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Biomedical subjects

J S Cheng

Publications and source records attributed to J S Cheng.

At least 73 records · Page 4Linked to original sources
PubMed1999

Electroacupuncture reduces rat's neuronal ischemic injury and enhances the expression of basic fibroblast growth factor.

The present study was designed to investigate whether the Electroacupuncture (EA) is beneficial to extenuate cerebral injuries following transient Middle Cerebral Artery Occlusion (MCAO), as well as to observe the effect of EA on expression of Basic Fibroblast Growth Factor (bFGF) -like Immunoreactivity (IR) in rat brains. The results indicate that gross neuronal damages include infarction, swelling and neuron loss, accompanied by increased bFGF-like IR expression following MCAO. In peri-infarct striatum, bFGF-like IR was mainly located in astrocytes except some neurons also showed an upregulation of the IR; in frontoparietal cortex, strong induction of bFGF-like IR was mostly seen in neurons. Both the EA applied during ischemia and reperfusion could evidently alleviate cerebral lesion extent, notably upregulate the expression of bFGF-like IR in striatum and cortex, but there was no significant difference between the effects of EA applied during ischemia and reperfusion, except EA applied during reperfusion seems to be more effective in reducing the cerebral swelling. The results implied that, in striatum, astrocytes might play an important role in the protection of neuron via the expression of bFGF; whereas in cortex, neurons may exert autoprotection through secreting bFGF themselves. One possible protective effect of EA lies in regulating the endogenous expression of bFGF.

Animals↗
PubMed1999

Follow-up study in patients with no stone retrieval from the bile duct after endoscopic sphincterotomy.

BACKGROUND: No stones are retrieved from the bile duct in 10-20% of patients with suspected common bile duct (CBD) stones after endoscopic sphincterotomy (EST). The clinical outcome in these patients remains unclear. This study followed patients from whom no stones were retrieved, to discover their clinical outcome. METHODS: From October, 1990, to October, 1996, 401 patients with suspected CBD stones received EST for stone removal. Only patients from whom no stones were retrieved from the bile duct were included in this study. All enrolled patients were regularly interviewed and received liver function tests. Sonography, computerized tomography, endoscopic retrograde cholangiopancreatography (ERCP), and/or intrapapillary biopsy were performed as indicated. RESULTS: Forty-two patients were included in this study. The indications for EST included 34 cases with filling defects in the common bile duct on ERCP and eight cases with suspected impacted stones as seen by imaging studies. After a mean follow-up period of 28.6 months (range, 1-61 months), six patients developed biliary stones, four had carcinoma of the ampulla of Vater, one was found to have intrabiliary growth of hepatocellular carcinoma, and there was no pathologic change in 31 cases. Of the six patients with formation of biliary stones, two had an intact gallbladder and four had received previous cholecystectomy. Of the four patients with ampullary tumors, three were diagnosed by intrapapillary biopsy soon after EST, and one was diagnosed nine months later. CONCLUSIONS: Biliary problems were found in 26% of patients soon after EST, although no stones were retrieved from the bile duct. Regular follow-up is warranted.

Bile Duct Diseases↗
PubMed1999

Long-term effect of large biliary endoprostheses in high-risk surgical patients with irretrievable common bile duct stones.

BACKGROUND: Endoscopic sphincterotomy and basket extraction are currently used to remove bile duct stones, with a duct clearance rate of 85% to 90%. A biliary endoprosthesis (stent) is an alternative method to treat difficult cases, especially high-risk surgical patients. The aim of this study was to investigate the long-term effect of biliary endoprostheses in patients with irretrievable common bile duct stones. METHODS: From December, 1990, to November, 1998, 546 patients were referred to the Veterans General Hospital-Kaohsiung for endoscopic removal of common bile duct stones. Of them, 12 received long-term biliary endoprosthesis because endoscopic removal or surgery was not suitable. Large-caliber stents (> 10 French) were inserted into 12 patients (5 women and 7 men, mean age, 78.4 years) and they were followed up with regular clinical visits. Quantitative cholescintigraphy was performed in four patients to evaluate biliary emptying after liver function returned to normal. RESULTS: No early complications from stent insertion occurred and a satisfactory resolution of jaundice, pain and fever were noted in all patients. One patient had repeated cholangitis due to stent occlusion and five died from unrelated causes. The median effective period of stent placement was 11 months (range, 1-38 months). Quantitative cholescintigraphy revealed delayed biliary drainage in four patients despite an absence of symptoms after their liver function returned to normal. CONCLUSIONS: Large-caliber stents are a safe and effective treatment for long-term palliation in high-risk patients with retained common bile duct stones.

Aged↗
PubMed1999

[Effect of electroacupuncture and 7-NI on penicillin-induced epilepsy and their relation with intrahippocampal NO changes].

In order to investigate the effect of 7-nitroindazole (7-NI) on penicillin-induced epilepsy and the relationship between NO and anti-epileptic effect of electro-acupuncture, computerized physiological polygraph and NO-sensitive electrode with potentiostat were respectively used to record the total power spectrum (TPS) of EEG and the concentration of NO in rat hippocampus pretreated with electro-acupuncture or 7-NI for 30 min before penicillin. The results showed that the TPS of EEG and concentration of NO in hippocampus increased greatly after the epilepsy induction. Treatment with electroacupuncture inhibited the TPS of EEG sharply (P < 0.01). The latency and threshold of epilepsy induction were decreased by 7-NI, but paroxysm abated and the TPS was inhibited (P < 0.05) as compared with the control group. Both pretreatments with 7-NI and electroacupuncture decreased the NO concentration (P < 0.01). The above results suggest that the propagation of penicillin-induced seizures is facilitated by nNOS, but with some increase in the latency and threshold of induction. Electroacupunture may inhibit seizure through decreasing nNOS transcription in hippocampus.

Animals↗
PubMed1998

NMDA antagonist displays anticonvulsant effect via NO synthesis inhibition in penicillin-treated rat hippocampal slices.

The present study investigated the role of nitric oxide (NO) in epileptogenesis and whether this role correlated with ionotropic glutamate receptor (IGR). Using a self-constructed NO-sensitive microelectrode (SNM), we observed the effect of nitric oxide synthase (NOS) inhibitors, NMDA and non-NMDA selective antagonists on penicillin(PEN)-treated hippocampal slices by simultaneously recording evoked field potentials and nitric oxide release from CA1 pyramidal neurons. 7-nitroindazole (7-NI),Nomega-nitro-L-arginine (L-NNA) and DL-2-amino-phospho-novaleric acid (APV), but not 6,7-dinitroquinoxaline-2,3 (1h,4h)-dione(DNQX), depressed NO release and partly reversed PEN's epileptogenetic effect, while APV + 7-NI + L-NNA did not display a further inhibitory effect. These findings suggest both NOS inhibitor and NMDA antagonist involve as anticonvulsant factors in epileptogenesis, providing direct evidence for NO release in response to NMDA receptor activation. The anticonvulsant effect of NMDA antagonist may ascribe to its action on NO release.

2-Amino-5-phosphonovalerate↗
PubMed1998

The additive effect of sclerotherapy to patients receiving repeated endoscopic variceal ligation: a prospective, randomized trial.

Endoscopic variceal ligation (EVL) is a new technique designed to manage esophageal varices. The effect of sclerotherapy following repeated banding ligation remains unknown. Seventy-two patients with a history of esophageal variceal bleeding received regular EVL until variceal disappearance or until left with residual small varices. Subsequently, patients were randomized to receive sclerotherapy (Group 1, 37 patients) or serve as a control (Group 2, 35 patients). Group 1 received one to two sessions of low-dose sclerotherapy to achieve complete variceal disappearance. After a mean follow-up of 2 years, 4 months, recurrent esophageal varices developed in 14% of Group 1 and 43% of Group 2 (P < .02). Rebleeding was encountered in 8% of Group 1 versus 31% of Group 2 (P = .01). One case of esophageal stricture (2.7%) was encountered in Group 1. One patient in Group 1, compared with 3 patients in Group 2, died of massive variceal bleeding (P > .05). The multivariate Cox model indicated that treatment was the only factor predictive of variceal recurrence, and both Child-Pugh class and treatment were factors predictive of variceal rebleeding. The addition of low-dose sclerotherapy following repeated banding ligations proved safe and effective in the prevention of recurrence of esophageal varices and rebleeding.

Aged↗
PubMed1998

Ultrasound-guided percutaneous cholecystostomy as an initial treatment for acute cholecystitis in elderly patients.

BACKGROUND/AIMS: Acute cholecystitis may atypically present itself in the elderly, thus causing diagnostic and therapeutic problems, and it is well recognized as a high-risk condition for morbidity. The outcome has been attributed to the presence of severe co-morbid disease. In an attempt to minimize the postoperative morbidity and mortality, we performed ultrasound-guided percutaneous transhepatic cholecystostomy (PC) on elderly patients with acute cholecystitis for both initial treatment and subsequent diagnosis of their biliary tract disorders. METHODS: Those being more than 70 years old, had acute episode of cholecystitis for more than 48 h and still had positive Murphy's signs and distended gallbladders were candidates for ultrasound-guided PC. RESULTS: Forty-two elderly patients underwent ultrasound-guided PC. Once the condition of each patient showed signs of improvement and stability, cholangiography was performed via PC tube. The results of the cholangiography showed 20 patients with gallbladder stones, 16 with common bile duct stones and 6 with acalculous cholecystitis. Once stable enough, 32 patients underwent definite surgery, 18 having cholecystectomies, 14 having cholecystectomies and choledocholithotomies. The 6 patients with acalculous cholecystitis had the PC tube removed 3 weeks later, without further surgery. Two patients had gallbladder stones removed by choledochofiberscope. Two patients had common bile duct stone removed by endoscopic sphincteroplasty. Although postoperative complications occurred in 5 patients (11.9%), no instance of operative mortality was found. CONCLUSION: Our findings lead us to conclude that the use of PC in the early treatment of acute cholecystitis in elderly patients can decrease postoperative morbidity and mortality.

Acute Disease↗
PubMed1998

Neuroprotective effects of poly (ADP-ribose) polymerase inhibitors in transient focal cerebral ischemia of rats.

AIM: To explore the role of poly (ADP-ribose) polymerase (PARP) in focal cerebral ischemia with reperfusion injury. METHODS: Male Wistar rats underwent 3.5-h of temporary middle cerebral artery occlusion by intraluminal suture. Infarction volume was showed with 2,3,5-triphenyltetrazolium chloride (TTC) staining and quantitated by image analysis system, neurologic scores were determined with a 0-5 grading scale. RESULTS: 3-Aminobenzamide (3-AB) 10 mg.kg-1 or nicotinamide (Nic) at 20 mg.kg-1 showed potent neuroprotective effects within 0-6 h, neurologic deficits were attenuated. With the increasing dose of PARP inhibitors, beneficial effects were compromised, particularly, administration of Nic 60 mg.kg-1 at the onset of reperfusion drastically accelerated brain damage. Phytomenadione, a selective inhibitor of mono (ADP-ribosyl) transferase, had little effect on infarction volume. CONCLUSION: Transient incomplete inhibition of PARP provides a neuroprotective effects against cerebral ischemia-reperfusion injury, with a relatively wide therapeutic window, whereas severe inhibition of this enzyme, especially in reperfusion phase, is detrimental.

ADP Ribose Transferases↗
PubMed1998

[The relation between changes of nitric oxide synthase in hippocampus and activities of excitatory amino acid receptor during epilepsy].

The time course of alteration in neuronal nitric oxide synthase (nNOS) and the influence of glutamate receptor antagonists on immunoreactivity of nNOS were investigated immunohistochemically in rat hippocampus during penicillin-induced epilepsy. It was found that nNOS-like immunoreactivity in hippocampus increased at 4 h after initiation of seizure and reached a peak at 24 h. When MK-801 (6 micrograms) and DNQX (4 micrograms) were injected respectively into hippocampus 20 min before administration of penicillin, seizure was reduced in strength. Meanwhile, the nNOS-like immunoreactivity in hippocampus was decreased, compared with the group which were administered penicillin alone. These results suggest that the increase of nitric oxide may be related to the injury of neurons during and after epilepsy; the changes' of nNOS may be related to the activity of NMDA and non-NMDA receptors. Neuron protective effect of MK-801 and DNQX may be in part mediated by nNOS.

Animals↗
PubMed1998

[Changes of intracellular calcium level in hippocampal slice neurons: a confocal laser scanning microscopic study].

In this study, the fluorescent dye Fluo-3 (AM) was applied to rat hippocampus by microinjection, to label neurons in situ. A large number of CA1 pyramidal cells could be labeled by a single injection. With this improvement of labeling and the use of the confocal laser scanning microscope (Leica Lasetechnik GmbH), changes of calcium fluorescence intensity in CA1 pyramidal cells of rat hippocampal slices on the models of mimic epilepsy (induced by penicillin or glutamate) or hypoglycemia/hypoxia were studied in vitro. The results showed that in magnesium free artificial CSF, the intracellular calcium level of the CA1 pyramidal cells increased following application of glutamate or penicillin. Similar phenomenon was also observed on the in vitro model to hypoglycemia/hypoxia.

Animals↗
PubMed1998

[Effect of nitric oxide release on epileptiform discharge in CA1 area of hippocampal slices].

Using a nitric oxide (NO)-sensitive platinum microelectrode (SNM) modified with chitosan nickel (II) complex and Nafion (Nafion-CTS (Ni)-Pt), we observed the effect of nitric oxide synthase (NOS) inhibitor 7-nitro-indazole (7-NI) and N omega-nitro-L-arginine (L-NNA) on penicillin-treated hippocampal slices by simultaneously recording the stimulus-evoked field potentials and nitric oxide release from CA1 pyramidal neurons. Our results show: (1) The linear relationship range and detection limit of SNM were 4.5 x 10(-4)-1.0 x 10(-8) mol/L and 5.0 x 10(-8) mol/L respectively. (2) Penicillin (PEN) could elevate NO release, the number and amplitude of stimulus-evoked field potentials spike (SEPS) in concentration-dependent manner; (3) Both 7-NI and L-NNA depressed NO release and partly reversed the effect of penicillin. The above findings suggest that convulsant provoking effect of NO could be inhibited by NOS inhibitors. The NO-sensitive electrode may provide an useful tool for continuous detection of NO in biological tissues.

Animals↗
PubMed1997

Emergency banding ligation versus sclerotherapy for the control of active bleeding from esophageal varices.

Active bleeding varices are a great challenge to endoscopists. In this study, we compared the short-term efficacy and safety of banding ligation with injection sclerotherapy in the arresting of active bleeding from esophageal varices. Seventy-one cirrhotic patients with active variceal bleeding were randomized to receive banding ligation (37 patients) or sclerotherapy (34 patients) immediately after endoscopic examinations. Primary success rate (bleeding stopped for 72 hours) was 97% in the ligation group and 76% in the sclerotherapy group (P = .009). The efficacy of ligation was similar to sclerotherapy in the control of oozing varices (100% vs. 89%, P = .23), whereas ligation was superior to sclerotherapy in the control of spurting varices (94% vs. 62%, P = .012). The requirement of vasoconstrictors after emergency endoscopic treatment was lower in the ligation group than in the sclerotherapy group (11% vs. 41%, P = .007). Treatment failure within 1 month was 8% in the ligation group vs. 30% in the sclerotherapy group (P = .02). Blood transfusion requirements were significantly lower in the ligation group than in the sclerotherapy group (3.2 +/- 1.2 vs. 4.5 +/- 1.8 units, P < .01). Rebleeding rate within 1 month was 17% in the ligation group and 33% in the sclerotherapy group (P = .19). Significant complications were encountered in 5% of the ligation group and 29% of the sclerotherapy group (P = .007). Mortality rates within 1 month were 19% in the ligation group and 35% in the sclerotherapy group (P = .19). Banding ligation and sclerotherapy were comparable in the arresting of oozing varices, whereas ligation was superior to sclerotherapy in the control of spurting varices. Patients treated with ligation required fewer vasoconstrictors and fewer transfusion units than patients treated with sclerotherapy. Furthermore, banding ligation was associated with a lower complication rate than sclerotherapy.

Adult↗
PubMed1997

Synthesis, structure and anti-acetylcholinesterase activity of 4beta-methoxymethyl-4beta-demethyl territrem B.

4beta-Methoxymethyl-4beta-demethyl territrem B [5] was synthesized from 4beta-hydroxymethyl-beta-demethyl territrem B [4] by treatment with dimethyl sulfate in methanolic NaOH. The structure of 5 was elucidated by uv, nmr and mass spectra. The IC50 of 5 on acetylcholinesterase (AChE) was 6.30 x 10(-5) M, which indicated 0.4% of the anti-AChE activity of territrem B [2].

Journal Article↗
PubMed1997

Correlation of serum immunoglobulin G Helicobacter pylori antibody titers with histologic and endoscopic findings in patients with dyspepsia.

Serum immunoglobulin G (IgG) antibody tests are used extensively. We attempted to find out whether the titers of anti-Helicobacter pylori IgG antibody correlated with the degree of macroscopic gastrointestinal damage, the severity of antral gastritis, and the density of antral H. pylori colonization in symptomatic patients. Peripyloric antral biopsy specimens were obtained from 50 consecutive patients with dyspepsia undergoing upper gastrointestinal endoscopy. The macroscopic gastrointestinal damage and the histologic grades of antral gastritis were scored by a modified Lanza scale and Sydney system, respectively. In addition, the densities of antral H. pylori colonization were graded semiquantitatively. Serum IgG antibodies to H. pylori were measured by enzyme-linked immunosorbent assay. Thirty-six (M/F = 29/7) of the 50 patients had H. pylori infection documented by histologic examination or rapid urease test or both. Among the subjects, the IgG antibody titers to H. pylori correlated significantly with the grades of antral polymorphonuclear cell infiltration (p = 0.002) and antral bacterial density (p = 0.01) but not with endoscopic scores, the grades of mononuclear cell infiltration, mucosal atrophy, or intestinal metaplasia (p > 0.05). In addition, endoscopic scores also were found to be significantly correlated with antral bacterial density (p = 0.049) and the grade of polymorphonuclear cell infiltration (p = 0.012). We therefore conclude that high titers of IgG antibody to H. pylori in patients with dyspepsia indicate dense H. pylori colonization and severe antral polymorphonuclear cell infiltration. However, it cannot replace endoscopic examination to evaluate the degree of macroscopic gastrointestinal damage.

Aged↗
PubMed1997

Prediction of recurrent choledocholithiasis by quantitative cholescintigraphy in patients after endoscopic sphincterotomy.

BACKGROUND: Endoscopic sphincterotomy (EST) is widely used for the removal of stones from the bile duct, but stones recur in about one fifth of patients. AIMS: To investigate hepatic clearance by quantitative cholescintigraphy (QC) in patients after EST and to discern the relationship between biliary emptying and stone recurrence. METHODS: One hundred and forty nine patients who had EST and clearance of the bile duct for choledocholithiasis were selected. All patients were confirmed to have complete EST by sphincter of Oddi manometry and underwent QC soon after normalisation of liver function. Regular clinical follow up was performed for each patient. RESULTS: During a mean 36 month follow up, 22 (14.8%) patients developed recurrent stones in the bile duct. Irrespective of the status of the gall bladder, patients with recurrent stones had a slower hepatic clearance of radioisotope during QC compared with patients without stone recurrence, but only the differences in cholecystectomised patients had statistical significance. After carrying out multivariate analysis, one parameter of QC, percentage clearance of maximal count at 45 minutes, was found to be the only significant factor for stone recurrence. All recurrent stones in the common bile duct were successfully removed at endoscopy. CONCLUSION: Slower hepatic clearance as shown by QC is an important factor responsible for stone recurrence after sphincter ablation.

Adult↗
PubMed1997

[Hippocampal non-NMDA and GABA-A receptors in benzylpenicillin-induced epilepsy and electro-acupuncture antiepilepsy].

AIM: To study the effect of 6,7-dinitroquinoxaline-2,3-dione (DNQX) and bicuculline (Bic) on benzyl-penicillin-induced-epilepsy (PIE) and electroacupuncture (EA) antiepilepsy in rats. METHODS: Epilepsy was elicited by intra-hippocampal microinjection of benzylpenicillin in rats. The analysis of electroencephalogram (EEG) and power spectrum was used to measure the extent of convulsion. RESULTS: EA or DNQX (1 microgram) showed partial inhibitory effect on PIE. EA + DNQX caused further inhibition of PIE, and Bic attenuated EA antiepileptic effect. CONCLUSION: Antagonization of GABA-A receptor attenuated EA antiepileptic effect, and EA acted synergistically with the antagonists of non-N-methyl-D-aspartate (non-NMDA) receptors.

Animals↗