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Biomedical subjects

T Yeh

Publications and source records attributed to T Yeh.

At least 19 recordsLinked to original sources
PubMed2001

Risk for respiratory distress syndrome in preterm infants born to mothers complicated by placenta previa.

This study examined the risk factors for respiratory distress syndrome (RDS) in preterm infants from pregnancies complicated by placenta previa. Forty preterm infants born to mothers with placenta previa between January 1989 and December 1995 in a medical center were enrolled. Each of these patients was matched in gestational age and gender with an infant born immediately after to a mother without placenta previa. Obstetric and neonatal outcome variables were collected. The mean+/-S.D. gestational age for both groups was 33.0+/-3.1 weeks. There was no difference in mean birthweight between the placenta previa and control groups (2129+/-598 vs. 2136+/-493 g). All the patients in the former and 11 (28%) in the latter were born by cesarean section. About a half of the mothers in both groups received antenatal steroids. Infants from placenta previa pregnancies had a higher incidence (21/40 vs. 10/40, P<0.01) and more severe RDS than controls. Stratified by the status of treatment with antenatal steroid, we found that gestational age was a significant risk factor for RDS in both treated and untreated groups (P<0.01), but placenta previa was an independent risk factor (odds ratio 32; CI 1-4182) by multiple exact logistic regression in antenatal steroid-treated group. We conclude that preterm infants born to mothers with placenta previa had a higher risk for RDS than controls. It played an independent role, in addition to gestational age, only in infants treated with antenatal steroid. We speculate that placenta previa was not directly contributing to RDS, but through other associated risk factors for RDS.

Adrenal Cortex Hormones↗
PubMed2001

Overexpression of HER-2/neu enhances the sensitivity of human bladder cancer cells to urinary isoflavones.

Soybean foods have been suggested to be practical chemopreventives for human urinary tract cancers. Recently, we demonstrated that the co-operative action of isoflavones results in an increased dose-dependent growth inhibition and apoptosis than any single isoflavone compound. This study aimed to examine the potential of HER-2/neu as a biological target for soy isoflavones. The sensitivity of the bladder cancer cell lines (n=7) to the isoflavones was inversely related to the amount of HER-2/neu expressed. By using HER-2/neu transfection experiments, all three stable transfectants showed a significant growth inhibition by the isoflavone mixture at concentrations attainable in normal adult urine. An increased inhibition of tyrosine phosphorylation of proteins immunoprecipitated by HER-2/Neu was observed in the neu-transfectants compared with controls. The results of this study suggest that HER-2/neu may be a practical biochemical target for urinary isoflavones in vivo.

Antineoplastic Agents, Phytogenic↗
PubMed2000

Distinct distribution of rare us kshv genotypes in south texas. Implications for kshv epidemiology and evolution.

PURPOSE: Kaposi's sarcoma-associated herpesvirus (KSHV, or human herpesvirus 8) is etiologically associated with Kaposi's sarcoma (KS) and primary effusion lymphoma (PEL). Although previous studies have assessed the geographic distribution of KSHV genotypes, the molecular epidemiology of KSHV remains largely unknown. The purpose of the present study was to examine the genotypes of KSHV isolates from KS patients in South Texas.METHODS: Eighteen KSHV isolates from 16 KS and 1 PEL patients in South Texas were collected between 1996 and 1998 and analyzed for KSHV subtypes by PCR sequencing of ORFK1 gene and KS330 fragment, and by PCR of ORFK15 gene. DNA sequences were aligned with known sequences and KSHV subtypes were assigned based on sequence variations.RESULTS: Of 18 KSHV isolates, 13 exhibited C subtype, and 5 exhibited A subtype in ORF K1 gene. ORF K15 genotyping showed that 10 of the isolates exhibited M form, of which 9 had C3 subtype. A unique C subtype isolate was found and classified as C6 clade. All of the M form KSHV isolates were found among KS patients over 50 years of age. Conversely, all KS patients under 40 years of age had only the P form KSHV isolates.CONCLUSIONS: In South Texas there is a distinct distribution of C3/M KSHV isolates, which are rarely found in other US regions (1 of 29). The C3/M KSHV genotype is more prevalent in HIV-negative elderly KS patients while the P-form of KSHV is more common among many young AIDS-KS patients.

Journal Article↗
PubMed2000

Recombinant bactericidal/permeability-increasing protein (rBPI21) as adjunctive treatment for children with severe meningococcal sepsis: a randomised trial. rBPI21 Meningococcal Sepsis Study Group.

BACKGROUND: Endotoxin is a primary trigger of the inflammatory processes that lead to shock, multiorgan failure, and purpura fulminans in meningococcal sepsis. Bactericidal/permeability-increasing protein (BPI) is a natural protein, stored within the neutrophil granules, that binds to and neutralises the effects of endotoxin in vitro, in laboratory animals, and in humans. To establish whether a recombinant 21-kDa modified fragment of human BPI (rBPI21), containing the active antimicrobial and endotoxin-neutralising moiety, would decrease death and long-term disability from meningococcal sepsis, we did a randomised, double-blind, placebo-controlled trial of rBPI21 in children with severe meningococcal sepsis. METHODS: We enrolled children (2 weeks to 18 years of age) presenting to 22 centres in the UK and the USA with a clinical picture suggestive of meningococcal sepsis, and with evidence of severe disease. Children were randomly assigned rBPI21 (2 mg/kg over 30 min followed by 2 mg/kg over 24 h) or placebo (0.2 mg/mL human albumin solution) in addition to conventional medical therapy. Primary outcome variables were mortality, amputations, and change in paediatric overall performance category (POPC) from before illness to day 60. Analysis was by intention to treat. FINDINGS: Of 1287 patients screened, 892 were excluded, including 57 patients who died or who met criteria for imminent death before receiving the study drug. 190 patients received rBPI21, and 203 placebo. 34 (8.7%) of 393 patients died during the study: 14 (7.4%) in the rBPI21 group and 20 (9.9%) in the placebo group (odds ratio 1.31 [95% CI 0.62-2.74], p=0.48). Compared with patients randomised to placebo, fewer patients treated with rBPI21 had multiple severe amputations (six of 190 [3.2%] vs 15 of 203 [7.4%], odds ratio 2.47 [0.94-6.51], p=0.067), and more had a functional outcome similar to that before illness (as measured by the POPC scale) at day 60 (136 of 176 [77.3%] vs 126 of 190 [66.3%], p=0.019). INTERPRETATION: Because most deaths occurred in the interval between identification of patients and study drug administration, the mortality rate in the placebo group was substantially lower than predicted. The trial was therefore underpowered to detect significant differences in mortality. However, patients receiving rBPI21 had a trend towards improved outcome in all primary outcome variables. Given the excellent severity match between placebo and rBPI21 groups at study entry, the results overall indicate that rBPI21 is beneficial in decreasing complications of meningococcal disease.

Adolescent↗
PubMed2000

From fold recognition to homology modeling: an analysis of protein modeling challenges at different levels of prediction complexity.

An analysis of different approaches to protein structure prediction is presented based solely on the range of models submitted to the third Critical Assessment of Protein Structure Prediction (CASP3) conference. CASP conferences evaluate the current state of the art of protein structure prediction by comparing blind prediction efforts of many groups for the same set of target sequences. Target sequences may be highly similar to those with known structure or can be totally (at least superficially) sequentially dissimilar. Techniques applied to those blind predictions (over 40 targets) ranges from a detailed homology prediction to the detection of remote homologues well below a twilight zone of protein sequence similarity. For the CASP3 conference, we have submitted predictions, totaling 35, with various levels of difficulty and complexity. For ten submitted homology targets, eight of them were determined by experiment so far. The RMSD of C-alpha atoms are 1.2-1.7, 2.3, and 4.6-17.9 A for the three easy targets, two hard targets, and three very hard homology targets, respectively. Out of 18-fold recognition predictions available for analysis, we got six correct predictions, five near misses, three tough near misses and four far misses. Here we analyze successes and failures of those predictions in an attempt to identify common problems and common achievements.

Computer Simulation↗
PubMed1999

Absence of vasospasm in radial artery CABG on high-dose norepinephrine.

One of the concerns in using radial artery as coronary artery bypass grafts centers around its unusual propensity for vasospasm when experimentally exposed to norepinephrine. This case report demonstrates an absence of vasospasm in a radial artery graft on high dose norepinephrine and may provide reassurance when alpha-agonists are required in this setting.

Coronary Artery Bypass↗
PubMed1999

Atrioventricular discordance: results of repair in 127 patients.

OBJECTIVE: The conventional management of patients with atrioventricular discordance is directed at associated lesions, taking advantage of physiologic "correction"; however, the morphologic right ventricle and tricuspid valve support the systemic circulation. Questions surrounding survival using this approach led us to analyze our institutional results. METHODS: All patients with atrioventricular discordance undergoing biventricular repair were analyzed (n = 127, 1959-1997), excluding those with functionally univentricular hearts. The ventriculoarterial connection associated with atrioventricular discordance varied and was most commonly discordant (87%), but occasionally concordant (6%), double-outlet right ventricle (6%), or double-outlet left ventricle (1%). At initial presentation, the most common lesions associated with atrioventricular discordance were ventricular septal defect (86%), pulmonary stenosis (64%), tricuspid regurgitation (28%), and atrioventricular block (12%). Nine patients underwent a double switch procedure to create ventriculoarterial concordance and the remainder were managed conventionally without correcting discordant connections. RESULTS: Operative mortality was 6% and did not vary by associated lesion. Twenty years after repair, survival was 48%. Within 20 years, 56% of patients required reoperation, usually for atrioventricular valve incompetence (n = 16), pulmonary stenosis (n = 16), or both (n = 3). Pacemakers were required in 50 patients, 4 before repair, 40 within 2 months of repair, and 6 remotely after repair. In early follow-up, the double switch procedure (n = 9) had equivalent mortality and a high pacemaker requirement for atrioventricular block. CONCLUSIONS: Analysis of conventional management of atrioventricular discordance revealed cumulative increases in mortality, systemic atrioventricular valve (tricuspid) replacement, complete atrioventricular block, and incidence of reoperation. Alternative management should be examined.

Adolescent↗
PubMed1999

Acute brain death alters left ventricular myocardial gene expression.

OBJECTIVES: The depressed myocardial function observed in brain dead organ donors has been attributed to massive sympathetic discharge and catecholamine cardiotoxicity. Because elevated catecholamines are associated with altered myocardial gene expression, we investigated whether acute brain death from increased intracranial pressure alters the expression of myocardial gene products important in contractility. METHODS: A balloon expansion model was used to increase intracranial pressure in rabbits (n = 22). At timed intervals after brain death, mean arterial pressure, heart rate, electrocardiograms, histologic myocardial injury, and systemic catecholamines were assessed. Messenger RNA levels encoding myofilaments, adrenergic receptors, sarcoplasmic reticulum proteins, transcription factors, and stress-induced programs were measured with blot hybridization of total left ventricular RNA. RESULTS: Increased intracranial pressure induced an immediate pressor response that temporally coincided with diffuse electrocardiographic ST segment changes. Systemic epinephrine and norepinephrine levels concurrently increased (5- to 8-fold within 1 minute), then fell below baseline within 2 hours, and remained depressed at 4 hours. By 1 hour, histologic injury was evident. Four hours after the induction of increased intracranial pressure, levels of messenger RNA-encoding skeletal and cardiac alpha-actins, egr-1, and heat shock protein 70 were significantly increased. Sham-operated animals did not exhibit these changes. CONCLUSIONS: Select changes in myocardial gene expression occur in response to increased intracranial pressure and implicate ventricular remodeling in the myocardial dysfunction associated with acute brain death.

Actin Cytoskeleton↗
PubMed1999

Equivalent survival following cavopulmonary shunt: with or without the Fontan procedure.

OBJECTIVES: In 1992, an analysis of our experience with the cavopulmonary shunt (CPS) demonstrated equivalent long-term survival, with or without subsequent conversion to a Fontan circulation. Before 1992 (era 1) intervention was deferred until mandated by clinical deterioration. Since 1992 (era 2), timing of both CPS and Fontan was compressed in an effort to improve survival. Survival following CPS is analyzed to ascertain whether Fontan confers any survival advantage over no further definitive intervention. METHODS: From 1962 to 1997 inclusive, 490 patients underwent CPS, excluding those who had a CPS concomitant with a Fontan. In 55 patients the CPS was performed at or after a biventricular repair (BVR), or after a Fontan, and these patients are excluded. The 435 patients remaining followed a surgical protocol which included a subsequent BVR (n = 28), or a subsequent Fontan operation (n = 220), or no further definitive surgery (CPS only, n = 187). Between eras the mean age at surgery decreased for all procedures. RESULTS: Long-term survival 20 years after a CPS in 435 patients is 56 +/- 5%. Survival at 20 years among the 220 patients who were subsequently converted to a Fontan circulation is 65 +/- 8% compared to 50 +/- 11% for the 187 patients who did not have a Fontan. However, most of their survival difference is because all early deaths after a CPS occurred in the non-Fontan group. Multivariable analysis demonstrated that proceeding to a Fontan did have a small survival advantage which was not evident by univariate analysis. Independent risk factors for death, at any time, are a common atrioventricular valve, or pulmonary artery banding. The era had no effect on survival. CONCLUSIONS: The single ventricle circulation appears to have a limited durability of, an average, 30-40 years. There is a slight survival advantage in converting patients after a CPS to a Fontan circulation. A marked reduction in age at CPS and at Fontan has, as yet, not improved survival.

Adolescent↗
PubMed1997

Characteristics of the Sony Multiscan 17se Trinitron color graphic display.

Technical measurements of the Sony Multiscan 17se were made and are reported in the belief that they would be useful to visual scientists who consider employing this device as a display unit. Luminance, spatial uniformity, luminance additivity between the output of the guns, CIE1931 chromaticity coordinates, and gamma correction parameters were measured. The characteristics of individual monitors will probably be different from the one studied here but it is believed that the results obtained serve as a fair indication of what might be expected from this device.

Color Perception↗
PubMed1996

The time course of adaptation in macaque retinal ganglion cells.

The time course of adaptation of cells of the parvocellular (PC) and magnocellular (MC) pathways has been characterized following changes in retinal illuminance or chromaticity. Adaptation state was cycled between high and low luminance levels or between backgrounds with wavelengths metameric to 630 and 570 nm. Cell responsivity was probed with brief bursts of luminance or chromatic modulation. After a change in luminance, adaptation of both MC-cells (tested with a luminance probe) and red-green PC-cells (tested with a chromatic probe) was relatively rapid and largely complete within 100 msec or less. After a change in chromaticity, recovery of responsivity in red-green PC-cells was dependent on cell type. Recovery of responsivity with backgrounds elevating maintained firing was complete within a few seconds, but with backgrounds suppressing cell firing, recovery took many tens of seconds. This very slow time course may be due to a threshold effect. In experiments with backgrounds which selectively adapted one cone type, use of cone-isolating probes indicated that the time course of PC-cell chromatic adaptation may be determined at a site after the subtraction of cone signals. Recovery of responsivity of MC-cells was also prolonged over several seconds following a chromatic change. Our data suggest that adaptation in macaque ganglion cells depends on mechanisms both before and after the site of cone interaction, and that these mechanisms may differ in time course between MC- and PC-cells. The results indicate that it may be important in psychophysical adaptation experiments to consider the presence of multiple postreceptoral mechanisms with different adaptation characteristics.

Adaptation, Ocular↗
PubMed1995

Luminal non-selective cation and outwardly rectifying chloride channels in cultured strial marginal cells from gerbil.

Ionic channels located on the luminal side of strial marginal cells (MCs) of gerbil in culture were investigated using the patch-clamp technique. Two types of channels were identified. The most frequently recorded single-channel activity corresponded to a non-selective cation (NSC) channel with a conductance of 23.7 +/- 0.2 pS (n = 18) in symmetrical NaCl conditions. The channel was activated by internal Ca2+ and inhibited by internal adenine nucleotides and flufenamic acid. Spontaneous activity of NSC channels was found in 16% of the cell-attached patches and with a very high density (9 +/- 2 levels/patch, n = 28) in 100% of the excised patches. An outwardly rectifying chloride (ORC) channel was also identified in 14% of the patches but only after excision. The channel exhibited at 0 mV a unit conductance of 26.8 +/- 1.3 pS (n = 8) and a strong outward rectification in symmetrical NaCl conditions, and the open probability increased with depolarization. The luminal NSC channel and the ORC channel evidenced in this study might participate in the production of endolymph. Although extrapolation of the presents results to the in vivo situation should be made with caution, this study suggests that culture of strial MCs may be a suitable model for investigation of endolymph physiology.

Adenine Nucleotides↗
PubMed1995

Microvascular dysfunction after myocardial ischemia.

Endothelium-mediated relaxation and smooth muscle function in large coronary arteries are resistant to prolonged global ischemia. We used a small-vessel myograph to test the hypothesis that small intramyocardial artery endothelium and smooth muscle function have greater sensitivity to ischemic injury than large artery endothelium and smooth muscle. Normothermic global ischemia was induced in 15 porcine hearts. Intramyocardial arterial ring segments were assessed at 0, 30, 60, 90, and 120 minutes of ischemia in vitro with a small-vessel myograph. Potassium determined smooth muscle contraction, bradykinin endothelium-mediated relaxation, and sodium nitroprusside direct smooth muscle relaxation. Endothelium-mediated relaxation after 30 minutes of ischemia was similar to control (56% versus 66%) but was impaired at 60, 90, and 120 minutes of ischemia (32%, 11%, and 6%). Smooth muscle contraction was unchanged at 30 and 60 minutes compared with control (56 and 53 versus 63 mm Hg) but was significantly decreased at 90 and 120 minutes (33 and 13 mm Hg). Direct smooth muscle relaxation was significantly decreased at 120 minutes of ischemia compared with control (58% versus 95%). In a previous study, epicardial coronary artery endothelium-mediated smooth muscle vasodilation and direct smooth muscle vasodilation were preserved until 160 minutes of ischemia. After 160 minutes of ischemia, endothelium-mediated relaxation was lost and only direct smooth muscle vasodilation was preserved. In contrast to vasodilation, vasoconstriction was significantly reduced at 140 minutes of ischemia. These data indicate a greater and earlier adverse effect of ischemia on intramyocardial arterial endothelium-mediated relaxation than smooth muscle contraction or relaxation. These data support the hypothesis that there is an early functional endothelial cell injury associated with global ischemia. Relaxation that is endothelium-dependent in intramyocardial arteries is more sensitive to ischemic injury than in epicardial arteries. Unique to this study was the evaluation of small intramyocardial arteries (281 +/- 29 microns) that are the primary sites of coronary vascular resistance. Microvascular endothelial dysfunction after ischemia, therefore, may contribute to the "no-reflow phenomenon" seen during reperfusion injury.

Animals↗
PubMed1995

Mechanisms subserving temporal modulation sensitivity in silent-cone substitution.

Temporal contrast sensitivity data were collected with sine-wave-modulated lights for achromatic, chromatic, and silent-cone-substitution stimuli. Achromatic (556- and 642-nm lights in phase) and chromatic (556- and 642-nm lights in counterphase) modulation sensitivities were measured at a constant time-average retinal illuminance of 1256 trolands (Td) and chromaticity of 595 nm. These data were considered to represent isolated temporal responses of luminance and red-green chromatic channels, respectively. Silent cone substitution was achieved with counterphase modulation of the 556- and the 642-nm lights and by suitable adjustment of the modulations or the radiances of the two lights. (1) The peak modulation depth of the 642-nm light was reduced to silence the long-wavelength-sensitive (LWS) cone, and the peak modulation depth of the 556-nm light was reduced to silence the middle-wavelength-sensitive (MWS) cone. These protocols maintained the time-average retinal illuminance and chromaticity as for the control conditions. (2) The luminance of the 642-nm light was decreased to silence the LWS cone and was increased to silence the MWS cone. In this procedure the time-average retinal illuminance and chromaticity differ for the silenced-LWS-cone (1047 Td and 589.5 nm) and the silenced-MWS-cone (4358 Td and 622 nm) conditions. The response modulation of the achromatic and the chromatic channels was calculated for the silent-substitution conditions. The chromatic channel is more sensitive at low frequencies, with a transition to greater achromatic channel sensitivity near 13 Hz for the silenced-LWS-cone condition and near 6 Hz for the silenced-MWS-cone condition.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Temporal response of ganglion cells of the macaque retina to cone-specific modulation.

The temporal response of cone inputs to macaque retinal ganglion cells were compared with cone-specific sinusoidal modulation used to isolate each cone type. For all cell types of the parvocellular (PC) pathway, temporal responsivity was similar for short (S)-, middle (M)-, and long (L)-wavelength-sensitive cone inputs, apart from small latency differences between inputs to center and surround. The temporal response resembled that expected from receptor physiology. Responses of cells of the magnocellular pathway to M- or L-cone modulation showed more complex properties indicative of postreceptoral processing. Human psychophysical temporal-sensitivity functions were acquired with S-cone modulation under conditions similar to those for the physiological measurements. Ratios of psychophysical to physiological data from S-cone cells (the only cells that respond to this stimulus) yielded an estimate of the central filter acting upon PC-pathway signals. The filter characteristic could be described by a four-stage low-pass filter with corner frequency 3-5 Hz.

Animals↗