Biomedical subjects

M S Huang

Publications and source records attributed to M S Huang.

At least 37 records · Page 2Linked to original sources

PubMed1998

Nonoperative management for extensive hepatic and splenic injuries with significant hemoperitoneum in adults.

BACKGROUND: Although several retrospective studies have been published concerning nonoperative management of minor liver and spleen injuries, few studies have prospectively analyzed the results of nonoperative management for higher-grade liver and spleen injuries. Is it possible to manage extensive hepatic or splenic injuries with hemoperitoneum nonoperatively? The current study was conducted to evaluate the safety of nonoperative management of blunt hepatic and splenic trauma with significant hemoperitoneum in hemodynamically stable patients regardless of injury severity. METHODS: We used the nonoperative methods prospectively to treat consecutive patients with blunt spleen or liver injury during a 35-month period. Patients with unstable conditions underwent emergency laparotomies, and those who were stable underwent abdominal computed tomography for further evaluation. We analyzed the clinical characteristics and the success rate of this method thoroughly. RESULTS: Twenty-four patients with severe hepatic or splenic injuries treated nonoperatively were included in this study. Among these 24 patients, 18 (75%) with hepatic or splenic injuries had grades of III or greater on the Organ Injury Scale. Twenty patients (83.3%) had moderate to large amounts of hemoperitoneum. Four patients (16.7%) failed at observation and underwent emergency celiotomy, two for liver-related and two for spleen-related causes. There were no differences between the nonoperative and operative management groups in terms of mean age, initial systolic blood pressure, initial heart rate, emergency room fluid requirement except emergency blood transfusion, abdominal complications, and hospital length of stay. CONCLUSION: We suggest that nonoperative management may be undertaken successfully in appropriately designed areas with close observation for the hemodynamic stable patient.

Adolescent↗

PubMed1997

Differential activation of viral and cellular promoters by human T-cell lymphotropic virus-1 tax and cAMP-responsive element modulator isoforms.

We have previously proposed that cAMP-responsive element-binding protein (CREB) activity is stimulated by human T-cell lymphotropic virus-1 (HTLV-1) Tax through two mechanisms that are differentially dependent upon CREB phosphorylation. We have tested this model by examining how Tax affects transcriptional activation mediated by the cAMP-responsive element (CRE) modulator (CREM). The CREM proteins are highly homologous to CREB, particularly in their DNA-binding domains and the kinase-inducible domain (KID), a region that interacts with the coactivator CREB-binding protein (CBP) in a phosphorylation-dependent manner. Despite this similarity, most CREM isoforms are transcriptional repressors. CREMalpha lacks the glutamine-rich domains found in CREB that are essential for transcriptional activation. We show that the normally repressive CREMalpha activates the HTLV-1 and cellular CREs in the presence of Tax; activation of the viral element is phosphorylation-independent, and activation of the cellular CRE is phosphorylation-dependent. CREMDelta(C-G) lacks both the KID and the glutamine-rich regions. This isoform activates the HTLV-1 long terminal repeat in a phosphorylation-independent manner, but does not activate the cellular CRE. This study suggests that Tax, interacting with the basic/zipper region of CREM, recruits CBP to the viral promoter. Tax activation of the cellular CRE depends on the KID and its ability to interact with CBP in a phosphorylation-dependent manner.

Animals↗

PubMed1997

Comparison of cytokeratin fragment 19 (CYFRA 21-1), tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) as tumour markers in bronchogenic carcinoma.

To elevate the diagnostic value of the serum cytokeratin 19 fragment (CYFRA 21-1) and compare it with carcinoembryonic antigen (CEA) and tissue polypeptide antigen (TPA) in bronchogenic carcinoma, the sera of 161 patients (58 with benign pulmonary disease and 103 with bronchogenic carcinoma) was investigated using immunoradiometric assay. Sensitivities for CYFRA 21-1, CEA and TPA (using 3.5 ng ml-1, 5.0 ng ml-1, 110 U l-1, respectively, cut-off values corresponding to a 95% specificity for benign pulmonary disease) in bronchogenic carcinoma were 64, 47 and 61%, respectively. Positive CYFRA 21-1 levels were identified in 75% of patients with squamous cell carcinoma (n = 36), in 67% with adenocarcinoma (n = 45), in 17% with large cell carcinoma (n = 6), and in 50% with small cell lung cancer (SCLC) (n = 16). However, CYFRA 21-1 levels were not significantly different between squamous cell carcinoma and the other histological types. The sensitivity of the combined measurement of CYFRA 21-1 with any other tumour marker was significantly higher than that of CYFRA 21-1 measurement alone. Elevated CYFRA 21-1 levels were observed in 44% of Stages I and II (n = 18) and 72% of Stage III and IV (n = 69) patients with non-small cell lung cancer (P < 0.05). A significant inter-marker correlation was observed between CYFRA 21-1 and TPA (n = 103, r = 0.448, P < 0.0001). Twenty-one patients were monitored by CYFRA 21-1, and significantly different changes in progressive patients (P = 0.0058) and regressive patients (P = 0.016) were obtained. These results indicate that CYFRA 21-1 may be not only a sensitive tumour marker in the diagnosis of bronchogenic carcinoma, but also a useful marker for the monitoring of bronchogenic carcinoma.

Adenocarcinoma↗

PubMed1997

Leakage of intrathoracic oesophagovisceral anastomoses in adenocarcinoma of the gastric cardia: changes in serial APACHE II scores and their prognostic significance.

OBJECTIVE: To evaluate changes in serial Acute Physiology and Chronic Health Evaluation (APACHE) II scores in patients with intrathoracic oesophageal anastomotic leaks and to assess their prognostic significance. DESIGN: Retrospective study. SETTING: Teaching hospital, Taiwan. SUBJECTS: 18 patients (4%) who developed intrathoracic oesophageal anastomotic leaks in a total of 491 patients who underwent oesophagogastrectomy for adenocarcinoma of the gastric cardia between 1980 and 1994. MAIN OUTCOME MEASURE: APACHE II scores in those that survived (n = 10) compared with those who died (n = 8). RESULTS: Of the 18 patients, 8 (44%) died. The preoperative general condition, biochemical data, and perioperative APACHE II scores were similar in the two groups. Leakage from the oesophageal anastomoses caused similar degrees of sepsis in the two groups in terms of APACHE II scoring, but the APACHE II scores of survivors started to decline within a week of initial management. In contrast, the APACHE II scores of those who died had increased one week after the leak had been diagnosed despite initial management. There were significant differences in the APACHE II scores of survivors and those who died from one week after leakage until discharge or death (p < 0.001). Only one patient (1/9) survived if the APACHE II score one week after diagnosis of the leak was more than 10. None died of the leak if the APACHE II scores were equal to or less than 10 after a week. CONCLUSIONS: Adequate surgical drainage, antibiotic cover according to the microbiological picture, and nutritional support are essential in the management of intrathoracic oesophageal fistulas. Early reoperation to close early leaks by simple suture or secondary wrapping and to improve local drainage is recommended. The APACHE II scoring system is valuable in evaluating the severity of sepsis caused by intrathoracic oesophagovisceral anastomosis leaks and may serve as an indicator of adequate management. Aggressive surgical measures should be considered if APACHE II scores rise during initial management.

APACHE↗

PubMed1997

Heparin-binding epidermal growth factor-like growth factor and transforming growth factor-alpha in human non-small cell lung cancers.

Transforming growth factor-alpha (TGF-alpha), a member of the epidermal growth factor (EGF) family that binds to the EGF receptor (EGFR), is thought to function in an autocrine manner in non-small cell lung cancers (NSCLC). Heparin-binding EGF-like growth factor (HB-EGF), a novel member of the EGF family, also binds to EGFR. To compare the expression of HB-EGF, TGF-alpha and EGFR genes in NSCLC and normal lung tissue, we measured the levels of messenger RNA (mRNA) for these genes in human NSCLC and normal lung tissues by Northern hybridization, reverse transcription-polymerase chain reaction (RT-PCR), and in situ hybridization. A total of eight specimens (paired tumor tissue and normal lung tissue) were harvested from four patients who underwent resection of primary resectable NSCLC. HB-EGF was not expressed in either tumor tissue or normal lung tissue, while EGFR and TGF-alpha were expressed in all samples. TGF-alpha was overexpressed in all tumor tissue samples by several hundred-fold, while the expression of EGFR was not significantly different in tumor tissue and normal lung tissue. There was no correlation between the expression of TGF-alpha and EGFR. In situ hybridization showed that TGF-alpha mRNA was localized mainly in the cancer cells of tumor tissues and in the macrophages of alveoli in normal lung tissue. Our results showed that HB-EGF plays no role in the growth of NSCLC, and that there was no significant overexpression of EGFR in tumor tissue. TGF-alpha may play a major role in the growth of NSCLC. This supports a new direction in rational NSCLC treatment.

Carcinoma, Non-Small-Cell Lung↗

PubMed1997

Reflux esophagitis after proximal subtotal gastrectomy.

BACKGROUND: Carcinoma of the cardia of stomach or carcinoma of the esophagocardiac (EC) junction has a poor prognosis. Proximal subtotal gastrectomy is often performed for a smaller tumor. It achieves a prognosis similar to that of total gastrectomy and prevents pernicious anemia. A better functional result was expected than that total gastrectomy did from us, but the clinical observation was surprising. Most patients had symptoms of reflux esophagitis after surgery. All of these patients were reevaluated. METHODS: From November, 1990 to March, 1996, there were 27 patients who received proximal subtotal gastrectomy at this hospital. Twenty of these were involved in this study. Floppy Nissen's fundoplication was performed during operation as a anti-reflux procedure. Continuous 24-h pH monitoring, esophageal manometry, and endoscopic examination were performed for study. RESULTS: Most of the patients had symptoms of gastroesophageal reflux. 80% (16/20) of the patients were found to have reflux esophagitis under endoscopy. The patients had higher pH scores (mean 85.8 +/- 45.6) than normal (< 17.5), lower pressure of LES (8.03 +/- 7.01 mmHg), shorter total lengths (mean 1.60 +/- 0.56 cm) and intraabdominal lengths (mean 1.29 +/- 0.30 cm) of new lower esophageal sphincters. CONCLUSIONS: Clearly there was failure to prevent reflux esophagitis through floppy Nissen's fundoplication. Severe gastroesophageal reflux did appear after proximal gastric resection. A gastric remnant with safe cut-margin is often too short to perform complete wrapping. Proximal subtotal gastrectomy is not recommended for early cancer of the cardia of the stomach.

Aged↗

PubMed1996

DNA ploidy and protein content in bronchioloalveolar carcinoma multi-variable flow cytometry.

Multi-variable flow cytometry studies were done on paraffin-embedded surgical specimens from 97 patients with bronchiolalveolar carcinoma (BAC) and on 10 normal lung tissue specimens to assess the value of nuclear protein content besides DNA ploidy. Tumor tissues were stained for DNA content with propidium iodide and for protein content with fluorescein isothiocyanate. DNA ploidy measurements were successful in 87 of the 97 specimens. Twenty-four (28%) specimens were DNA diploid, and 63 (72%) were DNA nondiploid (DNA tetraploid or DNA aneuploid). There was no significant difference in survival between patients with DNA diploid and with DNA nondiploid tumors (P = 0.69). The protein histogram pattern was bimodal in 26/87 (30%) of patients; these had significantly shorter survival than patients with either normal or right-shift protein histogram patterns (61/87) (P = 0.0033). The nuclear protein measurement was an independent prognostic indicator when corrected for tumor grade and tumor size in a Cox model analysis (P = 0.04). The nuclear protein measurement correlated with nuclear size as determined by nuclear volume measurements. The combination of DNA ploidy, protein, and cell size measurements by flow cytometry provide a useful biologic basis for the variable prognosis seen with BAC tumors.

Adenocarcinoma, Bronchiolo-Alveolar↗

PubMed1996

Spirometry in life-long non-smoking, healthy Chinese women in Taiwan.

To establish the spirometric values for normal, healthy Chinese women in Taiwan, the spirometry of 506 life-long non-smoking, healthy Chinese women was examined, including 140 subjects over the age of 60 years. Significant correlations among age, height and forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC%, peak expiratory flow (PEF), Vmax75, Vmax50, Vmax25 were found. However, there were no significant correlations between age and FEV1/FVC%, nor age and Vmax25 in the elderly group. FEV1 (FEV1*) and FVC (FVC*) were standardized to the overall mean height for elderly women using Cole's formula. The decline in FEV1* and FVC* with age were observed. The predicted value for the average 70-year-old woman with a height of 1.5 m derived from the present study is compared with those from other surveys of the elderly. The values from the present study are somewhat higher than the values from the Hong Kong study. The authors believe the fact that all of the present subjects were life-long non-smokers might explain the differences.

Adult↗

PubMed1996

Adenosine modulation of neurotransmission in human uterine arteries.

The relaxing effects of adenosine, N-[(R)-1-methyl-2 phenylethyl]-adenosine (R-PIA) and 5-N-ethylcarboxamide adenosine (NECA) were investigated in human uterine arteries precontracted by phenylephrine in vitro. Adenosine, R-PIA and NECA relaxed isolated uterine arteries with intact endothelium, the potency order was NECA > R-PIA > adenosine. When tested on vessels devoid of their endothelium, the relaxing effect of adenosine was the same. These results suggest the vasodilatation effect on human uterine arteries is endothelium-independent, and might be via the A2 receptor (by pharmacological classification). By administering adenosine to human uterine arterial cell culture, single cell intracellular calcium change was also determined by laser cytometry. Decreased intracellular calcium was observed after administration of adenosine 10(-6) M and 2 x 10(-6) M. We concluded from the results that adenosine acts on human uterine artery cell by A2 receptor, independently of the endothelium, and decreases the intracellular calcium concentration, thus causing uterine artery relaxation.

Adenosine↗

PubMed1996

Cytokeratin fragment 19 (CYFRA 21-1) as a tumor marker in non-small cell lung cancer.

To evaluate the diagnostic value of the serum cytokeratin 19 fragment (CYFRA 21-1) in bronchogenic carcinoma, we investigated the sera of 138 patients (58 with benign pulmonary disease and 80 with non-small cell lung cancer (NSCLC)) using immunoradiometric assay. The mean (SD) value of serum CYFRA 21-1 in NSCLC (13.26 (16.54)) was significantly higher than in benign lung diseases (1.74 (1.55)) (p < 0.0001). Sensitivity for CYFRA 21-1 (using 3.5 ng/ml, a cut-off value corresponding to a 95% specificity for benign pulmonary disease) in NSCL was 62%. Positive CYFRA 21-1 levels were significantly higher in 75% of patients with squamous cell carcinoma (n = 36) than in 53% with other NSCLC (n = 44) (p < 0.05). CYFRA 21-1 levels were significantly different between squamous cell carcinoma (17.28 (19.94)) and the other NSCLC (9.96 (12.44)) (P < 0.05). Elevated CYFRA 21-1 levels in patients with stage III and IV disease (n = 64, 18.19 (26.51)) were significantly higher than in stage I and II (n = 16, 4.41 (5.76)) (p < 0.02). The positive rate of CYFRA 21-1 in tumor stage I and II was only 37%. Our results indicate that CYFRA 21-1 may be a useful tumor marker in NSCLC, especially in squamous cell carcinoma. However, CYFRA 21-1 cannot be used for the diagnosis of early stage disease of NSCLC. CYFRA 21-1 may also contribute to the monitoring of NSCLC.

Adolescent↗

PubMed1996

Decreased production of IFN gamma and increased production of IL-6 by cord blood mononuclear cells of newborns with a high risk of allergy.

BACKGROUND: The underlying mechanisms of elevated IgE level in atopic patients are still obscure, however, extensive efforts have been tried to identify an immunological parameter as a predictor of atopy. OBJECTIVE: This study compared the difference in cytokine production by cord blood mononuclear cells between new borns with high-risk of allergy (family allergy score, FAS > or = 3) and those with low-risk (FAS = 0). METHODS: Following stimulation with PHA (100 micrograms/mL) and PMA (1 ng/mL), the cytokines produced by cord blood CD4+ T cells in the presence of monocytes were measured by ELISA kits and the mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR) technique. RESULTS: Our results showed: CD4+ T cells in the presence of monocytes and isolated monocytes from the high-risk group produced a much greater amount of IL-6, either spontaneously or after stimulation, than did those of the low-risk group; CD4+ T cells of low-risk group produced a significantly greater amount of interferon gamma (IFN gamma) than did those from the high-risk group; IL-4 cannot be detected by ELISA kit, and only a trace amount of IL-4 mRNA was detected by RT-PCR technique; cord blood basophils stimulated with PHA and PMA could produce a significant amount of IL-4; there was an inverse correlation between the production of IFN gamma and cord blood IgE level (high-risk group, r = 0.647, n = 17) and the number of natural killer (NK) cells (CD3- CD16+ CD56+) was significantly lower in high-risk group than for low-risk group. CONCLUSION: Our data suggested increased production of IL-6 and decreased production of IFN gamma of cord blood mononuclear cells appear to be the hallmark of newborns from the high-risk population.

Basophils↗

PubMed1996

Pulmonary hyperinfection with Strongyloides stercoralis.

Strongyloides stercoralis is an intestinal parasite in humans. Infected patients may be asymptomatic or have mild to moderate abdominal symptoms. It may spread to the lungs and, finally, disseminate in the immunocompromised patient. S. stercoralis is an important cause of severe pulmonary infection and death in many areas of the world. Here we describe an 87-year-old man with S. stercoralis pulmonary hyperinfection. He had respiratory failure with severe abdominal distention. Chest x-ray showed infiltration over the right upper lung field. Papanicolaou stain of sputum demonstrated the rabditiform larvae of S. stercoralis. Stool examination revealed S. stercoralis larvae and eggs. He received two courses of albendazole treatment, but died 5 weeks after admission from Gram-negative bacteremia. This case is a classic presentation of the S. stercoralis pulmonary hyperinfection syndrome.

Aged↗

PubMed1995

Establishment of human IgE system in severe combined immunodeficient mice with peripheral blood mononuclear cells from asthmatic children.

The frequency of allergic diseases, such as asthma, has increased rapidly during the past decade; however, the exact mechanisms have not been established. In this study we tried to establish an in vivo system to investigate immune regulation of allergic diseases by using severe combined immunodeficient (SCID) mice. Peripheral blood mononuclear cells isolated from asthmatic children or normal adults were injected into peritoneal cavities of SCID mice. Human IgG, IgA, IgM, and IgE could be detected in SCID mice reconstituted with human PBMCs (SCID-PBL-hu mice) 3 weeks later. Moreover, the mice injected with peripheral blood mononuclear cells from asthmatic children had much higher IgE levels than mice reconstituted with cells from normal adults. Phenotypic analysis of spleen cells and peritoneal exudate cells from SCID-PBL-hu mice demonstrated that human lymphocytes could survive in the peritoneal cavity and spleen for several months. After intraperitoneal immunization, mite-specific IgE antibodies could also be detected in SCID-PBL-hu mice. This study indicates that the human IgE system can be established in SCID mice and that this model can be used to study the regulation of IgE production and the immunopathogenesis of human allergic disease.

Animals↗

PubMed1995

Urgent laparotomy versus emergency craniotomy for multiple trauma with head injury patients.

In blunt multiple trauma (MT) with head injury (HI) patients, it is difficult to decide whether to proceed with immediate laparotomy or craniotomy. In August 1989, abdominal ultrasonography (US) using a simple US scoring system was introduced for MT and HI patients as an initial rapid screening procedure. In MT and HI patients with a US score > or = 3 (n = 14), urgent laparotomy was the procedure of first choice. However, immediate head CT scan, then emergency craniotomy, may be justified in hemodynamically stable MT and HI patients with a US score < 3 (n = 98). Appropriate decision making can be applied to decide which procedure is most exigent.

Abdomen↗

PubMed1995

Utility of Argyrophilic nucleolar organizer regions (AgNOR) in differentiating malignant from benign of colorectal tumors.

BACKGROUND: Argyrophilic nucleolar organizer regions (AgNOR) can reflect the activity of cellular proliferation. The purpose of this study is to evaluate the potential value of AgNOR in differentiating benign from malignant colon epithelial neoplasms, and to determine the correlation between the nucleus AgNOR and the grade of colonic adenocarcinomas. METHODS: In this study, AgNOR technique was applied to 61 paraffin embedded sections of colorectal tissue including normal mucosa (n = 10), adenomatous polyp (n = 16), and adenocarcinoma (n = 35). RESULTS: The mean +/- standard error (SE) numbers of AgNOR dots per nucleus of normal mucosa, adenomatous polyp, and adenocarcinoma were 2.17 +/- 0.07 (n = 10) 3.89 +/- 0.10 (n = 16) and 5.52 +/- 0.10 (n = 35), respectively (p < 0.00001). In addition, the mean numbers of AgNOR dots per nucleus of well differentiated (WD) adenocarcinoma (n = 14), moderately differentiated (MD) adenocarcinoma (n = 11) and poorly differentiated (PD) adenocarcinoma (n = 10) were 5.20 +/- 0.12, 5.81 +/- 0.20, 5.67 +/- 0.15, respectively. MD and PD tumor had significantly higher AgNOR count than that of WD tumor (p < 0.05). However, there was no significant difference between MD and PD colorectal adenocarcinoma. CONCLUSION: AgNOR method is a simple, rapid method in diagnosis of colorectal tumors, and it provides a useful adjunct to histopathology in the diagnosis of colorectal tumors.

Adenocarcinoma↗

PubMed1995

Emergency surgical intervention for severe corrosive injuries of the upper digestive tract.

BACKGROUND: In treating severe corrosive injury of the esophagus and stomach, prompt diagnosis, adequate fluid resuscitation and warranted surgical intervention are the most important factors in rescue of critically ill patients. The purpose of this study was to evaluate the need for, and the advantages of, a surgical approach to treatment of such corrosive injuries to the upper gastrointestinal (UGI) tract, as well as to select the most suitable technique to achieve a good survival rate. METHODS: From January 1983 to December 1991, 220 patients were treated for caustic ingestion injury to the UGI tract. A retrospective review of their records allowed targeting of 27 patients with severe corrosive injury that surgical intervention was required. In this study, peritoneal sign was taken as the key indicator for early emergency operation. The age, sex, elapsed time from injury to operation, the sort and quantity of caustic agent used, injury mechanism, clinical manifestations, alternative surgical treatment methods and causes of death were also reviewed and analyzed in this study. RESULTS: The patients included 13 men and 14 women, of whom the majority were adults (96.3%) who had attempted suicide (85.2%). All of them had taken liquid corrosive agents, usually hydrochloric acid (63%). Eighteen underwent emergency operations; the other nine received only supportive treatment, given their terminal status. The mortality rates for patients with surgery and supportive treatment were 66.7% and 100%, respectively. Four patients died after undergoing esophagectomy with resection of the stomach using the thoracoabdominal method. Only three of the eight patients who received esophageal stripping combined with resection of the stomach through the abdomen died (37.5%). CONCLUSIONS: The time elapsed between injury and development of peritoneal sign is a good indicator of the severity and extent of the injury. When peritoneal sign manifests at a very early stage, it is an indicator that the corrosive injury is very advanced in its progress and that, no matter what procedures were performed, the outcome would be the same. Yet if there were a six-hour gap then aggressive surgical management can rescue some patients. It is recommended based on experience here, that when using the surgical approach, resection of the stomach with stripping of the esophagus is superior to the thoracoabdominal method.

Adolescent↗

PubMed1994

An active v-abl protein tyrosine kinase blocks immunoglobulin light-chain gene rearrangement.

Lymphoid cells transformed by Abelson murine leukemia virus have provided one of the classic models for study of early B-cell development and immunoglobulin rearrangement. Most of these cells have rearranged their heavy-chain locus but not their light chain genes, suggesting that an active v-abl protein interferes with this differentiation step. To test this hypothesis, light-chain gene structure was examined in pre-B cells transformed by temperature-sensitive mutants of the Abelson virus and in derivatives that survive at the nonpermissive temperature because they express a human BCL-2 gene. Our studies reveal that inactivation of the v-abl protein tyrosine kinase triggers high-frequency rearrangement of kappa and lambda light-chain genes. These events are accompanied by marked increases in the expression of RAG-1 and RAG-2 RNAs. These increases occur in the absence of protein synthesis but are dependent on inactivation of the v-abl protein tyrosine kinase. As documented in the accompanying paper (Klug et al., this issue), an active v-abl protein also suppresses the activity of NF-kappa B/rel and expression controlled by the kappa intron enhancer. Together these data demonstrate that the v-abl protein specifically interferes with light-chain gene rearrangement by suppressing at least two pathways essential for this stage of B-cell differentiation and suggest that tyrosine phosphorylation is important in regulating RAG gene expression.

Abelson murine leukemia virus↗

PubMed1994

Ultrasonography for the evaluation of hemoperitoneum during resuscitation: a simple scoring system.

To assess the need for therapeutic laparotomy in patients with blunt abdominal trauma (BAT), ultrasonography (US) and a simple US scoring system were used to estimate the amount of hemoperitoneum during resuscitation. In group I (BAT with a US score > or = 3), 24 of 25 patients (96%) required therapeutic laparotomy. In group II (BAT with a US score < 3), therapeutic laparotomy was required in only 9 of 24 patients (38%); nonsurgical treatment may be justified in hemodynamically stable patients. Appropriate decisions can be made to perform urgent laparotomy when intra-abdominal bleeding is the culprit in BAT patients. Unnecessary laparotomy can be avoided when the major site of blood loss is not in the abdomen. Ultrasonography, an initial rapid screening procedure in BAT patients, is useful for trauma surgeons in decision making during resuscitation.

Abdominal Injuries↗