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Biomedical subjects

K C Chu

Publications and source records attributed to K C Chu.

At least 37 records · Page 2Linked to original sources

Successful treatment of disseminated coccidioidomycosis with amphotericin B lipid complex.

Coccidioidomycosis is endemic in regions of the Americas, but this infection may be encountered in travellers who return from an endemic region. A case is reported of a disseminated infection in a Hong Kong Chinese man, who was successfully treated with amphotericin B lipid complex (ABLC) after intolerance and toxicity precluded the use of other antifungal agents. Lipid-based formulations of amphotericin B merit further evaluation in the treatment of coccidioidomycosis and other systemic mycoses.

Adult↗

The significance of CT scan or MRI in the evaluation of salivary gland tumors.

Imaging modalities such as CT scan or MRI are frequently employed for the diagnosis of neoplastic lesions in the salivary glands. To evaluate the efficacy of the CT scan and the MRI in differentiating malignant neoplasm from benign lesions, 120 CT scans and 31 MRIs were retrospectively analyzed from 147 patients with salivary gland masses. All images were analyzed focusing on the presence of several relevant features. The pathologic results were matched with radiological features and also tabulated with radiological assessment. For the CT scans, the contour and margin of the lesion and tissue plane obliteration were found to be statistically significant indicators for malignant neoplasms. Among 69 CT scans interpreted as 'benign' by a radiologist, five cases (7%) were histologically diagnosed as 'malignant'. On the other hand, 20 out of 51 CT scans (39%) were misinterpreted as 'malignant'. For MRI, two out of 14 cases (14%) were radiologically misdiagnosed as 'benign' and six out of 17 patients (35%) as 'malignant'. In conclusion, whereas both the CT and MRI showed a similar level of accuracy in evaluation of salivary gland tumors, they showed a considerable tendency of misdiagnosis, especially by interpreting benign tumors as 'malignant'.

Biopsy↗

Aberrant cervical thymus: a case report and review of literature.

This article illustrates a case of an aberrant cervical thymus presented as a neck mass. This is a case of a 4-month-old boy presenting with a right submandibular mass whose preoperative diagnosis was lymphangioma or neoplastic lesion. The mass was successfully removed and the histopathological examination showed normal thymic tissue with no diagnostic abnormality. This paper reviews the embryological background of aberrant cervical thymus, the varying clinical presentations with an emphasis on differential diagnosis, clinical work-up, and surgical treatment.

Choristoma↗

Activation-dependent exposure of the inter-EGF sequence Leu83-Leu88 in factor Xa mediates ligand binding to effector cell protease receptor-1.

Binding of factor Xa to human umbilical vein endothelial cells (HUVEC) is contributed by effector cell protease receptor-1 (EPR-1). The structural requirements of this recognition were investigated. Factor Xa or catalytically inactive 5-dimethylaminonaphthalene-1sulfonyl (dansyl) Glu-Gly-Arg-(DEGR)-chloromethylketone-factor Xa bound indistinguishably to HUVEC and EPR-1 transfectants, and inhibited equally well the binding of 125I-factor Xa to these cells. Similarly, factor Xa active site inhibitors TAP or NAP5 did not reduce ligand binding to EPR-1. A factor X peptide duplicating the inter-EGF sequence Leu83-Phe84-Thr85-Arg86-Lys87-Leu88- (Gly) inhibited factor V/Va-independent prothrombin activation by HUVEC and blocked binding of 125I-factor Xa to these cells in a dose-dependent manner (IC50 approximately 20-40 microM). In contrast, none of the other factor X peptides tested or a control peptide with the inter-EGF sequence in scrambled order was effective. A recombinant chimeric molecule expressing the factor X sequence Leu83-Leu88 within a factor IX backbone inhibited binding of 125I-factor Xa to HUVEC and EPR-1 transfectants in a dose-dependent fashion, while recombinant factor IX or plasma IXa had no effect. An antibody generated against the factor X peptide 83-88, and designated JC15, inhibited 125I-factor Xa binding to HUVEC. The JC15 antibody bound to factor Xa and the recombinant IX/X83-88 chimera in a concentration dependent manner, while no specific reactivity with factors X or IXa was observed. Furthermore, binding of 125I-factor Xa to immobilized JC15 was inhibited by molar excess of unlabeled factor Xa, but not by comparable concentrations of factors X or IXa. These findings identify the inter-EGF sequence Leu83-Leu88 in factor Xa as a novel recognition site for EPR-1, and suggest its potential role as a protease activation-dependent neo-epitope. This interacting motif may help elucidate the contribution of factor Xa to cellular assembly of coagulation and vascular injury.

Binding Sites↗

Birth cohort and calendar period trends in breast cancer mortality in the United States and Canada.

BACKGROUND: Previous studies of regional and temporal variation in U.S. breast cancer mortality rates have been confined largely to analyses of rates for white women. PURPOSE: Breast cancer mortality rates from 1969 through 1992 for white women and black women in four regions of the United States and for all women throughout Canada were compared to identify racial, regional, and temporal differences. Differences and trends in the rates were evaluated in view of breast cancer risk factors and relevant medical interventions. METHODS: Age-period-cohort models were fit to the data, and changes in birth cohort trends (suggesting a change in a breast cancer risk factor or protective factor) and calendar period trends (suggesting, in part, the impact of new or improved medical interventions) were examined. RESULTS: Breast cancer mortality rates for white women were significantly higher in the Northeast than in any other region of the United States (two-sided t tests; P<.005); the rates for black women were not. Birth cohort trends for all women were similar until about 1940, with a moderation of mortality risk beginning around 1924. A marked moderation of risk by 4-year birth cohorts was observed for U.S. white women born after 1950, whereas stable or slightly decreasing trends were observed for U.S. black women and Canadian women. For women born from 1924 to around 1938, fertility rates increased for all three groups; after 1950, they declined uniformly. Looking at temporal effects, we found that the slope of the mortality calendar period trend increased in the 1980s compared with the 1970s for all women. In the last calendar period, 1991-1992, a trend of decreasing mortality rates was found for white women in the United States and for Canadian women. IMPLICATIONS: Widespread environmental exposures are unlikely to explain the higher relative breast cancer mortality rates observed for U.S. white women in the Northeast, since the rates for black women in this region were not higher than in other regions. The moderation of breast cancer mortality rates for women born between 1924 and 1938 coincides with increased fertility rates following World War II. Stable or decreasing mortality rates for U.S. women and Canadian women born after 1950 were not expected in view of declining fertility rates, suggesting a change in a breast cancer risk factor or protective factor. The increase in calendar period trend slope in the 1980s likely reflects the coincident rise in breast cancer diagnosis via mammography. The recent decline in calendar period trend for white women in the United States and for Canadian women may be the result of earlier detection and increased use of adjuvant therapy.

Adolescent↗

Polyvinyl alcohol cryogel: an ideal phantom material for MR studies of arterial flow and elasticity.

The authors present a unique application of polyvinyl alcohol (PVA) cryogel as an anthropomorphic, elastic, vascular phantom material that can be used in MR imaging. The composition consists of two nontoxic ingredients: water and PVA. The biomechanical and MR properties can be adjusted to be similar to those of excised porcine aortas by varying the number of freeze-thaw cycles to which the PVA solution is exposed. The authors present the T1, T2, shrinkage, and tensile properties of PVA cryogel tubes as a function of freeze-thaw cycles. MR images of a dual elastic aortic phantom undergoing pulsatile motion are shown.

Animals↗

Use of CHROMagar Candida for genital specimens in the diagnostic laboratory.

OBJECTIVE: To evaluate CHROMagar Candida (CA), a new yeast differential medium, for yeast isolation in a clinical laboratory for the routine examination of high vaginal swabs. METHODS: Results of high vaginal swab cultures processed in a standard manner on plates containing equal halves of Sabouraud dextrose agar (SDA) and CA were compared. Non-Candida albicans yeast isolates were further speciated with API 20C AUX or API 32C. To assess the ease of use of CA, laboratory staff lacking in experience of the medium were asked to identify 23 unlabelled yeast cultures on CA by referring to six labelled reference plates. RESULTS: Of the 1784 swab cultures processed, yeasts were isolated from 373 SDA and 368 CA. Of the 78 non-albicans isolates further speciated, CA identified correctly all cultures of C krusei and C tropicalis, and 82% of C glabrata. All the 38 inexperienced laboratory staff achieved 100% accuracy for C albicans and over 90% for C krusei and C tropicalis. CONCLUSIONS: CA is a satisfactory isolation medium for genital specimens, allowing immediate and correct identification of the commonly encountered yeasts and easy recognition of mixed cultures.

Candida↗

Establishment and characterization of nine new head and neck cancer cell lines.

We established new cell lines from head and neck cancer patients for studies of adhesion molecules and cellular behavior in nine patients with primary or metastatic cancer treated at the Asan Medical Center. Explant cultures of fresh tumor tissue were used to develop new permanent tumor cell lines. Lines were tested for tumor formation and histology in nude mice. Flow cytometry and indirect immunofluorescence were used to assess DNA content and expression of the alpha 6, beta 4, and beta 1 integrin subunits and the intercellular adhesion molecule 1 (ICAM-1). In vitro growth patterns and adhesion to plastic were assessed using phase contrast microscopy. AMC-HN-1 to -8 were derived from patients with squamous cell carcinoma. AMC-HN-9 was from an undifferentiated carcinoma of the parotid gland. The 8 lines we tested produced nude mouse tumors that are identical to the histology of the original tumors. AMC-HN-1, -2, -5, and -9 have epithelioid or spindle cell morphology with poor cell-to-cell and cell-to-substrate adhesiveness. AMC-HN-3, -4, -7, and -8 grow as adherent epithelioid monolayers. AMC-HN-6 exhibits multilayer stratification. Four lines are near diploid, 4 are hyperdiploid and 1 is hypodiploid. Only three express ICAM-1. All lines express the alpha 6, beta 4, and beta 1 integrin subunits but to different extent. Four, AMC-HN-1, -2, -5, and -6, express the beta 4 integrin at low levels, AMC-HN-3, -4, -7, and -9, have intermediate beta 4 expression, and AMC-HN-8 has extremely high beta 4 expression. The AMC-HN cell lines are representative in vitro models for the study of head and neck cancer biology. Our preliminary results indicate a close relationship between integrin expression and cell adhesion in vitro.

Adult↗

A survey on dental caries in schoolchildren on Lanyu Island.

BACKGROUND: Lanyu Island has approximately 3000 inhabitants, mainly Yami aborigines. No survey of dental caries in schoolchildren has been done on this isolated island during the past decade. The purposes of this study were to investigate the prevalence of caries in schoolchildren on Lanyu and compare the results with the rest of Taiwan. METHODS: A total of 289 schoolchildren (152 boys and 137 girls) aged 4 to 12 on Lanyu Island, were selected for this study. The dental examinations were done by 2 senior pediatric dentists using flashlight, dental mirrors and explorers during 4 days of examination. The survey included caries prevalence rate, restorative index, and mean scores for deft, DMFT, defs, and DMFS. Mean scores for carious teeth by type of surface and sex differences for deft and DMFT were also checked. RESULTS: The results showed that Lanyu schoolchildren had a high caries prevalence rate (94.5%) and a low restorative index (5.75%). The mean scores of deft, DMFT, defs, and DMFS for all schoolchildren were 5.38 +/- 4.50, 1.67 +/- 2.22, 12.18 +/- 11.64, and 2.42 +/- 3.89, respectively. There were no significant sex differences in the overall mean scores of deft (p = 0.557) and DMFT (p = 0.151). CONCLUSION: The data showed that the caries prevalence of Lanyu schoolchildren was as high as other Taiwanese schoolchildren. For the caries prevalence in deciduous teeth, the scores were even worse than the Taiwan average. This study will provide a baseline for future oral health policies on Lanyu Island.

Child↗

Differential effects of vinblastine on polymerization and dynamics at opposite microtubule ends.

We have characterized the effects of vinblastine on the growing and shortening dynamics at opposite ends of individual bovine brain microtubules at steady state in vitro by video microscopy. Vinblastine exerted strikingly different effects on the dynamics and polymer mass at the plus and minus ends of microtubules. At concentrations between 0.1 and 0.4 microM, the drug strongly depolymerized microtubules at minus ends, whereas it did not significantly depolymerize microtubules at plus ends. Vinblastine stabilized plus ends by suppressing the rate and extent of growth and shortening, decreasing the catastrophe frequency, and increasing the rescue frequency. In contrast, vinblastine destabilized minus ends by increasing the catastrophe frequency and decreasing the rescue frequency, whereas it had no effect on the rate or extent of growth or shortening. Thus, vinblastine moderately increased the overall dynamicity at minus ends while strongly suppressing dynamicity at plus ends. Both the kinetic destabilization of microtubules at minus ends and the stabilization at plus ends may contribute to the altered function of mitotic spindle microtubules of cells blocked in mitosis by low concentrations of vinblastine.

Animals↗

Recent trends in U.S. breast cancer incidence, survival, and mortality rates.

BACKGROUND: Clinical trials have demonstrated that use of mammographic screening and advances in therapy can improve prognosis for women with breast cancer. PURPOSE: We determined the trends in breast cancer mortality rates, as well as incidence and survival rates by extent of disease at diagnosis, for white women in the United States and considered whether these trends are consistent with widespread use of such beneficial medical interventions. METHODS: We examined mortality data from the National Center for Health Statistics and incidence and survival data by extent of disease from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, all stratified by patient age, using statistical-regression techniques to determine changes in the slope of trends over time. RESULTS: The age-adjusted breast cancer mortality rate for U.S. white females dropped 6.8% from 1989 through 1993. A significant decrease in the slope of the mortality trend of approximately 2% per year was observed in every decade of age from 40 to 79 years of age. Trends in incidence rates were also similar among these age groups: localized disease rates increased rapidly from 1982 through 1987 and stabilized or increased more slowly thereafter; regional disease rates decreased after 1987; and distant disease rates have remained level over the past 20 years. Three-year relative survival rates increased steadily and significantly for both localized and regional disease from 1980 through 1989 in all ages, with no evidence of an increase in slope in the late 1980s. IMPLICATIONS: The decrease in the diagnosis of regional disease in the late 1980s in women over the age of 40 years likely reflects the increased use of mammography earlier in the 1980s. The increase in survival rates, particularly for regional disease, likely reflects improvements in systemic adjuvant therapy. Statistical modeling indicates that the recent drop in breast cancer mortality is too rapid to be explained only by the increased use of mammography; likewise, there has been no equivalent dramatic increase in survival rates that would implicate therapy alone. Thus, indications are that both are involved in the recent rapid decline in breast cancer mortality rates in the United States.

Adult↗

Evaluation of birth cohort patterns in population disease rates.

Interpretation of trends in disease rates using conventional age-period-cohort analyses is made difficult by the lack of a unique set of parameters specifying any given model. Because of difficulties inherent in age-period-cohort models, neither the magnitude nor the direction of a linear trend in birth cohort effects or calendar period effects can be determined unambiguously. This leads to considerable uncertainty in making inferences regarding disease etiology based on birth cohort or calendar period trends. In this paper, the authors demonstrate that changes in the direction or magnitude of long term trends can be identified unequivocally in age-period-cohort analyses, and they provide parametric methods for evaluating such changes in trend within the usual Poisson regression framework. Such changes can have important implications for disease etiology. This is demonstrated in applications of the proposed methods to the investigation of birth cohort trends in female breast cancer mortality rates obtained from the National Center for Health Statistics for the United States (1970-1989) and from the World Health Organization for Japan (1955-1979).

Adult↗

Improved MR images of arterial specimens by submersion in trichlorotrifluoroethane.

MR images of ex vivo arterial specimens immersed in 1,1,2-trichloro-1,2,2-trifluoroethane (R-113) have improved signal-to-noise ratio and contrast-to-noise ratio. R-113 has no hydrogen atoms, so it yields no proton signal; hence, the contrast between the specimen and its background is maximized. SNR is maximized because (i) R-113 is nonconductive so that coil loading and inductive noise are minimized, and (ii) the volume susceptibility of R-113 closely matches that of water and tissue so that T2* effects are minimized. Short-term submersion of porcine aortas in R-113 was found to have no significant effect on the artery's hydration level, relaxation time, tensile strength, and structure or quantity of elastin, collagen, or smooth muscle cells.

Animals↗

Colorectal cancer trends by race and anatomic subsites, 1975 to 1991.

OBJECTIVES: To determine whether colorectal cancer rates among black men and women show the abrupt declines seen in whites since the mid-1980s and to determine how the cancer trends vary by anatomic subsites. DATA SOURCES: Mortality data from the National Center for Health Statistics, Hyattsville, Md, and incidence and survival data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute, Bethesda, Md. MAIN OUTCOME MEASURES: Trends in incidence, survival, and mortality rates. RESULTS: For white men and women, cancer incidence rates declined for the right colon, left colon, and rectum after 1985. Stage-specific incidence rates for white men and women for each subsite had generally similar patterns. Distant-disease incidence rates declined beginning in the late 1970s, whereas regional-disease rates increased until the early to mid-1980s and then declined. An exception is the right colon in men, for which the incidence rates of distant disease did not decline, although the regional-disease pattern was similar to other sites. For blacks, colorectal cancer incidence rates changed little in the 1980s for men or women. In particular, there were no significant declines in the cancer incidence rates of the colorectum or of subsites after 1985. Black colorectal cancer mortality trends showed gender and age differences. Black men had significantly increasing colorectal cancer mortality rates from 1975 through 1992, but the increase after 1985 was observed only in men 65 years of age and older. The colorectal cancer mortality rates did not increase overall in black women in the 1980s, but the mortality rates increased slightly in women 65 years of age and older while declining in women younger than 65 years. CONCLUSIONS: For whites, the trends in colorectal cancer rates by anatomic subsite support the contention that early-detection procedures, such as sigmoidoscopy and colonoscopy, are contributing to the declines in incidence and mortality rates since 1985. The absence in blacks of significant declines in colorectal incidence or mortality rates since 1985 suggests the need for a greater emphasis on early-detection programs in the black community, particularly for elderly blacks.

Black People↗

MR gradient coil heat dissipation.

The temperature responses of five different gradient coil designs were modeled using simplified engineering equations and measured. The model predicts that the coil temperature approaches a maximum as an inverse exponential, where the maximum temperature is governed by two parameters: a local power density and a cooling term. The power density term is a function of position and is highest where the current paths have minimum widths and are closely packed. The cooling parameter consists of convective, conductive, and radiative components which can be controlled by (1) providing forced cooling, (2) having a coil former with high thermal conductivity and thin walls, and (3) varying the emissivity of the coil surfaces. For a given gradient strength, the average temperature rise is minimized by designing a coil with a small radius and thick copper. The model predicted the local temperature rise, which is also dependent on the current density, to within 5 degrees C of measured values.

Equipment Design↗

A novel transverse gradient coil design for high-resolution MR imaging.

The authors describe a new gradient coil design for high resolution human, animal, specimen, or phantom imaging with high gradient efficiency and a large region of excellent gradient uniformity. Important features of our new design are the simple analytical description of the wire patterns that comprise the design, and ease of construction. Wires are spaced in a sinusoidal distribution around the circumference of the cylinder, and curved in an arcsin shape along the length of the cylinder. This coil produces a magnetic field pointing in a direction transverse to the axis of the coil with a gradient in the direction parallel to the axis of the coil. The same arcsin coil can be used to create a magnetic field pointing in a direction parallel to its axis with a gradient in a direction perpendicular to the coil axis. A prototype coil was constructed; field and inductance calculations were verified. Geometric variations on this coil design were modeled and their performance characteristics compared. This coil design is ideal for rapid implementation of a transverse gradient coil, since no specialized design software is required.

Algorithms↗

Gastrointestinal bleeding due to whipworm (Trichuris trichiura) infestation: a case report.

Severe whipworm infestation, an exceedingly uncommon cause of gastrointestinal bleeding, has not been reported in Taiwan. The reported case concerns a 59-year-old female who had suffered from abdominal pain and passage of tarry stool for several days. Esophagogastroduodenoscopy was performed, and several roundworms were seen in the second portion of duodenum. After removal, the characteristic appearance of Trichuris trichiura was apparent. After exploratory laparotomy for intractable bloody stool, the result of operative findings and pathological reports also confirmed our diagnosis. This is a case presented of massive gastrointestinal bleeding in which the cause of bleeding was diagnosed before operation to be whipworm infestation by endoscopic examination. The clinical and pathologic characteristics of the trichuriasis are described, with a brief review and discussion.

Female↗

Temporal patterns in colorectal cancer incidence, survival, and mortality from 1950 through 1990.

BACKGROUND: Colorectal cancer mortality rates among U.S. white males remained relatively constant from 1950 through 1984 but declined sharply from 1985 through 1990. Those for U.S. white females decreased consistently from 1950 through 1984, with an acceleration of the decline from 1985 through 1990. PURPOSE: A study was planned to investigate patterns in incidence, survival, and mortality rates over time in order to examine possible reasons for the gender difference in mortality trends and for the decrease in the slope of the mortality trends for both males and females in the late 1980s. METHODS: Incidence and survival data from the Connecticut Cancer Registry were examined to investigate the gender differences in mortality rates from 1950 through 1984. Incidence and survival data from the Surveillance, Epidemiology, and End Results (SEER) Program were investigated to examine reasons for the abrupt downturn in mortality rates for both white males and white females beginning around 1985. RESULTS: During the period 1950 through 1984, the colorectal cancer incidence rates in Connecticut increased for males and declined slightly for females. Survival rates were similar for both sexes, increasing on average over 1% per year for both females and males from 1950 through 1984. Examination of SEER data from 1975 through 1990 revealed that for both males and females there were 1) declines in overall incidence and mortality rates beginning in the mid-1980s, 2) steady declines in distant disease incidence rates since 1975, 3) increases in regional disease incidence rates until the early 1980s followed by declines in the late 1980s, and 4) increases in local disease incidence rates until the mid-1980s followed by declines in the late 1980s. Age-period-cohort analyses of mortality rates indicated a statistically significant moderation of colorectal cancer risk with both advancing birth cohorts and recent calendar periods. CONCLUSIONS: The gender differences in colorectal cancer mortality rate trends observed from 1950 through 1984 are due to differences in incidence rate trends between males and females. Declining colorectal mortality rates in the late 1980s for males and females appear to reflect improved early detection. The peaking and subsequent decline of stage-specific incidence rates at later years for successively lower stage indicate sequential stage shifts as cancers are detected increasingly earlier over time. The increased use of sigmoidoscopy and fecal occult blood tests (triggering colonoscopy) appears to have played an important role in reducing colorectal cancer mortality. Improvements in birth cohort trends in risk for colorectal cancer for each sex suggest that lifestyle changes may have also contributed to the steady reductions in colorectal cancer mortality.

Adult↗