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Biomedical subjects

Pinchen Yang

Publications and source records attributed to Pinchen Yang.

18 recordsLinked to original sources

No allele variation of the MAOA gene promoter in male Chinese subjects with attention deficit hyperactivity disorder.

The aim of the current study was to examine any difference in the repeat sequence of the monoamine oxidase A (MAOA) gene promoter between males with attention deficit hyperactivity disorder (ADHD) and randomly selected subjects in a community. The role of the MAOA gene promoter in ADHD cases was also investigated. The total of 244 participants included 57 male ADHD subjects as the case group and 187 males, also in southern Taiwan, as the community controls. There was no significantly different distribution in the repeat sequence of the MAOA gene promoter (chi2 = 3.895, d.f. = 3, p = 0.273), and no significantly different distribution of 'long-form' and 'short-form' alleles between the ADHD group and the male community group was noted (chi2 = 2.484, d.f. = 1, p = 0.115). Some aspects of clinical response are mentioned in the discussion of this study which are worth exploring further in the future.

Adult↗

D-alanine added to antipsychotics for the treatment of schizophrenia.

BACKGROUND: Hypofunction of the N-methyl-d-aspartate (NMDA) subtype glutamate receptor had been implicated in the pathophysiology of schizophrenia. Treatment with D-serine, glycine, endogenous full agonists of the glycine site of the NMDA receptor (NMDA-glycine site), D-cycloserine, a partial agonist, or sarcosine, a glycine transporter-1 inhibitor, improves the symptoms of schizophrenia. D-alanine is another endogenous agonist of the NMDA-glycine site that might have beneficial effects on schizophrenia. METHODS: Thirty-two schizophrenic patients enrolled in a 6-week double-blind, placebo-controlled trial of D-alanine (100 mg/kg/day), which was added to their stable antipsychotic regimens. Measures of clinical efficacy and side effects were determined every other week. RESULTS: Patint who received D-alanine treatment revealed significant reductions in their Clinical Global Impression Scale and Positive and Negative Syndrome Scale (PANSS) total scores. The Scale for the Assessment of Negative Symptoms and PANSS subscores of positive and cognitive symptoms were improved. D-alanine was well tolerated, and no significant side effect was noted. CONCLUSIONS: The significant improvement with the D-alanine further supports the hypothesis of hypofunction of NMDA neurotransmission in schizophrenia and strengthens the proof of the principle that NMDA-enhancing treatment is a promising approach for the pharmacotherapy of schizophrenia.

Adult↗

Adjunctive treatment of acute mania with risperidone versus typical antipsychotics: a retrospective study.

Few studies have directly compared atypical antipsychotics (e.g. risperidone) with typical antipsychotics as adjunctive therapy in patients hospitalized for acute mania, especially during a lengthy hospital stay. Our retrospective, case-controlled study is a chart review of 64 patients with Diagnostic and Statistical Manual of Mental Disorders, 4th edition, defined bipolar I disorder (current episode, mania). Patients were divided into two groups according to the adjunctive medications used: the risperidone group (mood stabilizers plus risperidone) and the control group (mood stabilizers plus typical antipsychotics). Outcome at discharge, medications, adverse drug effects, and length of hospital stay were compared between groups, controlling for gender, age, number of prior admissions, and duration of illness. Results indicated no statistically significant differences between groups in the controlled factors, Global Assessment of Functioning and Clinical Global Impression-Improvement scores, and adverse drug events. Patients in the risperidone group used significantly lower doses of trihexyphenidyl than those in the control group (p < 0.05). Patients treated with risperidone had a shorter hospital stay than those treated with typical antipsychotics (p < 0.01). In conclusion, antipsychotics are effective as adjunctive agents in the treatment of acute mania. The use of risperidone, in particular, decreases the need for anticholinergics and may lead to a shorter hospital stay compared with typical antipsychotics.

Adult↗

Developing a family function questionnaire for families with developmentally delayed children.

The purpose of this study was to develop a "Family Function Questionnaire for Families with Developmentally Delayed Children". The questionnaire was created by sampling 300 parents with developmentally delayed children. Initially, families and early intervention services were observed and a qualitative interview with the child's family was conducted. The researchers created a family function database reflecting these steps and by referral to relevant literature. The final version of the questionnaire consisted of 42 items in 11 categories: cohesion, education, problem solving, affective involvement, independence, action participation, family support, recreation, rules implementation, collaboration, and financial management. The questionnaire had a Cronbach's alpha of 0.9326.

Child↗

Validation of Impact of Events Scale in nurses under threat of contagion by severe acute respiratory syndrome.

The purpose of the present study was to validate the Impact of Events Scale (IES) in a sample of nurses working under threat of severe acute respiratory syndrome (SARS). The internal consistency, construct validity and convergent validity of the instrument were examined in a sample of 128 nurses during the SARS outbreak in Taiwan. Principal component analysis followed by a quartimax rotation were used to derive a two-factor solution, labeled intrusion (factor 1) and avoidance (factor 2), with both factors accounting for 50.7% of the explained variance. The total Cronbach's alpha of 0.90 reflected the good internal consistency of the instrument. Correlation with the Symptoms Checklist 90-R demonstrated the convergent validity of the IES. In conclusion, the IES can be used as a convenient, reliable and valid instrument for evaluation of the psychological distress of nurses working with the highly contagious disease.

Adult↗

Psychological distress of nurses in Taiwan who worked during the outbreak of SARS.

OBJECTIVES: This study explored whether nurses who were working during the severe acute respiratory syndrome (SARS) crisis showed symptoms of distress. This study also examined whether nurses experienced stress from being conscripted to work in higher-risk units. METHODS: This study was conducted in Taiwan during the peak of the SARS outbreak in 2003. Participants were recruited from nursing staff in a community hospital. Participants were divided into three groups: those who originally worked in units with a high risk of SARS exposure (N=65), those who had been involuntarily conscripted into such units because of manpower demands (N=21), and those who worked in units with a low risk of SARS exposure (N=45). Participants were evaluated with two questionnaires: the Impact of Event Scale and the 90-item Symptom Checklist-Revised. RESULTS: The results showed that 11 percent of the nurses surveyed had stress reaction syndrome. The symptoms of psychological stress reactions included anxiety, depression, hostility, and somatization. The highest rate of stress reaction syndrome was observed in the group that originally worked in a high-risk unit, and the conscripted group experienced the most severe distress on average. CONCLUSIONS: These findings suggest that the psychological distress of nurses who worked during the SARS outbreak was moderate. The distress was more prominent among the two groups of nurses who were working with patients with SARS.

Adult↗

Zotepine-induced catatonia as a precursor in the progression to neuroleptic malignant syndrome.

A 39-year-old man with schizophrenia developed severe catatonia, hyperthermia, muscle rigidity, tachycardia, leukocytosis, and elevated muscle enzyme levels while receiving zotepine therapy. Neuroleptic malignant syndrome (NMS) was diagnosed. After withdrawal of zotepine therapy, transfer to a neurologic intensive care unit, provision of supportive care, and administration of adjunctive bromocriptine therapy, the patient's fever and catatonia subsided. Biochemical irregularities spontaneously returned to normal with no complications. Antipsychotic therapy was restarted with risperidone 12 days after the patient's NMS resolved. After more than 1 year of follow-up, he experienced no adverse events. A recent decrease in mortality from NMS is related to increased awareness of this disorder, but not to treatment with specific agents. Clinicians need to recognize NMS early; although rare, it is a potentially fatal complication of antipsychotic treatment.

Antipsychotic Agents↗

Evidence of early neurobiological alternations in adolescents with posttraumatic stress disorder: a functional MRI study.

Neuroimaging studies of patients with posttraumatic stress disorder (PTSD) have largely been performed in adult populations. The purpose of the current study was to investigate neural correlates of PTSD in adolescents. Specifically, this study investigates whether a differential brain response was present during the visual perception and imaginary recollection of traumatic reminders in adolescents who developed PTSD versus those who did not after experiencing earthquake. Eleven Taiwanese adolescents (age range: 12-14 years) with traumatic experience of earthquake were enrolled. Five subjects fulfilled PTSD criteria, while the other six served as non-PTSD controls. Brain activation was measured by functional magnetic resonance image (fMRI) during visual perception and imagery recall of earthquake and neutral pictures at 14 months after earthquake. During earthquake imagery (as compared with neutral imagery), PTSD group demonstrated activation in the bilateral visual cortex, bilateral cerebellum and left parahippocampal gyrus, while control group did not. During earthquake perception (as compared with neutral perception), the control group showed activation over anterior cingulate, but the PTSD group did not. Intergroup comparison confirmed above discrepancies was significant. We concluded that neurobiological alternation of PTSD in adolescent was similar to those in adult and might have developed within 14 months after trauma exposure.

Adolescent↗

Glycine transporter I inhibitor, N-methylglycine (sarcosine), added to antipsychotics for the treatment of schizophrenia.

BACKGROUND: Hypofunction of N-methyl-D-aspartate glutamate receptor had been implicated in the pathophysiology of schizophrenia. Treatment with D-serine or glycine, endogenous full agonists of the glycine site of N-methyl-D-aspartate receptor, or D-cycloserine, a partial agonist, improve the symptoms of schizophrenia. N-methylglycine (sarcosine) is an endogenous antagonist of glycine transporter-1, which potentiates glycine's action on N-methyl-D-aspartate glycine site and can have beneficial effects on schizophrenia. METHODS: Thirty-eight schizophrenic patients were enrolled in a 6-week double-blind, placebo-controlled trial of sarcosine (2 g/d), which was added to their stable antipsychotic regimens. Twenty of them received risperidone. Measures of clinical efficacy and side effects were determined every other week. RESULTS: Patient who received sarcosine treatment revealed significant improvements in their positive, negative, cognitive, and general psychiatric symptoms. Similar therapeutic effects were observed when only risperidone-treated patients were analyzed. Sarcosine was well-tolerated, and no significant side effect was noted. CONCLUSIONS: Sarcosine treatment can benefit schizophrenic patients treated by antipsychotics including risperidone. The significant improvement with the sarcosine further supports the hypothesis of N-methyl-D-aspartate receptor hypofunction in schizophrenia. Glycine transporter-1 is a novel target for the pharmacotherapy to enhance N-methyl-D-aspartate function.

Adult↗

Comparative study of early childhood high-function autism and developmental mixed receptive-expressive language disorder.

Verbal cognitive profile and general social functioning were compared between two groups of children aged 5 to 7 years, one with high-function autism and the other with developmental mixed receptive-expressive language disorders. The two groups, totaling 50 children, were matched for age and non-verbal IQ (mean, 90). Both groups had impaired verbal cognitive profile and social adaptive functioning, with no statistically significant differences between the two groups. The implications of our findings are discussed. Current preschool and early childhood medical-educational intervention programs in Taiwan must design and implement curricula in which children with language delay, whether autistic or/not, can develop essential social skills.

Autistic Disorder↗

Rapid improvement in academic grades following methylphenidate treatment in attention-deficit hyperactivity disorder.

In the present study a 16 week comparison study was conducted of behavioral, cognitive and educational measures in school-age Taiwanese children with attention-deficit hyperactivity disorder (ADHD) receiving open-label methylphenidate (MPH). Subjects include 14 male and five female ADHD children. They received MPH twice per day continuously for 16 weeks. Measures of behavior, cognitive function (Wisconsin Card Sorting Test, Tower of London and Continuous Performance Test), Chinese and arithmetic learning achievement were compared with those of their baseline condition. After MPH, 68-78% of children showed improving behavior in classroom and at home. Among the neuropsychological tests, only the percentage of preservative error was improved (P = 0.022). Approximately 61-66% of children had improvement in academic learning (P = 0.013 for Chinese, 0.004 for arithmetic). The MPH treatment demonstrated improvement in domains of classroom/home behaviors and academic performance, but showed minimal change on neuropsychological functioning in Taiwanese ADHD children. The finding of academic gain was unexpected, which might be due to the greater interest in achievement and better compliance to cultural expectations by Taiwanese versus Western students, which translated into more rapid improvement in academic performance.

Administration, Oral↗

Gender differences in a clinic-referred sample of Taiwanese attention-deficit/hyperactivity disorder children.

The purpose of this study was to examine gender differences within a clinic-referred sample of 6-11-year-old Taiwanese children with attention-deficit/hyperactivity disorder (ADHD)- combined subtype. The subjects were 21 girls with a diagnosis of ADHD from the 4th edition of the Diagnostic and Statistical Manual and 21 age-matched boys with ADHD. Comparisons were made of behavioral ratings, cognitive profiles, and vigilance/attention assessments between these two groups. The results found ADHD girls and ADHD boys to be statistically indistinguishable on nearly all measures except the subtests of block design (P = 0.016), the discrepancy between Performance Intelligence Quotient and Verbal Intelligence Quotient (P = 0.019), and the discrepancy between fluid and crystallized IQ (P = 0.041). In the study samples, ADHD girls and ADHD boys were strikingly similar on a wide range of measures. ADHD boys and girls in clinics may be expected to show more similarities than differences in treatment needs. However, these results should be interpreted with caution since data were only from clinic-referred samples.

Arousal↗

Preschool children with autism spectrum disorders in Taiwan: follow-up of cognitive assessment to early school age.

In this study, we longitudinally followed into childhood a cohort of preschool children, initially diagnosed as autistic or non-autistic with developmental delay, to evaluate the stability of cognitive assessments performed during the preschool period. The consistency in group means and intra-individual stability of developmental quotients (DQ) and non-verbal intelligence quotients (IQs) were compared for these two groups, which were matched by chronological age, initial non-verbal IQ/DQs, initial test given, and length of follow-up interval. The case group comprised 16 autistic children with average age at initial assessment of 3 years 8 months. The control group comprised 16 non-autistic developmental delayed children with average age at initial assessment of 3 years 11 months. Mean DQ/non-verbal IQ at initial assessment was 73.9+/-23.9 for the case group and 80.3+/-23.2 for the control group. ANOVA yielded no significant effect of time or time x diagnosis interaction (F=0.183, P=0.675). The absolute difference in scores and group means were equivalent for both groups of children, with no difference in patterns of change. Correlations between DQ/non-verbal IQs at initial assessment and follow-up were significant and high for the two groups (autistic group: r=0.87; control: r=0.77). Intellectual functioning can be a valid measure in Taiwanese preschool children with autism, and has an equivalent meaning for children with autism and for non-autistic children with developmental delay. Though the follow-up period is too short for definite prognostic conclusions to be drawn, we think that non-verbal intelligence should be an essential assessment for preschool oriental autistic children so that sound expectation and treatment plan can be made.

Autistic Disorder↗

Neuronal specificity of acupuncture response: a fMRI study with electroacupuncture.

Recently, neuronal correlates of acupuncture stimulation in human brain have been investigated by functional neuroimaging. The preliminary findings suggest that acupuncture at analgesic points involves the pain-related neuromatrix and may have acupoint-brain correlation. Although multiple models of control stimulations have been applied to address the specificity of the needling effect clinically, their impacts have not been evaluated by functional neuroimaging. With the advantage of objective parameter setting, electroacupuncture (EA) was used in this study to devise three distinct controls for real EA, i.e., mock EA (no stimulation), minimal EA (superficial and light stimulation), and sham EA (same stimulation as real EA) applied at nonmeridian points. Fifteen healthy volunteers received real EA at analgesic point Gallbladder 34 (Yanglinquan), sham EA, and one of either mock EA or minimal EA over the left leg in counter-balanced orders. Multisubject analysis showed that sham EA and real EA both activated the reported distributed pain neuromatrix. However, real EA elicited significantly higher activation than sham EA over the hypothalamus and primary somatosensory-motor cortex and deactivation over the rostral segment of anterior cingulate cortex. In the comparison of minimal EA versus mock EA, minimal EA elicited significantly higher activation over the medial occipital cortex. Single-subject analysis showed that superior temporal gyrus (encompassing the auditory cortex) and medial occipital cortex (encompassing the visual cortex) frequently respond to minimal EA, sham EA, or real EA. We concluded that the hypothalamus-limbic system was significantly modulated by EA at acupoints rather than at nonmeridian points, while visual and auditory cortical activation was not a specific effect of treatment-relevant acupoints and required further investigation of the underlying neurophysiological mechanisms.

Adult↗

Posttraumatic stress disorder among adolescent earthquake victims in Taiwan.

OBJECTIVE: To assess the exposure experience and prevalence of posttraumatic stress disorder (PTSD) among adolescent victims in the worst-affected region (Chungliao) near the epicenter of a severe earthquake (7.3 on the Richter scale) that occurred on September 21, 1999, in Taiwan. METHOD: The experience of exposure to the earthquake and subjective symptoms of junior high school students aged 12 to 14 who remained in the area were assessed with self-rated questionnaires. Psychiatrists made independent diagnoses for PTSD by using the Children's Interview for Psychiatric Syndromes. RESULTS: Six weeks after the earthquake, 21.7% of 323 students demonstrated PTSD. Those with PTSD showed significantly more psychiatric symptoms than did those without PTSD. Being physically injured and experiencing the death of a close family member with whom they had lived were the 2 major risk factors for PTSD. CONCLUSIONS: This study demonstrates that PTSD among adolescent victims of a severe earthquake in Taiwan is not as high as that reported in other studies. Methodological differences in the investigations are discussed, along with differences in symptom manifestations. However, long-term follow-up of these victims is recommended to prevent the development of other psychiatric complications.

Adolescent↗

Asperger's syndrome and aberrant neurofunctional organization--a case report.

Asperger's Syndrome(AS) is a severe developmental disorder characterized primarily by marked and sustained difficulties in social interaction and unusual patterns of circumscribed interests and behavioral peculiarities. AS differs from autism primarily in that there is no general delay or retardation in language. A 3. 5 year-old boy with AS was referred for psychological assessment and treatment. When the boy was 23 months old, he was assessed with Bayley Scales of Infant Development (2nd ed.). Both MDI and PDI were within normal limits. After the referral, this boy was assessed with WPPSI-R and then prescribed 5 weekly intervention sessions consisting of communication skills training. At a one week's follow-up the boy was reassessed with Leiter-R. The results of WPPSI-R and Leiter-R showed the boy was in the normal intelligence range. From the second session to the fifth session, the boy's mother recorded 526 of his utterances. According to the analysis of these speech data, the language development for this boy was at Stage V, which indicated that his language development was in the superior range for his age. After 5 intervention sessions, the improvements in the child's communication skills were such that no further sessions were warranted. This boy might represent a case of aberrant neurofunctional organization. He has defects in perceptual organization but has good pattern recognition, which is based on features. It is theorized that his excellent verbal ability competed with the perceptual organization, so that he compensated for perceptual organization with verbal ability. An intervention designed to inhibit verbal compensation and facilitate configural processing is recommended.

Asperger Syndrome↗

Single photon emission computerized tomography in children with developmental language disorder--a preliminary report.

Developmental language disorder (DLD) is a diagnosis given to a nonautistic child who has inadequate language acquisition despite adequate hearing, sensorimotor, and cognitive skills. We used high-resolution single photon emission computerized tomography (SPECT) with labeled technetium-99m-D, L-hexamethyl-propylene amine oxime (99mTc-HMPAO) to measure regional cerebral blood flow (rCBF) in 11 children with DLD. Their mean age was 5 years 10 months (range, 4 yr 2 mo to 10 yr 9 mo) and mean nonverbal IQ was 107 (range, 82-137). When inter-hemispheric flow discrepancy was defined as a bilateral rCBF difference of more than 10%, 10 children (90.9%) had discrepant blood flow. Temporal lobes were involved in all 10 children: lateral-temporal in five, medial-temporal in four, and mesial-temporal in four. Though the study was small and the results are preliminary, results suggest that DLD may be a consequence of an underlying neurobiologic problem in areas of the brain known to be involved with language.

Cerebrovascular Circulation↗