PubMed Health⌕ Search

Biomedical subjects

K H Lin

Publications and source records attributed to K H Lin.

At least 109 records · Page 6Linked to original sources

Recombinant alpha-interferon treatment of intracranial hemangioma and Kasabach-Merritt syndrome in an infant with cytomegalovirus.

A 2-month-old girl presented with enlarged head girth, generalized petechiae, anemia, coagulopathy and hepatosplenomegaly. Imaging studies showed a huge, dumbbell-shaped intracranial hemangioma located between the falx, and involving the supra- and infra-tentorium, extending through the posterior fontanel to involve the subgaleal area. A urine culture grew cytomegalovirus. Severe thrombocytopenia was refractory to a massive platelet transfusion, intravenous immunoglobulin and corticosteroid therapy. Hypertension, pulmonary hemorrhage and sepsis complicated the course. After establishing a diagnosis of Kasabach-Merritt syndrome, subcutaneous injections of alpha-interferon were given with an initial dose of 1 x 10(6) IU/m2 followed by 3 x 10(6) IU/m2 per day for 12.5 mo. Her platelet count rose gradually and became stable after 1.5 mo of interferon treatment. The intracranial hemangioma regressed remarkably and the hepatosplenomegaly was also resolved. The infant showed good growth and development, without obvious side-effects during the 23-month follow-up period. The treatment with recombinant alpha-interferon appeared to be effective in reversing thrombocytopenia associated with the patient's massive intracranial hemangioma.

Brain Neoplasms↗

Scanning electron microscopy of capsaicin-pretreated trachea in the rat during postnatal development.

The morphological changes of the tracheal surface were studied in neonatally capsaicin-pretreated rats by scanning electron microscopy. One week after neonatal capsaicin treatment, a sparse number of ciliated cells were dispersed among the microvilli-covered goblet cells similar to those of the sham-operated rats. Potential ciliated cells (progenitor cells) possessed a few long cilia and many short cilia. The ciliated cells possessed cilia with a smooth surface and a blunt end similar to that of the sham-operated rats. Two weeks after neonatal capsaicin treatment, numerous ciliated cells frequently in clusters were located among large patches of microvilli-covered goblet cells similar to those of sham-operated rats. Furthermore, the blunt ends of cilia and microvilli contained short star-shaped protrusions extending into the lumen of the trachea. One month after neonatal capsaicin treatment, the star-shaped protrusions became longer, and more irregular than those of sham-operated rats. The short cilia of the potential ciliated cells (progenitor cells) also became blunt and irregular in shape. The star-shaped protrusions of the microvilli of the goblet cells became larger and thicker than those observed at two weeks following capsaicin-pretreatment. Two months after neonatal capsaicin treatment, the tracheal surface was lined with a much greater population of the ciliated cells than that at one month. A striking characteristic at this age was that globular mucin-containing secretory products were trapped within the cilia of the ciliated cells. The results of this study suggest that mucus secretion is probably blocked by the capsaicin-pretreatment. Furthermore, the star-shaped protrusions of cilia and microvilli may indicate that the mucociliary clearance mechanism is interfered with by the capsaicin-pretreatment.

Animals↗

Detection of a novel lactate dehydrogenase isozyme and an apparent differentiation-associated shift in isozyme profile in hepatoma cell lines.

A hitherto unreported lactate dehydrogenase (LD) isoenzyme, which migrates electrophoretically to the relative position between LD2 and LD3 has been identified in the electropheratogram in 7 of 7 (100%) cultured hepatoma cell lines with various degrees of differentiation and is thus given the name LD2-3. LD2-3 seems to be specific for hepatoma cells because this atypical isoenzyme can not be detected in other tumor cell lines. In addition, the hepatoma cell lines also show a distinct pattern of LD isoenzyme and the isoenzyme pattern varies with the degree of differentiation. Hence, the expression pattern of LD isoenzyme phenotypes may provide a good marker for the investigation of human hepatoma cell differentiation.

Carcinoma, Hepatocellular↗

Stimulation of proliferation by 3,3',5-triiodo-L-thyronine in poorly differentiated human hepatocarcinoma cells overexpressing beta 1 thyroid hormone receptor.

To understand the role of thyroid hormone nuclear receptors (TRs) in hepatocarcinogenesis, we characterized the TRs in nine human hepatocarcinoma cell lines. The expression of TR proteins is receptor subtype- and cell type-dependent. TR alpha 1 protein expresses similarly at a low level in each of the nine cell lines. In contrast, TR beta 1 is overexpressed in hepatocarcinoma cells which are poorly differentiated. Furthermore, thyroid hormone was found to stimulate the proliferation of cells in which TR beta 1 is overexpressed. These results suggest that TR beta 1 is most likely involved in the differentiation and proliferation of hepatocarcinoma cells. Our studies have shed new light in the understanding of the role of TRs in liver carcinogenesis.

Biomarkers↗

Prognostic significance of left ventricular diastolic indexes in beta-thalassemia major.

OBJECTIVE: To define the prognostic significance of left ventricular diastolic function in patients with beta-thalassemia major by noninvasive M-mode echocardiography and Doppler measurements. DESIGN: Cohort analytic study. SETTING: A university hospital in Taipei, Taiwan. PATIENTS: Forty-five patients (age range, 4 to 25 years) with transfusion-dependent beta-thalassemia major followed up for 5 years. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: M-mode and Doppler echocardiography were used to determine the left systolic time interval; ejection fraction; left atrium emptying index; isovolumetric relaxation period; diastolic total period; the duration, slope, and height of the early diastolic flow-velocity peak; and the ratio between the heights of early and atrial diastolic flow-velocity peaks. All patients had normal systolic ventricular function initially, but impaired diastolic function developed, especially in the older age group who had more evidence of iron loading. In nine of those with abnormal diastolic total period (n = 10) and duration of the early diastolic flow-velocity peak (n = 12) values, regardless of age, congestive heart failure developed during the period of follow-up. Of these nine, four died within 2 years after the advent of heart failure and five remained compensated after anticongestive treatment and use of deferoxamine mesylate. The presence of an abnormal diastolic total period and duration of the early diastolic flow-velocity peak values correlated well with the prognosis. CONCLUSIONS: Left ventricular diastolic filling variables by echocardiography are important predictors of the outcome of patients with transfusion-dependent beta-thalassemia major and could provide useful measures in determining the effects of medication during long-term follow-up.

Adolescent↗

Peripheral T-cell lymphoma in childhood: a report of five cases in Taiwan.

We encountered five children with peripheral T-cell lymphoma (PTL) at National Taiwan University Hospital (NTUH) from 1985-1989. The patients were four boys and one girl, aged between 5 and 13 years. The duration of prediagnostic symptoms varied from 1 month to 5 years. All had pyrexia and lymphadenopathy; one had a prolonged history of granulomatosis with repeated infection. Four had hepatosplenomegaly. One patient presented with diffuse pulmonary infiltration and impending respiratory failure. All patients were negative for human T-cell leukemia virus (HTLV)-I antibody, and positive for HBsAg. Four patients who had EBV-viral capsid antigen (VCA) IgG and who were IgM tested were positive for EBV-VCA IgG, but only two had evidence of active EBV infection. Tumor cell markers were examined and showed the following phenotypes: all patients were CD2, CD3, and CD7 positive but CD19 and CD20 negative; three patients were CD4 positive and CD8 negative; the other two patients were CD4 negative and CD8 positive. Four patients died 2-7 months after diagnosis. The remaining patient received allogeneic bone marrow transplantation and has survived free of disease for more than 22 months after transplant. Our five cases reconfirm the high frequency of diagnostic delay, the heterogenous immunophenotypes, high mortality, and poor responsiveness to conventional therapy for PTL. Bone marrow transplantation in the early stage might be a possible cure of this disease.

Adolescent↗

Molecular subtypes of env sequences around V3 region of human immunodeficiency virus type 1 in Taiwan.

Samples of peripheral blood mononuclear cells (PBMC) were collected during 1990-91 from seropositive healthy, male HIV-1 carriers visiting Taipei Venereal Disease Control Center, and a male AIDS patient admitted to a general hospital. The V3 and its flanking nucleotide (nt) sequences in their DNA were amplified by polymerase chain reaction (PCR) and compared with those of known HIV-1 prototypes. The nt sequences obtained from 21 individuals (e.g., TW92) clustered as Group A, which were highly homologous (95.6-99.5%) to that of HXB2 virus while those from 6 individuals (TW90, TW91, TW97, TW99, TW102 and TW104) were classified as Group B showing low similarities (73.2-84.2%) to those of HXB2 and moderate similarities (80.7-90.0%) to those of SC and Bangkok (BK) viruses. By comparison of their deduced amino acid sequences with those of consensus sequences for subtypes A-F as defined by Myers et al. (1993), both Groups A and B viruses (except TW102) together with those of HXB2, SC and BK viruses could be identified as members or variants of subtype B, and the TW102 virus as a member of subtype E viruses. Individuals with the Group A viruses included 4 homosexual and 17 heterosexual Taiwanese males, 2 of the latter having a history of i.v. drug abuse. Among individuals with Group B viruses, those with TW97, TW99, TW104 and TW91, who was an AIDS patient, were heterosexual Taiwanese males, whereas both TW90 and TW102 viruses were from individuals who were overseas heterosexual Chinese from Thailand, the former with a history of i.v. drug abuse and the latter without.

Acquired Immunodeficiency Syndrome↗

Cytogenetic studies, ras mutation, and clinical characteristics in primary myelodysplastic syndrome. A study on 68 Chinese patients in Taiwan.

Cytogenetics and clinical features were studied for 68 Chinese patients with primary myelodysplastic syndrome (MDS). Ras mutation was analyzed in 25 of them. Thirty-four patients (50%) had clonal chromosomal abnormalities at initial analysis. The most common cytogenetic aberrations were -7, +8, 5q-, and 20q-, which occurred in 11 (16.2%), seven (10.3%), five (7.4%) and three patients, respectively. The incidence of -7 was higher and that of 5q- lower in our patients than in patients from most other geographic areas. The 17 patients with multiple chromosomal abnormalities had a significantly shorter median survival (9 months) than the 34 patients with normal karyotype (33 months) and the 17 patients with patients with single anomalies (26 months). Evolution to acute leukemia occurred in 20 patients (29%) after a median interval of 8 months following the diagnosis. Patients with multiple cytogenetic changes at initial analysis or in subsequent studies had a significantly higher frequency of acute transformation than others (55% vs. 18.6%, p = 0.007); the same was not true if only the data of initial study were considered. Serial cytogenetic studies are important in patient follow-up. N-ras mutation was detected in 5 (20%) of 25 patients within the study. There was no correlation between the gene mutation and acute transformation. But combing the data of N-ras mutation and cytogenetics, patients with either the N-ras mutation or clonal chromosomal abnormalities were at significantly higher risk for developing acute leukemia than those with neither of the changes (77% vs. 25%).

Adolescent↗

Long term clinical and virologic outcome of primary hepatitis C virus infection in children: a prospective study.

To investigate the long term natural course of primary hepatitis C virus infection in children from the beginning, we prospectively followed up 88 children at risk because of frequent blood transfusions or of hepatitis C virus infection from the mother. Ten of the 88 children contracted primary infection during follow-up. In the acute stage of infection acute hepatitis with elevation of aminotransferases and a positive IgM antibody was found in both children infected during open heart surgery, 3 of the 5 multiply transfused children with congenital hemolytic anemia and none of the 3 infants infected by their mothers. Four of the 10 children later lost hepatitis C virus RNA, whereas 6 had a chronic course. Three of the latter 6 children had abnormal aminotransferase activities in the chronic phase. Our study suggests that the very young age of primary infection and the underlying status of the host may affect the clinical course of hepatitis C virus infection in children.

Acute Disease↗

Infantile endodermal sinus tumor presenting with vaginal bleeding: report of a case.

Endodermal sinus tumor (EST) of the vagina is extremely rare and primarily affects infants. We report on a six-month-old female infant with EST of the vagina who presented with vaginal spotting of one month's duration. Pelvic ultrasound and computerized tomography showed a 3.8 x 3.5 cm heterogeneous mass between the bladder and the rectum. The serum alpha-fetoprotein (AFP) level was high (1270 ng/mL) and the beta-human chorionic gonadotropin was undetectable. She received surgical intervention followed by chemotherapy. The patient was disease-free and serum AFP remained undetectable during the eight-month follow-up period.

Endodermal Sinus Tumor↗

[General introduction to the clinical application of non-invasive respiratory aids].

Intermittent positive pressure ventilation via tracheostomy has been the most common method of providing ventilatory support for patients with respiratory failure since the late 1950s. It is the standard procedure for individuals who suffer from acute respiratory failure, impaired consciousness, and severe restrictive lung disease. However, numerous adverse complications from these invasive techniques have been reported in those who are long-term ventilator users. This paper describes the evolution and current application of non-invasive respiratory aids in both acute and long-term settings. The respiratory function can be aided by applying forces to the body or intermittent pressure to the air ways. The devices are negative pressure body ventilators which act on the body by creating negative pressure around the thorax and abdomen such devices effectively maintain the ventilation of individuals with respiratory failure, but have the shortcomings of bulkiness, high expense, and limitation on the users' activities. The non-invasive positive pressure ventilator applies intermittent pressure directly to the airway by a non-invasive interface; namely mouthpiece, nasal, or face masks. In this way, it can prevent patients from requiring either tracheostomy or endotracheal tube, but is not effective enough to ventilate patients with markedly decreased lung compliance because the high airway resistance provides air leakage from the non-invasive interface. Non-invasive respiratory aids should be the first choice to maintain ventilation for patients with respiratory failure secondary to neuromuscular disorder, because of their benefits of easy application, satisfactory results, fewer complications and early active rehabilitation. Increased understanding of non-invasive respiratory aids should assist in the management of patients with chronic respiratory failure.

Humans↗

Seroepidemiological study of coxsackievirus type A24 variant (CA24v) in Taiwan.

In October 1985 and June 1986, for the first time, Taiwan experienced two outbreaks of acute hemorrhagic conjunctivitis (AHC) caused by a variant of coxsackievirus A24 (CA24v). Sera of virologically and clinically confirmed cases were studied together with the pre- and post-epidemic serum samples by the microneutralization method (cut-off titer, 1:8). The serum samples included 16 cases of virologically confirmed AHC and 18 cases of clinically diagnosed AHC which were collected during the period of January to July, 1987 (i.e., 7 to 21 months after the epidemic). In the same period of time, 374 serum samples were randomly collected as a post-epidemic control group. Meanwhile, 206 serum samples, which were randomly collected in 1980, were studied as a pre-epidemic control group. The results showed that in terms of CA24v neutralizing antibody (NTAb) positivity, a significant difference was found between the pre- and post-epidemic random sample groups (5.3% vs. 28.1%, P < 0.001) while no significant differences among the virologically confirmed, the clinically diagnosed and the post-epidemic random sample groups were noticed (31.3% vs. 28.1%; 44.4% vs. 28.1%, P > 0.05). For comparison, the enterovirus 70 (EV70) NTAb of the samples was studied simultaneously. The results showed that the positive rate and geometric mean titer of CA24v NTAb were lower than those of EV70 even in the post-epidemic serum samples collected shortly after the CA24v epidemic.

Adolescent↗

L-asparaginase-related pancreatic pseudocyst: report of a case.

Pancreatitis following the administration of L-asparaginase (L-asp) has been well documented. However, the progression of such pancreatitis to pseudocyst formation in some patients has been rarely reported. The few reported cases have been teenagers, with the exception of one adult. All pseudocysts required surgical management. This report documents a pancreatic pseudocyst in a seven-year-old girl with acute lymphoblastic leukemia whose treatment regimen included L-asp. The pseudocyst was managed medically with nasogastric decompression, intravenous hyperalimentation, and antibiotics. The pseudocyst resolved spontaneously in one month without complication.

Acute Disease↗

Bone marrow transplantation in Taiwan: an overview.

In Taiwan, a country with 21 million people, 388 bone marrow transplants (BMTs), 308 allografts and 80 autografts, were performed in 5 BMT centers from November 1983 to October 1993. The commonest indications were leukemia, aplastic anemia, lymphoma and thalassemia. Campaigns promoting an unrelated marrow donor registry were started in August 1993 and recruited approximately 26,000 volunteers. A peripheral stem cell program is just beginning. The overall results of BMT in Taiwan are comparable to other countries. The complications of BMT are similar to Western series, except that acute GVHD was rarer in one large series; this observation needs further study. A particular indication for allogeneic BMT in Taiwan is thalassemia, accounting for 10% of all patients. Disease-free survival after BMT for thalassemia is 44%; graft rejection is the major cause of treatment failure. Another important issue is the role of hepatitis B virus (HBV) in BMT, since the prevalence of HBV infection in Taiwan is very high (> 90%). Abnormal liver function is currently the most common complication and might be related to HBV. Among nearly 100 allogeneic BMTs with HBV carriers as either donor or recipient, 2 patients (approximately 2%) died of HBV-related hepatic failure. Whether the HBV status of the donor and recipient is an important prognostic factor remains to be defined.

Anemia, Aplastic↗

Study on some biological and antigenic characteristics of CA24v isolates in Taiwan in 1985-1989.

In order to understand the relationship between the CA24v isolates which caused two epidemics of acute hemorrhagic conjunctivitis (AHC) in 1985-1986 and 1988-1989 in Taiwan, biological and antigenic characteristics were studied with four CA24v strains, L077/85, V116/86, 590/88 and 722/89, which were isolated during the epidemics. The prototype strain, EH24/70, was used for comparison. In terms of cross neutralization, kinetic neutralization, plaque assay and protein electrophoresis, no obvious differences were found between the isolates from the two epidemics though differences were found between these isolates and the prototype.

Conjunctivitis, Acute Hemorrhagic↗

Cell density-dependent DNA fragmentation and its suppression by heparin in primary culture of adult rat hepatocytes.

We show here that the internucleosomal DNA fragmentation, which is a biochemical hallmark of apoptosis, was induced in a cell density-dependent manner in primary culture of adult rat hepatocytes. This DNA fragmentation could be suppressed by a gene expression inhibitor, indicating the active nature of this process. Moreover, the viability changes in high and low cell density cultures showed a tendency corresponding with the incidence of the DNA fragmentation in them. These results suggest that in hepatocytes there may be a cell density-dependent apoptosis mechanism. In this report, we also show that heparin could suppress this DNA fragmentation with high specificity, and the cell death to some extent.

Animals↗

Anaerobic threshold and maximal oxygen consumption during arm cranking exercise in paraplegia.

The major purpose of this investigation was to compare the anaerobic threshold (AT) and maximal cardiopulmonary responses to arm exercise between persons with paraplegia and the able-bodied. The locomotive stress on the heart in paraplegic subjects was also examined. Thirty-nine paraplegic subjects (T1-L4 lesions) and 32 able-bodied subjects completed a continuous, progressive, resisted arm cranking exercise test. The AT was determined from the ventilatory parameters. At the AT, the mean values of Vo2/body weight (BW) for class II (T1-T5, N = 9), III (T6-T10, N = 11), and IV (T11-L4, n = 19) paraplegic subjects were 10.9, 13.2, and 13.5mL/kg/min, respectively, and only class II had significantly lower value than the able-bodied (14.4mL/kg/min). During maximal exercise, the mean values of maximal oxygen consumption per body weight (Vo2max/BW) for class II and III paraplegics were 17.4 and 17.7mL/kg/min, respectively, which were significantly lower (p < 0.05) than that of class IV (21.3mL/kg/min) and the able-bodied (28.2mL/kg/min). The heart rate (HR) during wheelchair-propelling (119bpm, n = 37) was significantly less than that at the AT (134bpm), but the HR during crutch-walking (151bpm, n = 17) was significantly higher. The results indicate that both submaximal and maximal cardiopulmonary functions in high-lesion paraplegics were less than that of the able bodied. Furthermore, the intensity of wheelchair-propelling at comfortable speed is not enough for improving the cardiopulmonary functions.

Adult↗

Cytogenetic characterization of Epstein-Barr virus-associated T-cell malignancies.

Recently, Epstein-Barr virus (EBV) infection has been found not only to be associated with Burkitt lymphoma and nasopharyngeal carcinoma but also with some T-cell malignancies. Cytogenetic studies were performed on four Chinese patients with EBV-associated T-cell neoplasms: three peripheral T-cell lymphomas and one large granular lymphocyte leukemia with coexpression of T-cell antigen. Clonal chromosomal abnormalities were detected in all four patients. Rearrangements of chromosome 7 were observed in three patients: one at 7p22, one at 7q35 or 36, and the remaining one at both sites. The last patient also had a chromosomal abnormality involving 14q11. Trisomy of part of the 1q segment was detected in two patients. The results revealed that the chromosomal abnormalities in these patients were similar to those observed in other T-cell lymphomas. Further studies on more patients are necessary to find out whether there are specific chromosomal aberrations in EBV-associated T-cell neoplasms.

Adolescent↗