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Biomedical subjects

L C Lin

Publications and source records attributed to L C Lin.

At least 37 records · Page 2Linked to original sources

Ultrasonic tissue characterization evaluates myocardial viability and ischemia in patients with coronary artery disease.

To evaluate whether or not ultrasonic tissue characterization (UTC) can detect jeopardized or salvageable myocardium in patients having chronic coronary artery disease, we studied 103 patients with sequential UTC, dobutamine stress echocardiography (DSE) and (201)thallium stress-reinjection single-photon emission computed tomography (T1-SPECT). This revealed that the weighted amplitude of the cyclic modulation of integrated backscatter was larger for the myocardium with less ischemia burden or greater viability (p<0.001). The segments with larger ischemia burden or the nonviable myocardium demonstrated the contrary result. Using the receiver-operating characteristic curve analyses to determine the cutoff value of weighted amplitude for various predictions, UTC can detect ischemia in normokinetic myocardium (kappa = 0.34 compared to DSE or T1-SPECT) and viability in dyssynergic myocardium (kappa = 0.57 compared to DSE and 0.45, to T1-SPECT). These observations show that UTC may prove useful in the identification and pathophysiological understanding of myocardial ischemia and viability.

Cardiotonic Agents↗

Ultrasonic tissue characterization with integrated backscatter during inotropic stimulation.

Ultrasonic tissue characterization with integrated backscatter is an objective method to quantitatively define the physical state of the myocardium. To determine if backscatter imaging during inotropic stimulation could be used objectively to determine the myocardial viability and ischemia in patients with ischemic heart disease, the backscatter changes were examined in 23 patients with myocardial infarction during dobutamine stress two-dimensional (2-D) echocardiography. Coronary angiography was performed within 1 to 2 days after the stress test. The results of this study demonstrated that changes in backscatter variability correlated significantly with the wall motion changes in stress echocardiography during dobutamine infusion (p < 0.0001). In addition, it was shown that the backscatter changes were significantly different in various types of myocardial tissue. In 23 healthy control segments, the ultrasonic backscatter variability was preserved and unchanged during inotropic stimulation (p = NS). In 15 viable infarct zones, restoration or an increase in backscatter variability during low-dose dobutamine infusion was noted, this being lost when ischemia developing during high-dose dobutamine infusion (p < 0.01). In 9 nonviable infarct zones, the phase-weighted variation was usually < or = 0 and did not change significantly during inotropic stimulation, regardless of the patency of the infarct-related arteries. In 15 remote ischemic myocardial zones, the backscatter variability was preserved at the baseline level, did not change during low-dose dobutamine infusion, but decreased significantly during high-dose dobutamine stress (p < 0.01). In conclusion, dobutamine stress tissue characterization could offer an objective approach for the detection of myocardial viability and ischemia, and might be a useful adjunct to the conventional stress echocardiography.

Cardiotonic Agents↗

Power Doppler-derived speckle tracking image of intraventricular flow in patients with anterior myocardial infarction: correlation with left ventricular thrombosis.

The abnormal spatial distribution of intraventricular flow is superior to clinical and two-dimensional (2-D) echocardiographic variables in predicting left ventricular thrombosis after myocardial infarction. Echocardiography was prospectively performed in 79 patients within 72 h after anterior wall myocardial infarction onset and repeated before discharge. The apical rotating flow pattern in color flow map was recognized as abnormal. By power Doppler echocardiography, the moving blood could generate speckle tracking images to delineate the intraventricular flow. A swirling flow pattern indicating the compartmentalization of left ventricular blood flow with some blood stagnant in the apical dyssynergic area was identified. The flow pattern shown by the speckle tracking image was superior to the color-flow map in correlating with left ventricular thrombosis. It implicated that the more the detail in which we can describe the blood flow pathway, the more information we can realize.

Adult↗

Cytotoxic biflavonoids from Selaginella delicatula.

Four new biflavonoids-robustaflavone 4'-methyl ether (1), robustaflavone 7,4'-dimethyl ether (2), 2",3" -dihydrorobustaflavone 7,4', -dimethyl ether (3), and 2",3" '-dihydrorobustaflavone 7,4', 7"-trimethyl ether (4)-as well as two known biflavonoids, robustaflavone and amentoflavone, and three caffeoylquinic acids, 3,5-di-O-caffeoylquinic acid, 3, 4-di-O-caffeoylquinic acid, and 4,5-di-O-caffeoylquinic acid, were isolated from Selaginella delicatula. The structures of the new compounds were established by spectroscopic analysis and chemical modification. The cytotoxic activity of these compounds on various tumor cell lines was evaluated, and both compounds 1 and 3 significantly suppressed the growth of Raji and Calu-1 tumor cell lines.

Antineoplastic Agents, Phytogenic↗

Anti-herpes simplex virus type-1 flavonoids and a new flavanone from the root of Limonium sinense.

From the root of Limonium sinense (Girard) Ktze a new (2R,3S)-3,5,7,4'-tetrahydroxy-3',5'-dimethoxyflavanone was isolated and named isodihydrosyringetin (3), together with nine other known compounds, (-)-epigallocatechin 3-O-gallate (1), samarangenin B (2), myricetin (4), myricetin 3-O-alpha-rhamnopyranoside (5), quercetin 3-O-alpha-rhamnopyranoside (6), (-)-epigallocatechin (7), gallic acid (8), N-trans-caffeoyltyramine (9), and N-trans-feruloyltyramine (10). All of them were examined for their inhibitory effects on herpes simplex virus type-1 (HSV-1) replication in Vero cells. Both compounds 1 and 2 exhibited potent inhibitory activities in HSV-1 replication. Comparison of the IC50 values indicated that compounds 1 and 2 had higher inhibitory activities than the positive control acyclovir (38.6 +/- 2.6 vs. 55.4 +/- 5.3 microM, P < 0.001; 11.4 +/- 0.9 vs. 55.4 +/- 5.3 microM, P < 0.0005). Cytotoxicity was unlikely involved because no cell deaths were observable in the Vero cells following 5 day treatments with compound 1 or 2.

Animals↗

Flavonoids and phenolics from Limonium sinense.

From the aerial part of Limonium sinense (Girard) Ktze, a new flavonol glycoside, myricetin 3-O-(2"-O-p-hydroxybenzoyl)-alpha-rhamnopyranoside has been isolated together with known flavonols, flavonol glycosides, flavonol glycoside gallates, flavones, flavanones, flavan-3-ols and gallic acid. The structural determinations of these compounds were based on spectral analyses.

Flavonoids↗

Regulation of cell proliferation, gene expression, production of cytokines, and cell cycle progression in primary human T lymphocytes by piperlactam S isolated from Piper kadsura.

Effects of piperlactam S (C(17)H(13)NO(4); mol. wt. 295) isolated from Piper kadsura on phytohemagglutinin (PHA) stimulated cell proliferation were studied in primary culture of human T cells. The results showed that piperlactam S suppressed T cell proliferation at about 0 to 12 h after stimulation with PHA. Synthesis of total cellular proteins and RNA in activated cell cultures was also suppressed. The inhibitory action of piperlactam S was not through direct cytotoxicity. Cell cycle analysis indicated that piperlactam S arrested the cell cycle progression of activated T cells from the G(1) transition to the S phase. In an attempt to further localize the point in the cell cycle at which arrest occurred, a set of key regulatory events leading to the G(1)/S boundary, including gene expression of cytokines and c-Fos protein synthesis, was examined. Piperlactam S suppressed, in activated T lymphocytes, the production and mRNA expression of cytokines such as interleukin-2 (IL-2), IL-4, and interferon-gamma in a dose-dependent manner. In addition, Western blot analysis indicated that c-Fos protein expressed in activated T lymphocytes was decreased by piperlactam S. Results of kinetic study indicated that inhibitory effects of piperlactam S on IL-2 mRNA expressed in T cells might be related to blocking c-Fos protein synthesis. Thus, the suppressant effects of piperlactam S on proliferation of T cells activated by PHA seemed to be mediated, at least in part, through inhibition of early transcripts of T cells, especially those of important cytokines, IL-2, IL-4, and arresting cell cycle progression in the cells.

Adult↗

Integrated backscatter for quantification and risk stratification of blood stagnation in left atrial appendages of patients with rheumatic mitral stenosis.

This study was designed to quantify the blood stagnation in left atrial appendages (LAA) of patients with rheumatic mitral stenosis, and to stratify the risk of spontaneous echo contrast (SEC) for thrombus formation. A total of 45 patients were enrolled in this study. Thirty of the 45 patients had rheumatic mitral stenosis. All the above patients were evaluated for LAA contractility by transesophageal echocardiography. Acoustic density of the stagnant blood was assessed using the integrated backscatter (IBS) mode. Multivariate linear regression analysis showed that the significant independent variables determining relative IBS in LAA were the mitral valve area (p = 0.02) and the atrial fibrillation rhythm (p = 0.0003). In patients with mitral stenosis, the IBS in LAA correlated well with the presence of thrombus (p = 0.004) and SEC (p = 0.002). Using the relative IBS in LAA with 6.8 dB as the cutoff value, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of SEC formation in LAA was 83, 86, 95, 60 and 83%, respectively. Using the relative IBS in LAA with 10.0 dB as the cutoff value, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of SEC with thrombus formation in LAA was 80, 80, 67, 89 and 80%, respectively. In conclusion, the blood stasis in LAA can be objectively quantified using IBS. Utilizing different cutoff values, the acoustic densitometry in LAA enables identification of stagnant blood which represents a risk for the development of either SEC only or SEC with thrombus formation.

Adolescent↗

Intraventricular isovolumic relaxation flow patterns improve the predicting power of Doppler echocardiography for the left ventricular filling pressure in patients with anterior wall myocardial infarction.

BACKGROUND AND PURPOSE: Previous studies have shown that left ventricular systolic asynchrony affects both the relaxation and filling phases of diastole. The purpose of this study was to delinate how the anterior wall dyssynergy influenced the intraventricular flow redistribution patterns during the isovolumic relaxation (IVR) period, which delineated the changes in diastolic suction performance and, therefore, determined the significant Doppler flow variables for predicting left ventricular filling pressure. METHODS: Seventy-three patients with anterior wall myocardial infarction and dyssynergy were enrolled. Those who exhibited the whole IVR intraventricular flow redistributing toward the mitral apparatus, which indicated the reverse physiologic intraventricular pressure gradient in early diastole, were classified as group B, otherwise, as group A. The Doppler echocardiographic variables of mitral inflow were correlated with the left ventricular end-diastolic pressures (LVEDP). RESULTS: With lower ejection fraction rate and more apical dyssynergy, the group B patients had much slower mitral flow propagation. For group A patients, the independent determinants for LVEDP were the ratio of mitral flow propagation rate to peak velocity in early diastole, the early mitral flow deceleration time and the IVR time, all occurring in early diastole. In contrast, the only independent determinant for LVEDP in group B patients was the ratio of mitral peak flow velocity in early diastole to that in late diastole. CONCLUSIONS: The intraventricular IVR flow patterns could delineate how the left ventricular systolic dyssynergy influenced the diastolic process, and determine which echocardiographic variables were more useful for predicting LVEDP in patients with anterior wall myocardial infarction.

Adult↗

Persistent myocardial ischemia after termination of dipyridamole-induced ventricular tachycardia by intravenous aminophylline: scintigraphic demonstration.

Ventricular tachycardia is a rare complication of dipyridamole stress testing. We present a case in which dipyridamole induced symptomatic ventricular tachycardia. The patient, a 41-year-old man with a history of chest discomfort on exertion for 1 year, underwent dipyridamole thallium imaging. Sustained ventricular tachycardia occurred 1 minute and 40 seconds after completion of the dipyridamole infusion. Intravenous aminophylline (125 mg) was given immediately and the tachycardia was terminated. Two minutes later, thallium-201 was injected and subsequent myocardial imaging showed reversible perfusion defects in the inferior wall, septum, and apex. Coronary angiography revealed three-vessel disease. This case discloses that reversible perfusion defects can still be demonstrated on thallium scan in spite of injection of aminophylline, an antagonist of dipyridamole, before thallium administration.

Adult↗

Significance of dobutamine-induced ST-segment evaluation and T-wave pseudonormalization in patients with Q-wave myocardial infarction: simultaneous evaluation by dobutamine stress echocardiography and thallium-201 SPECT.

The clinical significance of stress-induced ST-segment elevation and T-wave pseudonormalization in infarct-related leads is still controversial. Therefore, we conducted the present study to assess this issue using simultaneous dobutamine stress echocardiography (DSE) and thallium-201 single-photon emission computed tomography. A total of 119 patients with Q-wave myocardial infarction were enrolled in this study. There were 58 patients with (group I) and 61 patients without (group II) dobutamine-induced ST-T changes. Left ventricular ejection fraction was 43 +/- 13% in group I and 49 +/- 14% in group II (p <0.05). The baseline, low-, and peak-dose global wall motion scores were similar between these 2 groups (26.2 +/- 6.1 vs 26.2 +/- 6.3 [p = NS]; 24.1 +/- 5.3 vs 23.5 +/- 5.7 [p = NS]; 26.4 +/- 5.7 vs 26.7 +/- 6.1 [p = NS]). The sensitivity, specificity, and accuracy of these ST-T changes for detecting residual myocardial viability and ischemia documented by DSE in all patients were 50%, 53%, and 51% (for viability), and 47%, 48%, and 47% (for ischemia), respectively. The sensitivity, specificity, and accuracy of these ST-T changes for detecting a reversible perfusion defect documented by thallium-201 single-photon emission computed tomography were 51%, 54%, and 52%, respectively. In conclusion, dobutamine-induced ST elevation and/or T-wave pseudonormalization is associated with poor resting left ventricular function. These ST-T changes are not associated with residual myocardial ischemia and viability in the infarct area. Therefore, these electrocardiographic changes alone cannot be reliably considered as distinctive markers in formulating the therapeutic strategy of coronary intervention.

Cardiotonic Agents↗

Alterations in ultrasonic backscatter during intra-aortic balloon counterpulsation support in patients with acute myocardial infarction.

Alterations of ultrasonic backscatter parameters have been evident in humans with myocardial infarction or ischemia. The backscatter variability could be restored in ischemic or stunned myocardium after reperfusion. The aims of this study were to determinate changes in regional myocardial ultrasonic backscatter during intra-aortic balloon counterpulsation (IABP) support in patients with acute myocardial infarction (AMI), and to evaluate whether backscatter imaging could be a functional guide of IABP support. A total of 9 patients with AMI were investigated during IABP support with a two-dimensional (2-D) ultrasonic backscatter imaging approach for parasternal short-axis view. Coronary angiography was performed in 6 of the 9 patients. A total of 21 vessel territories were studied in different modes of IABP support: 1:1, 1:2 and standby. Restoration of cyclic variation of backscatter after IABP support was demonstrated in 10 vessel territories. Failure of restoration of cyclic variation of backscatter after IABP support was noted in 6 vessel territories with severe coronary lesions (total or nearly total occlusion) or scar tissue. No changes of the ultrasonic backscatter were found in nonischemic vessel territories with patent coronary arteries or TIMI III coronary flow. In addition, the wall motion score did not change significantly with different IABP support. These results suggest that IABP could restore the cyclic variation of backscatter in ischemic myocardium. Myocardial anisotropy may play an influential role in the alterations of ultrasonic backscatter. We propose that ultrasonic backscatter could be a noninvasively functional guide of IABP use in patients with AMI.

Aged↗

Immunomodulatory principles of Dichrocephala bicolor.

From the ethanolic extract of Dichrocephala bicolor eight compounds-4,5-dicaffeoyl quinic acid (1); 3,4-dicaffeoyl quinic acid (2); 3,5-dicaffeoyl quinic acid (3); ethyl 4,5-dicaffeoyl quinate (4); methyl 3,5-dicaffeoyl quinate (5); 5-caffeoyl quinic acid (6); caffeic acid (7); and quercetin-3-O-rutinoside (8)-were isolated and identified. All of them were selected for immunopharmacological activity testing. Human mononuclear cells (HMNC) were used as target cells. Cell proliferation was determined by 3H-thymidine uptake. Compounds 2 and 6 potently enhanced HMNC proliferation and interferon-gamma production. Enhancement mechanisms may involve the increase of cytokines production.

Adjuvants, Immunologic↗

The effectiveness of acupressure in improving the quality of sleep of institutionalized residents.

BACKGROUND: Elderly people often suffer from disturbed sleep. Because traditional Chinese medicine indicates that acupressure therapy may induce sedation, testing the effectiveness of acupressure in enhancing the quality of sleep of institutionalized residents with a well-designed scientific study is needed. METHODS: A randomized block experimental design was used. The Pittsburgh Sleep Quality Index (PSQI) questionnaire was used as a screening tool to select subjects with sleep disturbance. By matching the effects of hypertension, hypnosis, naps, and exercise, subjects were randomly assigned to an acupressure group, a sham acupressure group, and a control group. Each group had 28 subjects for a total of 84 subjects. The same massage routine was used in the acupressure group and the sham acupressure group, whereas only conversation was employed in the control group. RESULTS: There were significant differences in PSQI subscale scores of the quality, latency, duration, efficiency, disturbances of sleep, and global PSQI scores among subjects in the three groups before and after interventions. Furthermore, there was a significant reduction in the frequencies of nocturnal awakening and night wakeful time in the acupressure group compared to the other two groups. CONCLUSIONS: This study confirmed the effectiveness of acupressure in improving the quality of sleep of elderly people and offered a nonpharmacological therapy method for sleep-disturbed elderly people.

Acupressure↗

Portal hypotensive effects of combined terlipressin and DL-028, a synthetic alpha 1 adrenoceptor antagonist administration on anesthetized portal hypertensive rats.

AIMS/BACKGROUND: The purpose of this study was to investigate the therapeutic effects of terlipressin, alone or in combination with DL-028, a synthetic alpha 1-adrenoceptor antagonist on anesthetized portal hypertensive rats. METHODS: Portal hypertension was induced by either partial portal vein ligation (PVL) or bile duct ligation (BDL) in Sprague-Dawley rats. Each portal hypertensive rat received only one of the two regimens: vehicle plus terlipressin or DL-028 plus terlipressin. Terlipressin dosage was 0.017 mg/kg/min infused for 3 min, while vehicle or DL-028 (0.50 microgram/kg/min) was continuously infused for 40 min, starting 10 min before terlipressin infusion. RESULTS: In PVL rats, infusions of vehicle plus terlipressin induced significant, maximum reduction of portal venous pressure (PVP, -11.0 +/- 1.8%) and prominent elevation of mean arterial pressure (MAP, 50.3 +/- 9.0%) from baseline. Infusions of DL-028 plus terlipressin induced maximum PVP reduction (-17.5 +/- 2.8%) and MAP elevation (39.8 +/- 7.4%). In BDL rats, infusion of vehicle plus terlipressin also induced significant, maximum reduction of PVP (-6.8 +/- 2.1%) and prominent elevation of MAP (61.4 +/- 7.8%) from baseline. Infusions of DL-028 plus terlipressin induced maximum PVP reduction (-17.9 +/- 2.2%) and MAP elevation (47.9 +/- 7.4%). Compared to vehicle plus terlipressin, DL-028 significantly enhanced portal hypotensive effects of and attenuated systemic pressor effects of terlipressin in both PVL and BDL rats. CONCLUSIONS: Our results suggest that terlipressin, alone or in combination with DL-028, induced portal hypotensive effects in portal hypertensive rats. The combination of terlipressin with DL-028 was beneficial in enhancing the portal hypotensive effects and ameliorating the systemic pressor effects of terlipressin.

Adrenergic alpha-Antagonists↗

Disease-inducible transgene expression from a recombinant adeno-associated virus vector in a rat arthritis model.

Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting 1% of the world's population, with significant morbidity and mortality. In this study, we investigated a recombinant adeno-associated virus (rAAV) vector for its potential application in RA gene therapy. rAAV encoding Escherichia coli beta-galactosidase was injected into rat joints which had already been induced into acute arthritis after local lipopolysaccharide (LPS) administration, and the efficiency of in vivo transduction was evaluated. We observed a striking correlation between vector transgene expression and disease severity in arthritic joints. The inflammatory reaction peaked at 3 to 7 days after LPS treatment, and, at the same time, 95% of the synoviocytes had high-level transgene expression. Gene expression diminished to the basal level (5%) when the inflammation subsided at 30 days after LPS treatment. More importantly, the diminished transgene expression could be efficiently reactivated by a repeated insult. The transgene expression in normal joints transduced with rAAV remained low for a long period of time (30 days) but could still be induced to high levels (95%) at 3 to 7 days after LPS treatment. This is the first demonstration of disease state-regulated transgene expression. These findings strongly support the feasibility of therapeutic as well as preventative gene transfer approaches for RA with rAAV vectors containing therapeutic genes, which are expected to respond primarily to the disease state of the target tissue.

Animals↗

Evaluation of pre- and postdilutional on-line hemodiafiltration adequacy by partial dialysate quantification and on-line urea monitor.

On-line highflux hemodiafiltration (HDF) is a clinically interesting and effective mode of renal replacement therapy, which offers the possibility to obtain an increased removal of both small and large solutes. The fundamental role of urea kinetic monitoring to assess dialysis adequacy in conventional hemodialysis has been widely studied. Both direct measurement of the urea removed by the modified direct dialysate quantitation (mDDQ) based on partial dialysate collection (PDC) and dialysate-based urea kinetic modeling (DUKM) using urea monitor have been advocated. The validity of this assessment tool in the patients with on-line HDF remained unclear. The aims of this investigation were (1) to compare the delivered Kt/V, urea mass removal (UMR), solute removal index (SRI) and normalized protein catabolic rate (nPCR) between pre- and postdilutional high-flux HDF; (2) to verify and compare the efficiency of pre- and postdilutional HDF using DUKM with on-line dialysate urea sensor, and mDDQ with partial dialysate collection. During both mode of HDF, the paired analysis urea removed and Kt/V showed no significant difference. Using mDDQ, mean values for predilutional mode were as follows: Kt/V 1.53 +/- 0.01 UMR, 16.8 +/- 0.3 g/session; urea clearance 178 +/- 18 ml/min; SRI 75.5 +/- 7.7%; urea distribution volume (V) 28.3 +/- 1.2 liters; nPCR 1.34 +/- 0.18 g/kg/day; on the other hand, mean values for postdilutional mode were Kt/V 1.58 +/- 0.01; UMR 17.10 +/- 0.28 g/session; urea clearance 184 +/- 21 ml/min; SRI 77.2 +/- 3.5%; urea distribution volume, 27.8 +/- 1.5 liters; nPCR 1.34 +/- 0.19 g/kg/day. The mean value of urea generation rate was 5.82 +/- 1.12 mg/min during HDF. Our results showed that dialysis adequacy was achieved with both high-volume predilutional HDF and postdilutional HDF. These two modes of HDF provided similar and adequate small solute clearance. In addition, we found that on-line analysis of urea kinetics is a reliable tool for quantifying and assuring delivery of adequate dialysis.

Adult↗

Surgery for symptomatic Freiberg's disease: extraarticular dorsal closing-wedge osteotomy in 13 patients followed for 2-4 years.

From 1992 through 1995, we have treated 13 patients (10 men) with Freiberg's disease by debridement and dorsal closing-wedge osteotomy of the metatarsal neck. The lesion was located in the second metatarsal head in 10 patients and in the third metatarsal head in 3. After osteotomy, the lesion was away from the joint, so that the smooth and healthy articular cartilage of the metatarsal head faced the phalangeal cartilage. The average follow-up period was 40 (28-54) months. The subjective outcome was good or excellent in 11 patients, fair in 1, and poor in 1. We found MRI useful in determining the extent of the lesion when planning correction.

Activities of Daily Living↗