Biomedical subjects
Publications and source records attributed to J S Hwang.
Metastasis to the paranasal sinuses is rare. We report a case of a patient with metastasis to the paranasal sinuses from carcinoma of the oesophagus. Our patient presented with symptoms mimicking the more common acute sinusitis. Although rare, metastatic disease of the paranasal sinuses should be considered especially in patients with a known primary carcinoma elsewhere presenting with sinu-nasal symptoms.
In 1994-1995 a cross-sectional epidemiological study investigating the respiratory health of school children in two Taiwan areas was conducted; one area was located in a region with petrochemical manufacturing complexes (Linyuan), and the other was situated in a reference area with no local industrial emissions (Taihsi). All primary school children residing in the two areas were involved in the study. Four hundred seventy children were studied in the area with high exposure to industrial emissions, and 611 children lived in the reference area. Respiratory health was assessed by evaluation of the children's respiratory symptoms and illnesses, using a parent-completed questionnaire. Particulates, sulfur dioxide (SO2), nitrogen dioxide (NO2), and acid aerosols levels were significantly higher in the exposed area than in the reference area. The school children in the petrochemical area had significantly more upper respiratory symptoms and asthma compared with the children living in the control area. Although the association with known petrochemical air pollution is suggestive, this cross-sectional study cannot confirm a causal relation and further studies are needed.
A stable smectic phospholipid bilayer phase aligned with the director parallel to the magnetic field can be generated by the addition of certain trivalent paramagnetic lanthanide ions to a bicellar solution of dimyristoylphosphatidylcholine (DMPC) and dihexanoylphosphatidylcholine (DHPC) in water. Suitable lanthanide ions are those with positive anisotropy of their magnetic susceptibility, namely Eu3+, Er3+, Tm3+, and Yb3+. For samples doped with Tm3+, this phase extends over a wide range of Tm3+ concentrations (6-40 mM) and temperatures (35-90 degrees C) and appears to undergo a transition from a fluid nematic discotic to a fluid, but highly ordered, smectic phase at a temperature that depends on the thulium concentration. As a membrane mimetic, these new, positively ordered phospholipid phases have high potential for structural studies using a variety of techniques such as magnetic resonance (EMR and NMR), small-angle x-ray and neutron diffraction, as well as optical and infrared spectroscopy.
In order to reduce the number of immunoprotected islets required in xeno- or allogenic transplants for reversing diabetes, analogues of glyburide (a sulfonylurea), an extremely hydrophobic insulin secretagogue, were synthesized and used in an attempt to produce water soluble sulfonylurea (SU) grafted polymers. After synthesizing various polymers containing glyburide analogues, a poly(N-vinyl-2-pyrrolidone-co-sulfonylurea succinyl PEO (Mw = 3000) acrylate) was found to be soluble in a cell culture medium at pH 7.4. However, solubility was only obtained by decreasing solution pH from 11 to 7.4. When the copolymer was added to the islet cell culture media at a concentration of 5 microg ml(-1) (based on the theoretical SU content of the copolymer), insulin secretion was enhanced by about 30% at low glucose concentrations of 50 and 100 mg dl(-1) compared to the control. This is equivalent to 40-60% bioactivity of glyburide. The polymer's effect on insulin secretion at a higher glucose concentration of 200 mg dl(-1) was not significant. Considering the previous results where a similar but insoluble polymer without a PEO spacer was used and the polymer showed SU bioactivity only at a glucose concentration of 50 mg dl(-1), the observations from this study indicates that the solubility of SU-grafted polymers may affect the binding of SU groups to SU receptors on the pancreatic beta-cells, resulting in improved pharmacodynamic effect of SU.
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Since late 1992, over 100 building complexes in Taiwan, including both public and private schools, and 1,000 apartments have been identified as emitting elevated levels of gamma-radiation. These high levels of gamma-radiation have been traced to construction steel contaminated with 60Co. Accurate reconstruction of the radiation exposure dosage among residents is complicated by the discovery of multiple radioactive sources within the living spaces and by the lack of comprehensive information about resident life-style and occupancy patterns within these contaminated spaces. The objective of this study was to evaluate the sensitivity of current dose reconstruction approach employed in an epidemiological study for the health effects of these occupants. We apply a statistical method of local smoothing in dose rate estimation and examine factors that are closely associated with radiation exposure from multiple radioactive sources in the apartment. Two examples are used, a simulated measurement in a hypothetical room with three radioactive sources and a real apartment in Ming-Shan Villa, one of the contaminated buildings. The simulated and estimated means are compared along 5-10 selected points of measurement: by local smoothing approach, with the furniture-adjusted space, and with the occupancy time-weighted mean. We found that the local smoothing approach came much closer to theoretical values. The local smoothing approach may serve as a refined method of radiation dose distribution modeling in exposure estimation. Before environmental exposure assessment, "highly occupied zones" (HOZs) in the contaminated spaces must be identified. Estimates of the time spent in these HOZs are essential to obtain accurate dosage values. These results will facilitate a more accurate dose reconstruction in the assessment of residential exposure in apartments with elevated levels of radioactivity.
This study is a part of the Study On Air Pollution and Health In Taiwan (SOAP&HIT), an ongoing research project involving cooperation of several universities in Taiwan. In this study, the objective was to evaluate the effects of ambient air pollution on respiratory symptoms and diseases of school children, in addition to considering indoor air pollution. Six communities were selected: one community located in a rural area (Taihsi), two in urban areas (Keelung and Sanchung), and the other three in petrochemical industrial areas (Toufen, Jenwu, and Linyuan). We sampled 5,072 primary school students in six communities from the main study population of SOAP&HIT. Respiratory health was assessed by evaluation of the children's respiratory symptoms and diseases using a parent-completed questionnaire. Data were analyzed using logistic regression analysis to compute odds ratios of adverse effect. The school children in the urban communities had significantly more respiratory symptoms (day or night cough, chronic cough, shortness of breath, and nasal symptoms) and diseases (sinusitis, wheezing or asthma, allergic rhinitis, and bronchitis) when compared with those living in the rural community. However, only nasal symptoms of children living in the petrochemical communities were more prevalent than in those living in the rural community. Although the association with ambient air pollution is suggestive, the cross-sectional study cannot confirm a causal relationship; thus further studies are needed.
Accurate classification of diabetes in some young patients is difficult but clearly of importance in deciding the appropriate treatment. We report the different clinical courses and beta-cell function changes in 2 young-onset diabetics. In the beginning, each of them was considered to be a patient with insulin-dependent diabetes mellitus (IDDM) and was treated with insulin. Then, treatment was shifted from insulin to oral hypoglycemic agents (OHA) because each patient's beta-cell function was comparable to that of patients with non-insulin-dependent diabetes mellitus (NIDDM). In case 1, the patient's glycemic control and beta-cell function progressively deteriorated and finally insulin therapy was required. In case 2, the patient was continuously treated with OHA. Although his blood glucose was not well-controlled, his beta-cell function had been well-preserved. Recently he achieved near-normoglycemia by improving his diet and OHA compliance. Clearly, case 1 was a slowly progressive Type 1 DM patient and case 2 was a young Type 2 DM patient. This classification was further supported by the finding that the patient in case 1 had human leukocyte antigen (HLA)-DR3, but the patient in case 2 did not.
In Escherichia coli K-12, the repression of tyrP requires the binding of the TyrR protein to the operator in the presence of coeffectors, tyrosine and ATP. This operator contains two 22-bp palindromic sequences which are termed TyrR boxes. Methylation, uracil, and ethylation interference experiments were used to identify the important sites in the TyrR boxes that make contacts with the TyrR protein. Methylation interference studies demonstrated that guanines at positions +8, -5, and -8 of the strong TyrR box and positions +8, -4, and -8 of the weak box are close to the TyrR protein. Uracil interference revealed that strong van der Waals contacts are made by the thymines at position -7 and +5 of the top strands of both strong and weak boxes and that weaker contacts are made by the thymines at positions +7 (strong box) and -5 and +7 (weak box) of the bottom strand. In addition, ethylation interference suggested that the phosphate backbone contacts are located at the end and central regions of the palindrome. These findings are supported by our results derived from studies of symmetrical mutations of the tyrP strong box. Overall, the results confirm the critical importance of the invariant (G x C)(C x G)8 base pairs for TyrR recognition and also indicate that interactions with (T x A)(A x T)7 are of major importance. In contrast, mutations in other positions result in weaker effects on the binding affinity of TyrR protein, indicating that these positions play a lesser role in TyrR protein recognition. Alanine scanning of both helices of the putative helix-turn-helix DNA-binding motif of TyrR protein has identified those amino acids whose side chains play an essential role in protein structure and DNA binding.
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To compare both mortality and quality of life (QOL) across different illnesses, we propose an estimator to calculate the expected quality adjusted survival (QAS) by multiplying the QOL into the survival function. While the survival function can be determined by the usual life table method, the QOL data can be collected by a cross-sectional survey among patients who are currently surviving. The area under the QAS curve is thus the expected utility of health of the specific illness, which may take a common unit of quality adjusted life year ready for outcome evaluation and policy decision. A simulation is performed to demonstrate that the proposed estimator and its standard error are relatively accurate. The limitations and guidelines for using this estimator are also discussed.
BACKGROUND: Dysfunction of the sphincter of Oddi (SOD) is one of the causes of postcholecystectomy syndrome and biliary pain. Endoscopic sphincterotomy (EST) is recommended in some patients refractory to conservative treatment. This study was designed to evaluate the efficacy of, and complications from EST in patients with SOD. METHODS: Between 1990 and 1993, 24 patients clinically diagnosed as having papillary stenosis were treated by endoscopic sphincterotomy. All patients had dilated common bile duct (CBD) in addition to 1) elevation of transaminases and alkaline phosphatase (n = 13); 2) elevation of transaminases and serum amylase (n = 4); 3) normal liver enzymes but delayed biliary emptying on quantitative hepatobiliary scintigraphy (QHS) (n = 7). No CBD stones, organic obstruction or other disorders were found in these patients. RESULTS: EST was successfully performed in 24 patients. One patient had minor hemorrhage and one patient developed pancreatitis after EST. Twenty-two of the 24 patients (91.7%) were symptomatically improved before discharge. Twenty-one patients were regularly followed over a median period of 18 months (range 5-36) after EST. Two patients with symptom had recurrence at five and eight month follow up because of restenosis of papilla; another two patients with recurrent biliary symptoms, but the sphincter of Oddi remained wide open. Seventeen of 21 regularly followed patients were symptom free after the median 18-month follow up. CONCLUSIONS: EST is an effective and safe modality for treatment of sphincter of Oddi dysfunction.
A bioflocculant from a fungus, Aspergillus sp. JS-42, was purified by precipitations with acetone and cetylpyridinium chloride. The flocculating activity was not significantly affected by pH from 3 to 8, but was stimulated by the addition of CaCl2, and was effective only when the reaction mixture contained an adequate amount of flocculant. The flocculant could efficiently flocculate all tested solids suspended in aqueous solution, including various microorganisms, organic acids, and inorganic materials.
This paper proposes a normal mixed effects model for stability analysis. An EM algorithm is developed to compute the maximum likelihood estimates of regression coefficients of the fixed effects and random effects, and variance components. The likelihood ratio test is used for the preliminary testing of batch-to-batch variation. An example from a marketing stability study is given to illustrate the proposed procedure.
Urbanization and industrialization has resulted in a vast amount of artificial water containers in Taiwan, especially discarded automobile tires. 3.5 million automobile tires and several million motorcycle tires are discarded annually. The discarded tires contaminate the environment and also become a substantial number of breeding sites for the dengue vector mosquitoes. In order to establish a sound system for the recovery and disposal of discarded tires and to control dengue fever through source reduction, it has been emphasized that users must pay for their waste. It is necessary to recover and properly dispose of these discarded tired. The commercial firms which sell or manufacture tires are therefore advised to cooperate with the Environmental Protection Administration of the Executive Yuan, R.O.C. and follow the "Regulations of Recovery and Disposal of Discarded Tires". They are requested to establish foundations for the recovery of discarded tires. Those who are willing to join should prepay a deposit or related charge by the size of tire, which is imported or locally manufactured. The foundation utilizes the deposits for the recovery and disposal of discarded tires. From 1991 to 1993 the commercial tire firms had already achieved the 80% recovery rates declared by the authorities concerned. Some of the tires, after having been recovered, were recycled in the original form and the rest were cut into small pieces for recycling after physical treatment. It should be mentioned that the Department of Environmental Protection of Kaohsiung City has collected 80 thousand discarded automobile tires to be used as ocean jetty.(ABSTRACT TRUNCATED AT 250 WORDS)
Due to rapid urbanization, industrialization and social changes in recent years, the use of packing materials and tires has dramatically increased in the Taiwan area. What is more is that some parts of southern Taiwan are short of water resources and water preservation with huge containers becomes part of custom in those areas. Storage water containers, waste vessels and tires are good habitats for Aedes. Meanwhile, some persons traveling to dengue endemic countries bring the dengue disease back to Taiwan. Surveys taken since 1988 show that dengue occurs mainly in the urban and coastal areas where Aedes aegypti is prevalent. This species is the most important, if not the only, vector of dengue in Taiwan. It appears that the types of Aedes breeding have changed quickly. In dengue fever epidemic areas, the most popular breeding sites are ornamental containers (38.8%), storage water containers (30.1%), discarded containers (25.4%), receptacles (3.3%) and water collection in the basement (2.2%). In dengue fever epidemic areas, those building basements, huge water containers, waste vessels and waste tires in open fields are most difficult to clean up and manage and become the most popular Aedes habitats. We established a waste recycling system and promoted a breeding site reduction campaign for waste management, including the application of Temephos in containers to kill larvae. For the drinking water management, fish were released in water containers to prevent larval breeding. It should be mentioned that with the integrated pest control and regular inspections of Aedes larvae in Taiwan the density figures 1, 2-5, and 6 or above for Aedes aegypti were 38.7%, 42.9%, and 18.4%, respectively, in 1988, and in 1993 were 90.8%, 9.2% and 0%. The incidence of dengue fever cases has 98% decreased since 1988. In 1990 and 1993, there was no indigenous cases. We have concluded that integrated pest control is the best and most effective method for dengue fever control, including solid waste and drinking water management.
A prospective, randomized evaluation of operative choledochoscopy was carried out during emergency surgery in patients with acute cholangitis or acute suppurative cholangitis when conservative management had failed. After common bile duct exploration, 79 patients were randomized to have choledochoscopy and 78 patients to the control group. Laboratory and clinical parameters showed that choledochoscopy did not increase the incidence of septicaemia, acute pancreatitis, persistent cholangitis, postoperative wound sepsis, intraperitoneal sepsis and hospital mortality. The incidence of retained common bile duct stones detected by T tube cholangiography performed in the second postoperative week was significantly reduced (P less than 0.01) after choledochoscopy. Choledochoscopy detected stones missed by conventional common bile duct exploration in ten patients. It is concluded that choledochoscopy is a safe and effective technique in patients with acute cholangitis and acute suppurative cholangitis.
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