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Biomedical subjects

Lee-Wen Huang

Publications and source records attributed to Lee-Wen Huang.

At least 19 recordsLinked to original sources
PubMed2007

Adipocyte resistin mRNA levels are down-regulated by laparoscopic ovarian electrocautery in both obese and lean women with polycystic ovary syndrome.

BACKGROUND: The aim of this study was to investigate serum and adipocyte mRNA expression of resistin in lean and obese women with polycystic ovary syndrome (PCOS) before and 3 months after laparoscopic ovarian electrocauterization (LOE). METHODS: Adipose tissue obtained from 12 women with PCOS (six obese and six lean, body mass index > 27 kg m(-1) as threshold point) before and after LOE was analysed. Gene expression of resistin was measured by semi-quantitative RT-PCR. Ten lean, age-matched healthy women served as controls. RESULTS: Both lean and obese women with PCOS had significantly higher fasting and 2 h insulin and homeostasis model insulin resistance index (HOMA(IR)) values and lower fasting glucose-to-insulin ratios (G(0)/I(0)) than did the controls. The serum levels of glucose and insulin and HOMA(IR) were significantly decreased, and the G(0)/I(0) ratio was significantly increased 3 months after LOE. No difference was found in serum resistin levels between controls and either obese or lean women with PCOS before LOE, nor between PCOS patients before and after LOE. However, resistin mRNA expression levels in both lean and obese women with PCOS before LOE were significantly higher than that in controls and were decreased significantly after LOE back to control levels. CONCLUSION: Local resistin activity may be actively involved in the pathogenesis of PCOS. LOE reduces insulin resistance and down-regulates resistin mRNA expression in lean and obese women with PCOS.

Adipocytes↗
PubMed2007

Amelioration of insulin resistance in women with PCOS via reduced insulin receptor substrate-1 Ser312 phosphorylation following laparoscopic ovarian electrocautery.

BACKGROUND: Increased Ser(312) phosphorylation of insulin receptor substrate (IRS)-1 is one possible molecular mechanism of insulin resistance in polycystic ovary syndrome (PCOS). We investigated whether laparoscopic ovarian electrocautery (LOE) improved insulin sensitivity in women with PCOS and examined the underlying molecular mechanism of LOE. METHODS: Adipose tissue and blood samples from 12 women with PCOS before, and 3 months after, LOE were analysed. RESULTS: Before LOE, women with PCOS were found to have significantly higher 2 h glucose, fasting and 2 h insulin levels, homeostasis model insulin resistance index and lower fasting glucose-to-insulin ratio (G(0)/I(0)) than healthy, lean, age-matched controls. Serum levels of glucose and insulin were significantly decreased, and G(0)/I(0) ratio was significantly increased 3 months after LOE. Levels of activated extracellular signal-regulated kinase 1/2 in PCOS women were higher than in controls, but were significantly decreased after LOE. Levels of insulin receptor, glucose transporter-4 and phosphatidylinositol 3-kinase were lower in PCOS patients before LOE than in controls and increased after LOE. Levels of Ser(312)-phosphorylated IRS-1 in PCOS women before LOE were higher than in controls and decreased significantly after LOE, whereas IRS-1 tyrosine phosphorylation in PCOS women before LOE was lower than in controls and increased significantly after LOE. CONCLUSION: Over the short observation period of this study, our results demonstrated that LOE effectively ameliorated insulin resistance in women with PCOS via decreased IRS-1 Ser(312) phosphorylation.

Body Mass Index↗
PubMed2006

Human papillomavirus DNA in triple neoplasms of the cervix, perianus and ureter in one woman.

BACKGROUND: Multiple malignancies of the urogenital tract have been reported. We investigated the etiological role of human papillomavirus (HPV) in the pathogenesis of urogenital cancers. CASE: We present a case of cervical squamous carcinoma in a 64-year-old woman who subsequently developed Bowen's disease in the perianal skin and transitional cell carcinoma of the ureter. HPV DNA was detected in these tumor specimens using polymerase chain reaction. CONCLUSION: The results strongly suggest that HPV may play a major role in the carcinogenesis of urogenital and perianal tumors.

Carcinoma, Squamous Cell↗
PubMed2006

Outcomes and complications of laparoscopically assisted vaginal hysterectomy.

OBJECTIVE: To report whether operative time, intraoperative complications, and rate of conversion to laparotomy decreased after physicians had acquired an additional 4years experience with laparoscopically assisted vaginal hysterectomy (LAVH). METHODS: Group 1 (n=462) included the women who underwent LAVH from May 1, 1994 to December 31, 1997, and group 2 (n=583) included those who underwent LAVH from January 1, 1998 to December 31, 2001. RESULTS: The mean duration of surgery in groups 1 and 2 was 146 and 114 min, respectively, and the difference was significant (P<0.0001). The overall complication rate in the last 4years of the study was 7.1%, which was significantly lower than the 13.4% calculated for the first 4years (P=0.001). CONCLUSION: Operative time as well as rates of surgical complications and conversion to laparotomy decreased with increased surgeon experience at performing LAVH.

Clinical Competence↗
PubMed2006

Disability in patients with degenerative lumbar spinal stenosis.

OBJECTIVE: To determine factors associated with disability in patients with degenerative lumbar spinal stenosis. DESIGN: One-group cross-sectional study. SETTING: University hospital. PARTICIPANTS: One hundred eight patients with degenerative lumbar spinal stenosis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Oswestry Disability Index and 4 categories of factors, including patient demographics (age, sex, number of comorbidities, medications), symptom-related factors (intensity, location, onset duration, neurogenic claudication), body structure and function as described in the International Classification of Functioning, Disability and Health model (muscle strength, vibration sense, spine flexibility), and stenotic condition (type and number of spinal segments involved). RESULTS: Patients with symptoms in both back and leg reported greater disability than those with symptoms only in the leg or back (P=.008). Greater disability correlated significantly with greater symptom intensity (r=.385, P<.001) and higher vibration threshold (r=.236, P=.014). While controlling the variance in patient demographics in the regression analysis, vibration sense and symptom location each added 10% of the variance in disability, and symptom intensity and strength each added 5%, with a total of 44% variance explained (P=.044). CONCLUSIONS: Symptom intensity and location, vibration sense, and muscle strength were identified as significant factors and, together with patient demographics, accounted for 44% of the variance explained in disability. Further investigations are needed to determine if causal relationships exist between these factors and disability.

Age Distribution↗
PubMed2006

Comparison of outcome of clomiphene citrate/human menopausal gonadotropin/cetrorelix protocol and buserelin long protocol--a randomized study.

This study evaluates the efficacy of a stimulation protocol with clomiphene citrate (CC)/human menopausal gonadotropin (hMG)/cetrorelix and its effects on oocyte quality and endometrium. One hundred and twenty couples with male-factor infertility who were about to undergo their first intracytoplasmic sperm injection cycles were randomized into two groups. Sixty women were stimulated with the CC/hMG/cetrorelix protocol (cetrorelix group) and 60 received the buserelin long protocol (buserelin group). Fewer oocytes were recovered in the cetrorelix group than in the buserelin group (mean +/- standard deviation (SD): 11.1 +/- 4.0 vs. 17.3 +/- 5.8, p < 0.001); however, the percentages of metaphase II, metaphase I and germinal vesicle oocytes were similar between the two groups. Serum estradiol level was significantly lower in the cetrorelix than in the buserelin group (mean +/- SD: 2600.58 +/- 1189.11 vs. 3293.46 +/- 1221.49 pg/ml, p = 0.006), but the endometrial thickness was similar. The implantation rates (19.2% vs. 17.7%) and the pregnancy rates (41.7% vs. 40.0%) were similar between groups. The ampoules (mean +/- SD: 18.9 +/- 3.0 vs. 38.9 +/- 12.2, p < 0.001) and injections (mean +/- SD: 6.8 +/- 1.1 vs. 15.7 +/- 3.1, p < 0.001) of gonadotropin used were significantly lower in the cetrorelix group than in the buserelin group. No patients in either group developed a premature luteinizing hormone surge. The present study found no statistically significant difference between the two treatment modalities with regard to pregnancy rates.

Adult↗
PubMed2005

IVF versus ICSI in sibling oocytes from patients with polycystic ovarian syndrome: a randomized controlled trial.

BACKGROUND: This study compares the fertilization rate and embryonic development of oocytes randomly inseminated by conventional IVF or ICSI in patients with polycystic ovarian syndrome (PCOS) and normozoospermic semen during IVF cycles. METHODS: Sibling oocytes were randomized to be inseminated either by ICSI or IVF. Fertilization rate (two pronuclei/COC), day 2 embryonic morphology and rate of development were assessed. RESULTS: A total of 1089 cumulus-oocyte complexes (COC) were collected in 60 cycles (mean+/-SD, 18.2 +/- 7.2). Totals of 541 and 548 COC were inseminated by IVF and ICSI respectively, with a significantly higher fertilization rate in the ICSI group (ICSI versus IVF, 72.3 +/- 15.5 versus 44.8 +/- 25.1%). No fertilization failure occurred in the group of oocytes inseminated by ICSI, whereas the COC in nine patients (15%) inseminated by IVF had complete fertilization failure. The day 2 embryonic morphology and rate of development were not different regardless of the insemination method. CONCLUSIONS: Our results suggested that another randomized controlled study, randomizing patients instead of sibling oocytes, should be undertaken to compare the pregnancy rate per started cycle and to see whether ICSI should be performed on all, or at least on a portion of, oocytes for patients with PCOS undergoing IVF cycles.

Adult↗
PubMed2005

Cementless total hip arthroplasty and limb-length equalization in patients with unilateral Crowe type-IV hip dislocation.

BACKGROUND: Total hip arthroplasty in patients with unilateral congenital high dislocation of the hip (Crowe type IV) presents many challenges, including the problem of a marked limb-length discrepancy. The purpose of this retrospective study was to analyze the results of total hip replacement with limb-length equalization in these patients. METHODS: From 1988 to 1996, fifty-six patients (forty-seven women and nine men) with unilateral Crowe type-IV dislocation of the hip were treated with a cementless total hip arthroplasty at a mean age of 35.4 years. The preoperative limb-length discrepancy averaged 4.9 cm. Prior to the total hip arthroplasty, forty-eight patients with a limb-length discrepancy of >4.0 cm underwent iliofemoral distraction with use of an external fixator for eight to seventeen days. The acetabular cup was placed in the anatomical position in every patient. Shortening femoral osteotomies were not required. RESULTS: The iliac fixator pins loosened in six patients. No patient had a pin-site infection, hip joint infection, or nerve palsy. At the time of follow-up, at an average of 147.2 months, the Harris hip score averaged 90.2 points. Overall, the mean lengthening after the total hip arthroplasty was 4.6 cm. There were no revisions of the femoral stem. Nine cups were revised, four because of polyethylene wear and five because of loosening. CONCLUSIONS: We were able to safely place the acetabular cup at the anatomical position without femoral shortening by bringing the femoral head to the normal level preoperatively; thus, we could restore nearly normal limb length. We believe that our twelve-year results are similar to those of total hip arthroplasty in patients without dysplasia.

Adult↗
PubMed2004

Mediation of Endogenous beta-endorphin by Tetrandrine to Lower Plasma Glucose in Streptozotocin-induced Diabetic Rats.

The role of beta-endorphin in the plasma glucose-lowering action of tetrandrine in streptozotocin-induced diabetic rats (STZ-diabetic rats) was investigated. The plasma glucose concentration was assessed by the glucose oxidase method. The enzyme-linked immunosorbent assay was used to determine the plasma level of beta-endorphin-like immunoreactivity (BER). The mRNA levels of glucose transporter subtype 4 (GLUT4) in soleus muscle and phosphoenolpyruvate carboxykinase (PEPCK) in the liver of STZ-diabetic rats were detected by Northern blotting analysis. The expressed protein of GLUT4 or PEPCK was characterized by Western blotting analysis. Tetrandrine dose-dependently increased plasma BER in a manner parallel to the decrease of plasma glucose in STZ-diabetic rats. Moreover, the plasma glucose-lowering effect of tetrandrine was inhibited by naloxone and naloxonazine at doses sufficient to block opioid μ-receptors. Further, tetrandrine failed to produce plasma glucose-lowering action in opioid μ-receptor knockout diabetic mice. Bilateral adrenalectomy eliminated the plasma glucose-lowering effect and plasma BER-elevating effect of tetrandrine in STZ-diabetic rats. Both effects were abolished by treatment with hexamethonium or pentolinium at doses sufficient to block nicotinic receptors. Tetrandrine enhanced BER release directly from the isolated adrenal medulla of STZ-diabetic rats and this action was abolished by the blockade of nicotinic receptors. Repeated intravenous administration of tetrandrine (1.0 mg/kg) to STZ-diabetic rats for 3 days resulted in an increase in the mRNA and protein levels of the GLUT4 in soleus muscle, in addition to the lowering of plasma glucose. Similar treatment with tetrandrine reversed the elevated mRNA and protein levels of PEPCK in the liver of STZ-diabetic rats. The obtained results suggest that tetrandrine may induce the activation of nicotinic receptors in adrenal medulla to enhance the secretion of beta-endorphin, which could stimulate opioid μ-receptors to increase glucose utilization or/and reduce hepatic gluconeogenesis to lower plasma glucose levels in STZ-diabetic rats.

Journal Article↗
PubMed2004

Ovarian stimulation by concomitant administration of cetrorelix acetate and HMG following Diane-35 pre-treatment for patients with polycystic ovary syndrome: a prospective randomized study.

BACKGROUND: Patients with polycystic ovary syndrome (PCOS) may need a longer period of pituitary downregulation to suppress the elevated serum LH and androgen levels effectively during IVF treatment using the GnRH agonist long protocol. We proposed a stimulation protocol incorporating Diane-35 and GnRH antagonist (Diane/cetrorelix protocol) and compared it with the GnRH agonist long protocol for PCOS patients. METHODS: Part I of the study was an observational pilot study to evaluate the hormonal change as a result of the Diane/cetrorelix protocol (n = 26). Part II of the study was a prospective randomized study comparing the Diane/cetrorelix protocol (n = 25) and the GnRH agonist long protocol (n = 24). In the Diane/cetrorelix protocol, patients were pre-treated with three cycles of Diane-35, followed by 0.25 mg of cetrorelix on cycle day 3. From day 4, cetrorelix and gonadotrophin were administered concomitantly until the day of HCG injection. RESULTS: Serum LH, estradiol and testosterone levels were suppressed comparably in both protocols at the start of gonadotrophin administration. Serum LH was suppressed at constant levels without a premature LH surge in the Diane/cetrorelix protocol. The clinical results for both protocols were comparable, with significantly fewer days of injection, lower amounts of gonadotrophin used and lower estradiol levels on the day of HCG injection following the Diane/cetrorelix protocol. Furthermore, there was no significant difference in clinical pregnancy outcome between the two stimulation protocols. CONCLUSIONS: The Diane/cetrorelix protocol has a similar pregnancy outcome to the GnRH agonist long protocol for women with PCOS undergoing IVF treatment.

Adult↗
PubMed2004

Ovarian pregnancy torsion.

INTRODUCTION: Ovarian-cyst torsion is often seen in early pregnancy due to progesterone stimulation. It is the fifth-most-common gynecological emergency, with a reported incidence of 3%. An ectopic pregnancy implanted in the ovary is rare, occurring in only 0.5-1% of such pregnancies. CASE REPORT: We presented a case of ovarian pregnancy with concomitant ipsilateral side tubal torsion managed by laparoscopy. DISCUSSION AND CONCLUSIONS: Varying density distribution in the ovary can predispose to ovarian torsion. Emergency surgery may offer the possibility of avoiding the ablation of functional ovarian tissue. Early detection and prompt management can preserve fertility and ovarian function. The etiology, presenting syndrome and management are discussed.

Adult↗
PubMed2004

Human papillomavirus-31-related types predict better survival in cervical carcinoma.

BACKGROUND: The aim of the current study was to explore the clinical implications and prognostic value of human papillomavirus (HPV) genotype in cervical carcinomas. METHODS: A total of 152 patients diagnosed with International Federation of Gynecology and Obstetrics Stage I-IV cervical carcinoma were studied between 1992-1999. HPV DNA status was assessed from paraffin-embedded, formaldehyde-fixed cervical carcinoma specimens by polymerase chain reaction-based methods using E7 type-specific and L1 modified general primers (MY11/GP6+ and GP5+/GP6+). The authors divided the patients into four groups: HPV-16-related, HPV-18-related, HPV-31-related, and HPV-58-related types. The relations with clinicopathologic data and overall survival were evaluated. RESULTS: HPV DNA was detected in 98% of the tumor specimens and 28.9% of the tumor specimens contained multiple HPV types. The HPV-16-related types were detected more often in squamous cell carcinomas, whereas the HPV-18-related types were more prevalent in adenocarcinomas and adenosquamous carcinomas. In addition, Stage I-II diseases were found more frequently in the HPV-16-related group than in the other groups (P = 0.001). Otherwise, no significant correlation between the HPV genotype and other clinicopathologic parameters was found. After a median follow-up of 64.5 months, the 5-year survival rate was 92% in the HPV-31-related group compared with 70% in the HPV-16-related group, 69% in the HPV-18-related group, and 36% in the HPV-58-related group. The survival rates statistically differed among the four groups by log-rank test (P = 0.02). However, the presence of multiple HPV types was not associated with prognosis. After stratifying for clinical stage, multivariate analysis demonstrated that HPV genotype was an independent prognostic factor. Compared with the HPV-16-related group, the long-term mortality rate was 73 % lower in the HPV-31-related group (relative risk, 0.27; 95% confidence interval, 0.09-0.76; P = 0.013). CONCLUSIONS: The presence of HPV-31-related types was an independent predictor of better survival in patients with cervical carcinoma. Therefore, HPV genotyping of cervical carcinomas may have profound implications for future patient management.

Adult↗
PubMed2004

Multiple HPV genotypes in cervical carcinomas: improved DNA detection and typing in archival tissues.

BACKGROUND: Human papillomaviruses (HPV) have been considered to be the necessary and central agents of cervical carcinoma. OBJECTIVE: The aim of this study was to determine the prevalence and genotypes of HPV in archival cervical carcinomas. STUDY DESIGN: The study included 152 paraffin-embedded, formaldehyde-fixed cervical carcinoma specimens. To improve the detection and typing of HPV in archival tissues, we conducted a comprehensive study in which, polymerase chain reaction (PCR)-based methods using E7 type-specific (TS) and L1 modified general primers (MY11/GP6+ and GP5+/GP6+) were employed. RESULTS: Overall HPV prevalence was 98% in the cervical carcinomas. HPV 16 was detected in 66% of the tumors, HPV 18 in 22%, HPV 31 in 13%, HPV 33 in 9%, and HPV 58 in 9%. Notably, multiple HPV types were present in 44 (28.9%) of the 152 cervical carcinomas. The most common co-infections were HPV types 16/18 (12 cases), followed by HPV types 16/31 (7 cases). Additionally, HPV 18 was more frequent in adenocarcinomas and adenosquamous carcinomas (86%) than in squamous cell carcinomas (15.8%) (P = 0.0002). CONCLUSIONS: The combination of L1 general primers and E7 type-specific primers can be of use in detecting HPV DNA in archival tissues. The present study showed a high frequency of multiple HPV infections in cervical carcinomas. Hence, relevant HPV typing information in cervical carcinoma is very important for further HPV vaccine design and application.

Adenocarcinoma↗
PubMed2004

Subsequent pregnancy outcome after conservative treatment of a previous cesarean scar pregnancy.

BACKGROUND: To assess pregnancy course and outcome after conservative treatment of a cesarean scar pregnancy. METHODS: During an 8-year period, 15 cases of cesarean scar pregnancies were diagnosed at our institution. Seven of the 14 patients for whom we successfully preserved the uterus became pregnant within 3 years after termination of the scar pregnancy. The year of diagnosis, conservative method and gestational age for these five patients were recorded. Delivery method, time interval between the scar pregnancy and subsequent pregnancy, and maternal and neonatal outcome were evaluated. RESULTS: Seven pregnancies (eight live and one dead baby) were noted. The mean interval between the ectopic pregnancy and subsequent pregnancy was 13.3 months (range 0-34 months). One patient, who became pregnant 3 months after the scar pregnancy was found, suffered uterine rupture at 38.3 weeks' gestational age. Two patients with placental accrete, and one of them who continued the existing intrauterine twin pregnancy after transvaginal sono-guided aspiration of the scar pregnancy received a cesarean hysterectomy at 32 weeks of gestation. The remaining four pregnancies were uneventful, followed by early cesarean sections at 36 weeks. CONCLUSION: The results of this first series of seven subsequent pregnancies after conservative treatment of scar pregnancies are promising. An early cesarean section before over-extension of the uterus and spontaneous labor can help to prevent uterine rupture. Placenta accrete is another severe morbidity of these patients in addition to uterine rupture. Thus a cesarean hysterectomy may be the choice of treatment.

Adult↗
PubMed2004

The plasma glucose lowering action of tetrandrine in streptozotocin-induced diabetic rats.

The effect of tetrandrine, an active principle of Stephaniae tetrandrae, on the plasma glucose level in streptozotocin-induced diabetic rats (STZ-diabetic rats) was investigated. A single intravenous injection of tetrandrine decreased the plasma glucose in a dose-dependent manner in STZ-diabetic rats. Moreover, tetrandrine (1.0 mg x kg(-1)) significantly attenuated the rise in plasma glucose induced by the intravenous glucose challenge test in normal rats. A stimulatory effect of tetrandrine on glucose uptake was obtained in soleus muscles isolated from STZ-diabetic rats with a concentration-dependent manner from 0.01 to 10.0 micromol L(-1). The increase in glucose utilization by tetrandrine was further characterized using the enhancement of glycogen synthesis in the hepatocytes of STZ-diabetic rats. These results suggest that tetrandrine has the ability to enhance glucose utilization in peripheral tissue, resulting in the lowering of plasma glucose in diabetic rats lacking insulin.

Alkaloids↗