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Biomedical subjects

W J Su

Publications and source records attributed to W J Su.

At least 19 recordsLinked to original sources
PubMed1992

Effects of granulocyte-macrophage colony-stimulating factor and interleukin 6 on the growth of leukemic blasts in suspension culture.

We examined the stimulatory effects of recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin 6 (IL)-6 on the in vitro proliferation of leukemic blast cells from patients with acute leukemia. Bone marrow or peripheral blood leukemic blast cells were obtained from 21 patients, including 14 cases of acute myeloblastic leukemia (AML), four cases of acute lymphoblastic leukemia (ALL), two cases of acute undifferentiated leukemia, and one case of acute mixed-lineage leukemia. The proliferation of leukemic blast cells was evaluated by measuring the incorporation of 3H-thymidine into cells incubated with various concentrations of cytokines for 3 days. GM-CSF stimulated the DNA synthesis (with greater than 2.0 stimulation index) of blast cells in 9 of 14 (64%) AML cases, two cases of acute undifferentiated leukemia and one case of acute mixed-lineage leukemia. Only two cases of AML blasts responded to IL-6 to grow in the short-term suspension cultures. GM-CSF and IL-6 did not display a synergistic effect on the growth of leukemic cells. Moreover, GM-CSF and IL-6 did not stimulate the proliferation of ALL blast cells. Binding study also revealed the specific binding of GM-CSF on the blast cells of acute undifferentiated leukemia and acute mixed-lineage leukemia. Our results indicated that leukemic blast cells of acute undifferentiated leukemia and acute mixed-lineage leukemia possessed functional GM-CSF receptors.

Acute Disease↗
PubMed1992

Genetic and molecular analysis of pIP417 and pIP419: Bacteroides plasmids encoding 5-nitroimidazole resistance.

This report describes a genetic and molecular analysis of two transferable Bacteroides plasmids, pIP417 and pIP419, which carry genetic determinants conferring low-level resistance to 5-nitroimidazoles. The restriction endonuclease cleavage sites for each plasmid were localized. The NiR genetic determinants of pIP417 and pIP419 plasmids have been cloned into the Bacteroides cloning vector pBI191 (C.J. Smith, J. Bacteriol. 164, 294-301, 1985) as PvuII and Sau3A fragments, respectively. Both inserts had different restriction sites and did not cross-hybridize by Southern blot analysis. Genetic data obtained by cloning into pBI191 clearly show that the PvuII-generated fragments A (Rep) and B (Mob) of pIP417 are involved in plasmid replication and transfer, respectively. Although encoding resistance to the same antibiotic, both plasmids appeared different with regard to the 5-nitroimidazole resistance and replication genetic determinants. However, they share a homology in a region involved, at least in one case, in plasmid transfer. Considering the spontaneous high level of resistance to 5-nitroimidazole in Escherichia coli, this work, based on direct gene cloning into Bacteroides, demonstrates the value of such an approach.

Bacteroides↗
PubMed1992

Lymph node tuberculosis: 7-year experience in Veterans General Hospital, Taipei, Taiwan.

We retrospectively studied 71 cases of lymph node tuberculosis confirmed by culture or pathology from 1983 to 1989. Young adults were most frequently involved and the female to male ratio was 3:2. of 71 patients, three-quarters presented with palpable masses and two-thirds were asymptomatic. The cervical nodes were most frequently involved. Roentgenographic evidence of pulmonary tuberculosis was detected in 42% of patients and sputum culture-positive tuberculosis occurred in 7%. Tuberculin skin testing is less useful in our country due to routine BCG vaccination during infancy and early childhood. Selective excisional biopsy in addition to clinical information was necessary for differential diagnosis. 48 patients received regular treatment and were followed up for at least 1 year. Fresh nodes or enlargement of existing nodes developed in 10% of patients during treatment. Residual nodes were present in 10% of patients at the end of 9-month treatment with rifampicin, isoniazid and ethambutol, including prolonged or modified regimens in some individuals. In conclusion, in areas with a high frequency of tuberculous strains presenting a primary resistance to isoniazid, a 9-month regimen of rifampicin, isoniazid and ethambutol is recommended for lymph node tuberculosis.

Adult↗
PubMed1992

Effects of antibiotics and other drugs on toxin production in Clostridium difficile in vitro and in vivo.

In an attempt to understand more completely why patients treated with phenothiazines (chlorpromazine and cyamemazine), methotrexate, and certain antibiotics such as clindamycin have an increased risk of developing pseudomembranous colitis, the production of toxins A and B by Clostridium difficile in the presence of these drugs was measured in vitro as well as in vivo by using axenic mice. None of the drugs tested increased the production of toxins either in vitro or in vivo.

Animals↗
PubMed1992

In vitro antimicrobial activity of 18 phenothiazine derivatives: structure-activity relationship.

The antimicrobial activity of 18 phenothiazine derivatives has been evaluated against aerobic and anaerobic bacteria. The mean of the MIC reveals five active drugs against the bacterial strains tested: thioridazine, chlorpromazine, trifluoperazine, fluphenazine and triflupromazine. The other derivatives are less active and some show no antimicrobial activity. It seems that in vitro antibacterial activity alone is insufficient to explain certain intestinal diseases linked to the use of these molecules in psychiatry.

Bacteria↗
PubMed1992

[Anaphylactic shock after readministration of rifampicin: a case report].

Many reports have shown that rifampicin could induce a variety of adverse effects. However, anaphylactic shock occurring after readministration of rifampicin, to our knowledge, has not been reported thoughtfully. Herein we present a case with anaphylactic shock after readministration of rifampicin. The possible mechanism may be the interaction between IgE antibody and mast cell or basophils. Compared with continuous regimen, intermittent rifampicin regimen has longer interval to accumulate more rifampicin-induced antibodies, and more immunogenic side effects are the sequelae when re-encountered with rifampicin.

Aged↗
PubMed1992

Results of Senning operation for transposition of great arteries.

We report our results with 10 infants and children who underwent atrial repair using the Senning operation between 1985 and 1990. All cases had abdominal situs solitus, levocardia and atrio-ventricular concordance (D-bulboventricular loop). Nine patients had simple D-transposition of the great arteries without ventricular septal defects (VSD) or left ventricular outflow tract obstruction. The other patient had a double outlet right ventricle with subpulmonic VSD and pulmonary hypertension (PHT) and underwent a palliative Senning procedure. All patients had a balloon atrial septostomy (BAS) before surgery, except for one with Taussig-Bing syndrome. One patient had a Blalock-Hanlon operation after BAS. The age at the time of surgery ranged from two months to four years seven months (mean: 22 months) and weight ranged from 4.3-12 kg. There were two hospital mortalities including the patient with VSD and PHT. All of the patients had echocardiographic examinations and six of the eight survivors received cardiac recatheterization four to 19 months (mean: 7.4 months) postoperatively. No baffle leaks were noted in the survivors. Two patients had both mild tricuspid regurgitation and slightly decreased right ventricular contractility, and one patient had a pressure gradient of 6 mmHg between the superior vena cava and neo-right atrium. The clinical follow-up interval was eight to 64 months (mean: 31.4 months). All survivors showed a sinus rhythm on their latest electrocardiogram and were participating in normal daily activities without medication.

Child, Preschool↗
PubMed1992

Multiple cerebral aneurysms in a child with cardiac myxoma.

Neurologic involvement is not uncommon in cardiac myxoma, yet its association with multiple cerebral aneurysms is rare, especially in children. We describe a patient with left atrial and ventricular myxoma, who otherwise lacked cardiac symptomatology and did not exhibit auscultatory, roentgenologic, or electro-cardiographic evidence of heart disease. The clinical presentation was a sudden attack of a cerebrovascular occlusive disorder. Multiple fusiform aneurysms at the frontal and parietal branches of the left anterior and middle cerebral arteries were demonstrated on cerebral angiograms. The myxomas were surgically removed and the patient improved.

Child↗
PubMed1992

[An automatic gas scanning device, technical improvement for obtaining a favourable atmosphere for in vitro culture of anaerobic bacteria].

All methods for growth of anaerobic bacteria on solid media depend on the elimination of atmospheric O2 through use of a palladium catalyst (Deoxo-Catalyst), active in presence of at least 5% H2 with resultant formation of water. Anaerobic chambers and jars are the two conventional methods employed. Both are based on the elimination of air by means of a pump and its replacement with gas from a cylinder (evacuation-replacement technique). An alternative chemical technique for use in anaerobic jars consists of adding internal gas-generating sachets. The former techniques are more efficient but the trend, particularly in the clinical laboratories, is to use the simpler chemical system that has two inconveniences: a slow establishment of anaerobiosis, and a high cost. We propose a new system that does not require a vacuum pump and consists in flushing anaerobic jars with a convenient gas mixture (H2, CO2, N2: 4.5; 5; 90.5 v/v) by means of an automaton regulating both time and gas flow. Gas-liquid chromatography analysis of the gas inside the jar shows a rapid elimination of gaseous O2, whose residual concentration is low enough to permit growth of all anaerobes of clinical interest, including those which are more O2-sensitive. Comparative qualitative and quantitative data obtained with all available techniques demonstrate the advantages of the new system.

Anaerobiosis↗
PubMed1991

Delay of diagnosis of growth hormone deficiency in Taiwan.

In view of the importance of early detection of growth hormone deficiency, the height and age at the first pediatric endocrinologic clinic visit of 45 patients with growth hormone (GH) deficiency between January 1988 to December 1989 were retrospectively analyzed. Twenty-three patients with idiopathic GH deficiency had a median age of 13 years (range, from 3.8 to 29.9 years) at their first visit and a median height standard deviation score (SDS) of -3.87 (-2.14 to -7.93). Nineteen children with hypothalamopituitary tumors at their first visit, at a median of 2.17 years (0.42 to 7.83 years) after diagnosis of the tumor, had a median height SDS of -3.15 (-0.58 to -4.70). Three children with GH deficiency secondary to cranial irradiation at their first visit, at 8.17 years (1.33 to 10 years) after treatment for their malignancy, had a height SDS of -3.15 (-2.13 to -3.72). It is well known that the earlier the replacement therapy is begun in such patients, the better the prognosis is for final adult height. Regular height measurement and routine screening for shortness at school entry may overcome this delay in diagnosis. In addition, patients who have received cranial irradiation or had hypothalamopituitary tumors should be regularly measured and studied if their height velocities become subnormal. Physicians dealing with children should keep the possibility of growth hormone deficiency in mind when examining a short child.

Adolescent↗
PubMed1991

Clinical and hemodynamic results after Fontan operation.

Twenty-six patients, ranging in age from 2 to 14 years (mean, 6 years and 8 months), with tricuspid atresia or other complex cyanotic cardiac diseases underwent a modified Fontan operation between 1980 and 1990. In 13 patients, palliative operations had been previously performed. There were 7 mortalities within 1 month after the operation. Seventeen of the 19 survivors were followed up for 5-122 months (mean, 27) with no late deaths. Fifteen patients were in the New York Heart Association functional class 1. Two patients required reoperations at 2 and 57 months postoperatively: the former for atrio-ventricular valvular regurgitation, and the latter for late-developing conduit obstruction and residual atrial right to left shunting. Fourteen patients underwent cardiac catheterization after 1-57 months (mean, 9.8) postoperatively. Two patients had a residual right to left shunt at the atrial level, while the oxygen saturation in the remaining 12 patients was above 90%. Thus, the modified Fontan operation offers an alternate surgical approach for patients with complex congenital heart disease for whom no other palliative procedure can be expected to obtain significant improvement. It can be performed with good clinical and hemodynamic results in selected patients.

Adolescent↗
PubMed1991

[Mycobacterial lymphadenitis--case report].

Mycobacterial lymphadenitis is still a common and often poorly treated disease. Cervical lymph-node is most frequently involved. Mycobacterium tuberculosis clearly preponderates as the cause of mycobacterial cervical lymphadenitis in adults while other mycobacteria (MOTT) area mostly the causes of the same disease in children. Diagnostic methods and treatment choices between both groups are therefore different. It seems appropriate to perform total excisional biopsy in children especially in R.O.C. where skin test to differentiate between TB and MOTT is useless due to BCG vaccination. Current policy for mycobacterial lymphadenitis in adult is based on clinical diagnosis and chemotherapy. Biopsy is reserved for patients who fail to respond, including the small portion of patients in whom lymph nodes enlarge during chemotherapy. Lymph nodes can appear a fresh or enlarge during or after treatment, but they usually resolve spontaneously.

Adult↗
PubMed1991

Spiropent (clenbuterol): another choice for patients with chronic reversible airways obstruction.

Oral administration of spiropent (clenbuterol), 20 mcg on waking in the morning and 40 mcg before sleep, daily for 2 months, was studied in 34 patients, 19 males and 15 females, aged between 27 to 73 years (mean 47.8 +/- 17.5), who had chronic reversible airways obstruction as defined by the A.T.S.'s criteria. Assessments were made before and after the trial by monitoring lung function parameters and patient's comment on efficacy, side effects and comfort. Except 5 patients, 2 suffering from severe headache and 3 from poor control of asthma who had withdrawn from this study after one week of treatment, all patients completed the trial. Six out of 29 patients who completed the trial needed additional steroid treatment and 9 needed beta 2-agonist inhalation during the treatment period. The results showed improvement of FEV1 more than 15% in 21 patients (72%), FVC in 17 patients (59%) and PEFR in 20 patients (69%). These increases were significant (p less than 0.0001). However, only 12 patients (41%) had marked subjective improvement at the end of treatment. Cough (21%), headache (10%), nausea (7%) and dizziness (3%) were the commonest side-effects. No clinical or statistical difference was found in changes of vital signs and laboratory parameters. In conclusion, clenbuterol was effective and well-tolerated in the majority of patients enrolled in this study with minimal side-effects and good compliance. It may be used for long-term treatment of chronic reversible airways obstruction at lower cost.

Adult↗
PubMed1990

Bronchial adenoma--a heterogenous group of tumors: report of 38 patients.

Thirty-eight cases of bronchial adenoma seen at Taipei VGH during 1976-88 were reviewed. Nine were carcinoid tumors, 14 were mucoepidermoid carcinomas and 15 were cylindromas. There were 21 men and 17 women. Ages ranged from 6 to 81 years with a mean of 43. Twenty-five were primary tumors of lung and 13 were metastasized from distant sites. The commonest presenting symptoms were hemoptysis, persistent cough, dyspnea and chest pain. In primary bronchial adenomas, the mean duration of symptoms was similar for carcinoids and cylindromas, around 16 months, and shortest for mucoepidermoid carcinomas (2.9 months). Single mass lesion was the most common chest X-ray finding of primary adenomas, while multiple nodules were the commonest for metastatic adenomas. Most of the primary tumors (80%) were visible by bronchoscopy, which showed predilection of trachea for cylindromas, left-sided for mucoepidermoid carcinomas and right-sided for carcinoids. The mean age at presentation was similar for all types of primary adenoma, around 44.5 years, while more younger in patients with metastatic cylindroma than mucoepidermoid carcinoma. Most of the primary adenoma were resectable, however, post-operative chemotherapy or radiotherapy was required in 4 mucoepidermoid carcinomas and 2 cylindromas. All types of bronchial adenomas showed malignant potential, mean duration before metastasis was about 2 years (3 months to 4 years), most of them were mucoepidermoid carcinomas (60%). The 5-year survival rate was 11.1% for mucoepidermoid carcinomas, 55.6% for carcinoids and 83.3% for cylindromas. We conclude that the term bronchial adenoma represents a heterogenous group of tumors with considerable malignant potential and should not be ignored by its term of benignity.

Adenoma↗
PubMed1988

Doppler echocardiographic flow characteristics of isolated patent ductus arteriosus: better delineation by Doppler color flow mapping.

Eighteen infants and children with isolated ductus arteriosus and various hemodynamic states were examined with the Doppler color flow mapping technique to study the flow patterns of the patent ductus and its adjacent structures. Direct visualization of the ductus was achieved in all patients. All ductal flow was shunting left to right from the descending aorta to the pulmonary artery even in the presence of significant elevation of pulmonary artery pressure. However, transient bidirectional shunting was observed in two patients on serial studies. Disturbed systolic and diastolic flows were demonstrated within the ductus in each case. The blood flows in the main pulmonary artery consisted of three distinguishable areas: 1) a characteristic high velocity turbulent retrograde ductal jet throughout the entire cardiac cycle, located in the anterolateral aspect of the main pulmonary artery; 2) nonspecific low velocity retrograde late systolic and early diastolic flow, located in the posteromedial aspect of the main pulmonary artery; and 3) low velocity forward systolic and diastolic flow, occupying the remaining area of the pulmonary artery. The blood flows in the descending aorta near the ductal orifice consisted of disturbed systolic and diastolic flows in a reversed direction. By providing detailed real time blood flow information with simultaneous imaging of the ductus, Doppler color flow mapping greatly facilitates the detection of a small ductal shunt. This technique also allows detection of a bidirectional or right to left ductal shunt.

Aorta↗