well-defined splitting at the Fermi level. That is incompatible with the assignment to a spinon-holon pair in a Luttinger liquid. Instead, we propose that the two bands are associated with two nearly degenerate atomic chains, or a chain of step atoms with two broken bonds. Such an assignment explains why the surface is metallic despite an even number of electrons per unit cell.

Journal Article↗

Global distribution of atrial ectopic foci triggering recurrence of atrial tachyarrhythmia after electrical cardioversion of long-standing atrial fibrillation: a bi-atrial basket mapping study.

OBJECTIVES: The objective of this study was to assess the spatial distribution of atrial ectopic foci potentially triggering recurrent atrial tachyarrhythmias after electrical cardioversion of long-standing atrial fibrillation (AF). BACKGROUND: It remains unknown whether targeted ablation of atrial ectopic foci concentrated in the pulmonary veins is feasible in patients with long-standin

Adult↗

Environmental lead exposure and progressive renal insufficiency.

BACKGROUND: Several recent studies show that serum creatinine level or creatinine clearance is inversely associated with blood lead levels. However, the studies did not allow direct inferences about causality. OBJECTIVE: To evaluate the relation between body lead burden (BLB) and progressive renal insufficiency in patients without previous heavy lead exposure. DESIGN: A prospective, longitudinal study with a controlled clinical trial. PATIENTS: One hundred ten patients with chronic renal insufficiency (serum creatinine level, 133-354 micromol/L [1.5-4.0 mg/dL]) and normal BLB (EDTA mobilization tests, <600 microg per 72-hour urine collection) and without a history of previous heavy lead exposure were divided into 2 groups according to BLB: the high-normal BLB group (BLB > or =80 microg and <600 microg) and the low BLB group (BLB <80 microg). Patients were prospectively followed up for 2 years. MAIN OUTCOME MEASURES: The primary outcome was a 1.5 times increase in the initial creatinine level. The secondary outcome was a change over time in the value of creatinine clearance. At the end of follow-up, a 3-month clinical trial with chelation therapy for patients with high-normal BLB was performed to clarify the role of environmental lead exposure in progressive renal insufficiency. RESULTS: Fifteen patients (14 in the high-normal BLB group and 1 in the low BLB group) reached the primary outcome within 24 months. Renal outcome was significantly better in the low BLB group (P<.001). From month 12 to month 24, renal function of high-normal BLB patients had a greater rate of progressive renal insufficiency than that of low BLB patients. In the Cox multivariate regression analysis, BLB was the most important risk factor for determining the progression of renal insufficiency. After chelation therapy, significant improvement in renal function was noted. In addition, the effect of improving renal function lasted for more than 12 months in these patients. CONCLUSIONS: Long-term low-level environmental lead exposure may subtly affect progressive renal insufficiency in the general population. Progressive renal insufficiency may be improved for at least 1 year after lead chelating therapy. Further investigations are needed to clarify this observation.

Adolescent↗

Cardiac rhythm disturbances in patients with left atrial isomerism.

This long-term study sought to determine the clinical implication of defective sinus node and AV conduction tissue in patients with left atrial isomerism (LAI). From 1984 to 1998, a total of 22 patients were identified as LAI. Patient age at the last follow-up ranged from 2 to 276 months (90+/-70 months). Associated cardiac anomalies were interruption of the inferior vena cava (n = 18, 82%), common atrium (n = 9, 41%), AV canal (n = 14, 64%), double-outlet right ventricle (n = 8, 36%), and pulmonary stenosis (n = 15, 68%). Palliative interventions were performed in 16 patients (Fontan-type operation in 4 patients, shunt followed by Fontan-type operation in 2, repair of septal defect in 4, and extracardiac intervention in 6). During the follow-up, over half of the patients (n = 14, 64%) developed bradyarrhythmia (onset age: from 1 to 264 months; median 78 months): junctional rhythm (n = 11), sinus bradycardia (n = 8) (5 patients also had junctional rhythm), and AV block (n = 2, both also had junctional rhythm). The probability free from bradyarrhythmia was 80% and 46% at the age of 2 and 6 years, respectively. None of the bradyarrhythmias were directly related to open-heart surgery. Besides, junctional ectopic tachycardia occurred after Fontan-type operation in three of six patients. In two patients, a Mahaim-like pathway was identified during the electrophysiological study. The patients with LAI had a high probability of developing bradyarrhythmias due to abnormal sinus node function. Varied AV conduction abnormalities may include compromised AV conduction, junctional ectopic tachycardia after Fontan-type operation, and an association of Mahaim-like pathway.

Adolescent↗

Lead chelation therapy and urate excretion in patients with chronic renal diseases and gout.

BACKGROUND: It is known that chronic renal insufficiency (CRI) patients with gout may have subtle lead poisoning. In addition, gout episodes frequently aggravate progressive renal insufficiency because of the use of nephrotoxic drugs and urate deposition. Our study was arranged to evaluate the causal effect of environmental lead exposure on urate excretion in CRI patients. METHODS: A cross-section study and a randomized, controlled trial were performed. Initially, 101 patients with CRI and without a history of previous lead exposure received ethylenediaminetetraacetic acid mobilization tests to assess body lead stores (BLS). Then, a clinical trial was performed; 30 CRI patients with gout and high-normal BLS and the changes of urate excretion in these patients were compared before and after lead chelating therapy. The treated group received four-week chelating therapy, and the control group received a placebo therapy. RESULTS: The BLS of patients with CRI and gout was higher than that of patients with CRI only, and none had subtle lead poisoning. The BLS, not the blood lead level (BLL), significantly correlated to indices of urate excretion in all CRI patients after related factors were adjusted. In addition, after lead chelating therapy, urate clearance markedly improved after a reduction of the BLS of patients with CRI and gout (study group 67.9 +/- 80.0% vs. control group 1.2 +/- 34.0%, P = 0.0056). CONCLUSION: Our findings suggest that the chronic low-level environmental lead exposure may interfere with urate excretion of CRI patients. Importantly, the inhibition of urate excretion can be markedly improved by lead chelating therapies. These data shed light on additional treatment of CRI patients with gout; however, more studies are needed to confirm our findings.

Adult↗

Reversal of deteriorated fractal behavior of heart rate variability by beta-blocker therapy in patients with advanced congestive heart failure.

INTRODUCTION: The slope of the power spectrum in heart rate variability (HRV) reflects the fractal or scaling behavior in HR dynamics and recently was confirmed as an independent predictor of postmyocardial infarction survival. Whether or not the new measurement in HRV foresees the functional evolution in patients with advanced congestive heart failure treated by beta blockers is unclear. METHODS AND RESULTS: Sequential 24-hour Holter ECG recordings were obtained at baseline, and 1 and 3 months after addition of atenolol therapy for advanced congestive heart failure in 10 patients. The slope and intercept of the regression line of power-law behavior, the short- and intermediate-term of detrended fluctuated analysis (DFA), the approximate entropy (ApEn), and the standard frequency spectra of the 24-hour HRV were compared sequentially as well as with those in 12 age-matched normal controls. The results showed that the slope (-1.70 +/- 0.45 vs -1.22 +/- 0.21; P < 0.05) and the intercept (5.11 +/- 0.46 vs 5.62 +/- 0.24; P < 0.05) of the regression line of power-law behavior and the short-term DFA (for 4 to 11 beats) (0.78 +/- 0.18 vs 1.13 +/- 0.21; P < 0.05) increased after 3 months of atenolol treatment. However, the change in intermediate-term DFA (>11 beats) and ApEn was not apparent (1.24 +/- 0.21 vs 1.22 +/- 0.15 and 1.34 +/- 0.14 vs 1.36 +/- 0.11; both P > 0.05). The evolution of the slope or intercept of the regression line of the HRV power spectrum did not correlate with the echocardiographic or clinical cardiac function, or with the frequency spectral components of the HRV (P > 0.05). CONCLUSION: Additional beta-blocker therapy upregulated the fractal behavior control of the HRV in patients with advanced congestive heart failure. The improvement was independent of subjective and objective global cardiac performance.

Adrenergic beta-Antagonists↗

New method for predicting efficiency of heating by measuring bioimpedance during radiofrequency catheter ablation in humans.

INTRODUCTION: Efficiency of heating (defined as the average temperature divided by the average power) during radiofrequency (RF) catheter ablation (RFCA) can be predicted by the electrode-tissue contact pressure before RFCA. To predict the efficiency of heating during RFCA, we prospectively measured bioimpedance and correlated the bioimpedance with the efficiency of heating in patients undergoing RFCA for supraventricular tachycardias. METHOD AND RESULTS: Of 239 RF applications in 55 patients, bioimpedance was measured from the distal pair of the electrodes of the ablation catheter using an extremely low current (10 microA at 45 kHz). Tip electrode temperature was measured with a closed-loop RF generator. Efficiency of heating and the difference (delta bioimpedance) between preablation bioimpedance (measured from the target ablation site) and baseline bioimpedance (measured in the right atrium without tissue contact) were calculated. There was significant positive correlation between preablation bioimpedance and efficiency of heating (regression coefficient = 0.053; P = 0.003) and between delta bioimpedance and efficiency of heating (regression coefficient = 0.067; P = 0.003). The highest degree of correlation was found during RFCA of the accessory pathways in the left free wall (regression coefficient = 0.14; P < 0.01). With preablation delta bioimpedance >21.5 ohms, applications targeted at the left free-wall, left posteroseptal, or right septal accessory pathways had a greater likelihood of achieving effective tissue heating (defined as maximal temperature achieved >55 degrees C). CONCLUSION: Both preablation bioimpedance and delta bioimpedance have positive correlation with efficiency of heating during RFCA of supraventricular tachycardia. Measuring preablation bioimpedance appears to be a useful tool for predicting the efficiency of heating during RFCA.

Adolescent↗

Taxonomic characterization of new alkaliphilic and alkalitolerant methanotrophs from soda lakes of the Southeastern Transbaikal region and description of Methylomicrobium buryatense sp.nov.

Five strains of obligate methanotrophic bacteria (4G, 5G, 6G, 7G and 5B) isolated from bottom sediments of Southeastern Transbaikal soda lakes (pH 9.5-10.5) are taxonomically described. These bacteria are aerobic, Gram-negative monotrichous rods having tightly packed cup-shaped structures on the outer cell wall surface (S-layers) and Type I intracytoplasmic membranes. All the isolates possess particulate methane monooxygenase (pMMO) and one strain (5G) also contains soluble methane monooxygenase (sMMO). They assimilate methane and methanol via the ribulose monophosphate pathway (RuMP). The isolates are alkalitolerant or facultatively alkaliphilic, able to grow at pH 10.5-11.0 and optimally at pH 8.5-9.5. These organisms are obligately dependent on the presence of sodium ions in the growth medium and tolerate up to 0.9-1.4 M NaCl or 1 M NaHCO3. Although being mesophilic, all the isolates are resistant to heating (80 degrees C, 20 min), freezing and drying. Their cellular fatty acids profiles primarily consist of C(16:1). The major phospholipids are phosphatidylethanolamine and phosphatidylglycerol. The main quinone is Q-8. The DNA G+C content ranges from 49.2-51.5 mol %. Comparative 16S rDNA sequencing showed that the newly isolated methanotrophs are related to membres of the Methylomicrobium genus. However, they differ from the known members of this genus by DNA-DNA relatedness. Based on pheno- and genotypic characteristics, we propose a new species of the genus Methylomicrobium Methylomicrobium buryatense sp. nov.

DNA, Ribosomal↗

Acute poisoning with the neonicotinoid insecticide imidacloprid in N-methyl pyrrolidone.

BACKGROUND: Imidacloprid [1-(6-chloro-3-pyridylmethyl)-N-nitroimidazolidin-2-ylideneamine, CAS 138261-41-3] belongs to a relatively new class of insecticidal chemistry, the chloronicotinyl neonicotinoid compounds. Animal studies indicate relatively low toxicity to mammals because they have resistant nicotinic receptor subtypes compared to insects, as well as protection of the central nervous system by the blood brain barrier. Despite wide usage, human exposure experience resulting in toxicity is quite limited. CASE REPORT: Here, we report a case of acute ingestion of an insecticide formulation containing 9.7% imidacloprid, <2 % surfactant, and the balance as solvent, N-methyl pyrrolidone. Clinical manifestation included drowsiness, disorientation, dizziness, oral and gastroesophageal erosions, hemorrhagic gastritis, productive cough, fever, leukocytosis, and hyperglycemia. The patient recovered without complication with supportive treatment and was discharged 4 days after ingestion. Follow-up barium upper gastrointestinal examination 1 month later was normal. Because moderate to high dose imidacloprid in animals causes central nervous system activation similar to nicotine, including tremors, impaired pupillary function, and hypothermia, it is unclear whether imidacloprid had a causal role in the patient's initial drowsiness and dizziness. It is more likely that the formulation ingredients, particularly N-methyl pyrrolidone, caused most of the clinical symptoms including minor central nervous system depression, gastrointestinal irritation, and hyperglycemia.

Blood Cell Count↗

Severe reversible bone marrow suppression induced by Selaginella doederleinii.

CASE REPORT: We report a 52-year-old female patient with cholangiocarcinoma who developed severe bone marrow suppression after taking Selaginella doederleinii as an alternative anticancer treatment. She developed severe pancytopenia with initial presentations of skin ecchymosis, itching, and gum bleeding 2 weeks after taking Selaginella doederleinii daily. Bone marrow smear and biopsy showed severe hypocellularity with no malignant cell infiltration. Approximately 1 week after stopping Selaginella doederleinii, her hemogram returned to previous levels. Selaginella doederleinii, a popular anticancer herb, may contain an as yet unidentified substance that contributes to reversible bone marrow suppression.

Antineoplastic Agents, Phytogenic↗

Time-Frequency analysis of heart rate variability during transient segments.

The spectral characteristics of heart rate variability (HRV) are related to the modulation of the autonomic nervous system. As the physiological condition is changed by such external stimuli such as drugs, postural changes, and anesthesia, or by internal deregulation such as in syncope, adjective autonomic responses could alter HRV characteristics. Time-frequency analysis is commonly used to investigate the time-related HRV characteristics. An alteration of the autonomic regulation resulting in a change in mean heart rate induces a transient component in heart rate, which, with any analysis method based on signals from multiple beats, results in the apparent spread of the spectrum of frequencies. This obscures the spectral components related to the autonomic function. In this paper we investigated the influence of the transient component in several time-frequency methods including the short-time Fourier transform, the Choi-Williams distribution, the smoothed pseudo Wigner-Ville distribution (SPWVD), the filtering SPWVD compensation, and the discrete wavelet transform. One simulated signal and two heart rate signals during general anesthesia and postural change were used for this assessment. The result demonstrates that the filtering SPWVD compensation and the discrete wavelet transform have small spectrum interference from the transient component.

Anesthesia, General↗