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Biomedical subjects

S C Chang

Publications and source records attributed to S C Chang.

At least 19 recordsLinked to original sources

The 16S rRNA gene of Streptomyces lividans TK64 contains internal promoters.

A 632-bp Sau3AI fragment of Streptomyces lividans TK64 genome was found to confer promoter activity in Streptomyces and Escherichia coli. This fragment showed almost identical sequence (97.8%) to the S. coelicolor 16S rRNA segment encompassing from nucleotide 706 to 1337 region. The transcription start points of this fragment were identified by the primer extension method. Analysis of the nucleotide sequence upstream the transcription start points revealed two putative E. coli-like promoters resided within this fragment. The occurrence of internal promoters active in Streptomyces and E. coli was also confirmed in the 16S rRNA gene of rrnE operon from TK64.

Base Sequence

[Neurogenic pulmonary edema following a grand mal seizure: a case report].

A case of neurogenic pulmonary edema following a grand mal epileptic seizure is presented. This condition is rather rare and the exact pathophysiology remains unknown, but it is believed that the event may be related to transitional increase of intracranial pressure during seizure attack. Pulmonary edema may be a serious complication of epileptic seizure. Rapid recognition and management is very important since the prognosis depends on the severity of pulmonary edema and appropriate treatment.

Adolescent

Primary malignant melanoma of the vagina and cervix uteri: case report and literature review.

Malignant melanoma of vagina is rare. Malignant melanoma of the cervix is even rare. To date, only 96 cases of the former and 26 cases of the latter have been reported. We report here a very rare case of primary malignant melanoma involving both vagina and cervix in a 70-year-old woman. The clinical, cytologic, light microscopic and ultrastructural findings are presented, and the pertinent literature is reviewed and discussed.

Aged

In vitro antibacterial activities of ticarcillin alone and ticarcillin plus clavulanic acid against beta-lactamase producing and non-producing microorganisms.

A total of 818 clinical bacterial isolates were tested for the production of beta-lactamase by rapid chromogenic cephalosporin method and for the susceptibility to ticarcillin alone and in combination with clavulanic acid (2 micrograms/mL) by agar dilution method. These included 83 strains of methicillin-sensitive Staphylococcus aureus (MSSA), 31 of methicillin-resistant S. aureus (MRSA), 49 of Neisseria gonorrhoeae, 58 of Haemophilus influenzae, 112 of Escherichia coli, 118 of Klebsiella pneumoniae, 58 of Proteus mirabilis, 30 of Proteus vulgaris, 60 of Serratia marcescens, 113 of Enterobacter cloacae, 60 of Pseudomonas aeruginosa and 46 of Bacteroides fragilis. The results revealed that 46.6% of P. mirabilis, 53.4% of H. influenzae, 57.1% of N. gonorrhoeae, 80% of P. vulgaris, 83.9% of MRSA, 85.6% of MSSA, 87.5% of E. coli, 91.7% of S. marcescens, 95.7% of B. fragilis, 98.2% of E. cloacae, and 100% of K. pneumoniae and P. aeruginosa strains produced beta-lactamase. In general, beta-lactamase nonproducers were more susceptible to ticarcillin than beta-lactamase producers. The ranges of minimum inhibitory concentrations (MICs) of ticarcillin for beta-lactamase nonproducers of MSSA, MRSA, H. influenzae, E. coli, P. vulgaris, S. marcescens, E. cloacae, B. fragilis and beta-lactamase producers of MSSA, H. influenzae strains were all within the in vitro susceptible range. The presence of clavulanic acid resulted in a significant enhancement of the antibacterial activity of ticarcillin against beta-lactamase producers of MRSA, N. gonorrhoeae, E. coli, K. pneumoniae, P. mirabilis, P. vulgaris and B. fragilis strains. Clavulanic acid had no synergistic activity for ticarcillin against S. marcescens, P. aeruginosa and E. cloacae.

Bacteria

Urodynamic findings in interstitial cystitis.

Fifty patients with irritative voiding symptoms and a painful bladder when full were engaged in this study to clarify the role of urodynamics in the diagnosis of interstitial cystitis (IC). Patients underwent urodynamic study, cystoscopic hydrodilatation of the bladder under general anesthesia and bladder biopsy. Twenty-eight women and two men who presented with signs of glomerulations or petechial hemorrhage of the bladder mucosa were classified as having IC, while 20 women without this characteristic were classified as having non-IC. A hypersensitive urge sensation, a small bladder capacity, a lower maximal flow rate and an abnormal flow pattern were observed in both groups of patients, but no significant difference was noted. More IC patients had a lower bladder compliance than non-IC patients (p < 0.025), and the maximal bladder capacity under anesthesia was smaller in IC patients (p < 0.05). However, there does not seem to be any definite correlation to the pathologic findings, except in patients with marked bladder inflammation, in whom a small capacity and severe clinical symptomatology were found.

Adult

Epidemiologic investigation of nosocomial outbreak of methicillin-resistant Staphylococcus aureus by plasmid pattern analysis.

Nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) have become an important problem with increasing frequency. In order to learn if plasmid pattern analysis can be used in epidemiologic investigations of MRSA infections, the authors did plasmid extractions of 70 MRSA stock isolates using a rapid lysostaphin lysis method. All isolates carried at least one plasmid. Most of the isolates had one large plasmid of 24-28 megadaltons (Md). Many also carried one or two small plasmids. Accordingly, 12 different patterns were identified. From these background results, we applied this method to the investigation of two small nosocomial outbreaks of MRSA infection. It was found that the analysis of plasmid pattern and restriction endonuclease analysis are more discriminative than antibiograms. Strains with the same antibiograms can be different by plasmid analysis. It is concluded that the plasmid pattern with a restriction endonuclease analysis study is a reliable method for epidemiologic study of MRSA infections.

Cross Infection

Staging of cervical cancer: comparison between magnetic resonance imaging, computed tomography and pelvic examination under anesthesia.

A prospective study was undertaken to compare magnetic resonance imaging (MRI) with computed tomography (CT) and examination under anesthesia (EUA) in staging cervical carcinoma, with special emphasis on parametrial status. Twenty patients with carcinoma of the cervix, in whom the extent of the disease was surgically confirmed, were analyzed by MRI, CT and EUA. The tumor size estimated by MRI correlated well (r = 0.79, p < 0.001) with those obtained by histopathologic measurement of the surgical specimen. Neither clinical examination nor CT could precisely estimate tumor size. The overall accuracy rate of MRI in staging carcinoma of the cervix was 75%, compared with 32% for CT staging and 55% for clinical staging. The accuracy rate of these modalities for parametrial status was 90% for MRI, 55% for CT and 82.5% for EUA. MRI accurately excluded all 20 patients with pelvic side wall, bladder and rectal involvement. In conclusion, MRI is superior to CT and EUA in assessment of the parametrium (90% vs 55% vs 82.5%, p < 0.005). From MRI, tumor size can be estimated precisely. Although a larger scale study comparing MRI and CT is needed to determine their roles, both should help in the diagnosis and selection of proper treatment for cervical carcinoma. Our preliminary report agrees with previous reports that MRI is promising and indispensable. MRI should be routinely used in conjunction with clinical staging to determine appropriate therapy in patients with cervical carcinoma.

Adult

Successful treatment of cytomegalovirus pneumonitis with ganciclovir and high-dose intravenous immunoglobulin in a bone marrow transplant recipient.

A 35-year-old man with acute lymphoblastic leukemia in second remission received an allogeneic bone marrow transplant from an HLA-compatible sibling donor. Unfortunately, cytomegalovirus (CMV) pneumonitis was histologically documented on Day +72. Combination therapy with ganciclovir (9-[2-hydroxy-1-(hydroxy-methyl) ethoxymethyl] guanine) and high-dose intravenous immunoglobulin (IVIG) was started immediately. The treatment comprised a three-week induction course (ganciclovir, 2.5 mg/kg q8h and IVIG, 500 mg/kg qod) and a seven-week fixed-dose maintenance course (ganciclovir 5 mg/kg thrice a week for 20 doses and IVIG 500 mg/kg twice a week for eight doses). The pneumonia resolved gradually, and he was free from symptoms within two weeks. The only significant side effect was moderately severe myelosuppression which was reversible after discontinuation of ganciclovir. The patient had a relapse of leukemia on Day +186, but there was no recurrence of CMV pneumonitis. This result confirms that such combination therapy is effective in the treatment of CMV pneumonitis in a patient with a bone marrow transplant.

Adult

A data storage and retrieval system for clinical research.

A data storage and retrieval system is presented that can be used for clinical research studies. The system is designed in such a way that the programs are independent of the application. It can be used by non-computer experts via a simple query language. Since it is bulit up in a modular way extensions can be easily made. The system is implemented on a PDP 11/70 under FORTRAN.

Computers

Dose response in radiotherapy for glottic carcinoma.

All consecutive patients with glottic squamous cell carcinoma treated primarily by radiotherapy from 1965 through 1974 have been analyzed to reveal response of the primary tumor in relation to the dose. This study appears to indicate presence of dose response for all stages of the primary lesions (T) of the glottic carcinoma except for the smallest ones namely TIS, T1a and T1b. The total number of advanced tumors is small and selected. But they tend to indicate presence of dose response. Out of 15 selected patients with T3 and T4 glottic tumors, 5 (33%) had attained local control by primary radiotherapy; two had distant metastasis at onset of therapy, while 5 (33%) needed salvage surgery for control of the residual or recurrent disease. The ultimate success rate is 66% (10 out of 15) for the patients with advanced tumors treated with a conservative approach. An ongoing study indicates similar, if not better preliminary results with high dose radiotherapy.

Adult

The psychology of consciousness.

All psychologic phenomena occur in consciousness. However, "consciousness" has two meanings: the faculty and the content of awareness. Traditional psychologies have largely concerned themselves with the content, neglecting the problem of the faculty, thus, limiting our understanding of human psyche. Study of meditation is a viable approach to the exploration of both meanings of consciousness. Meditation aims at a "cleansing" of the mind to reach, thereby, a content-free and conflict-free state--pure consciousness.

Awareness

Oncologic research and computerized data retrieval.

A computer-based data retrieval system for clinical research in oncology is described. The system has been designed to enable busy clinicians to retrieve and analyze data directly without major involvement of a computer specialist. The system uses texts similar to those in daily practice. In most situations no code is printed. The other important feature of the system is its ability to analyze clinical data in the form of tables, frequency distribution, etc. It may also furnish actuarial characteristics of the total population or subpopulations. Mathematical functions are calculated easily. Amendments and updating are simple enabling follow-up data to be incorporated. The system is under use for about 2 years and appears to be a versatile tool in the field of clinical research.

Clinical Trials as Topic