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Biomedical subjects

Y L Yu

Publications and source records attributed to Y L Yu.

119 records · Page 7Linked to original sources

The clinical picture of ectasia of the intracerebral arteries.

Thirty-one patients with ectasia of intracranial arteries were studied. The carotid system was more frequently involved than the vertebrobasilar. The condition is relatively rare and usually occurs with other vascular disease. Ectasia presents with a variety of neurological symptoms, amongst which visual disorders are common. The overall mortality was 52%, but the prognosis was appreciably worse for the vertebrobasilar group, probably because of a higher incidence of compression of surrounding neural structures. Defects in the internal elastic lamina, with or without associated atheroma, are often found in the affected arteries.

Adult

Chronic effects of phenytoin on brain-stem auditory evoked potentials in man.

The effects of phenytoin (PHT) on brain-stem auditory evoked potentials (BAEPs) were studied in 65 epileptic patients who received long-term PHT monotherapy at therapeutic and supra-therapeutic levels with no clinical evidence of brain-stem toxicity. Abnormal BAEPs were found in 7.5% and 33.3% of patients with therapeutic and supra-therapeutic PHT levels respectively. Serum PHT levels had a trend towards a positive relationship with the I-V interpeak latency (IPL), and a significant negative relationship with the amplitudes of waves I and V. At supra-therapeutic levels, both I-V and I-III IPLs were significantly prolonged while at therapeutic levels only I-III IPLs were prolonged. The absolute latency of wave I was prolonged in both the therapeutic and the supra-therapeutic groups. These results suggest that PHT acts both peripherally on either the auditory nerve or the cochlea, and centrally on brain-stem conduction.

Adolescent

Diet composition, alcohol utilization, and dependence.

Experiments were carried out in which a nutritionally balanced liquid diet previously used in this laboratory was modified as to total calorie content and high or low carbohydrate and fat concentration. Ethanol was added at 4.5% and 6.2% of diet weight and provided either 27% or 34-37% of total calories depending upon the changes in nutrient content. Measurements included 8-day food/calorie and ethanol consumption, plasma ethanol level, liver alcohol dehydrogenase (ADH) activity, and rate of audiogenic-induced withdrawal seizures. The original liquid diet with 4.5% ethanol was consumed in significantly lesser amounts than the alcohol-free diet, and essentially no body weight gain occurred, regardless if the major nonalcohol, nonprotein calorie source was fat or carbohydrate. When the calorie content of the diet was boosted through the addition of extra carbohydrate or fat (at the expense of water), appreciable weight gain was noted; in the case of the higher calorie diet boosted with more carbohydrate (maltodextrin) calories, growth was similar to that observed on the alcohol-free control diet. On this latter diet ethanol calories appeared to be utilized close to their theoretical value of 7 kcal/g. Blood alcohol levels were significantly higher on the lower calorie diets and were lowest on the high-calorie, high-carbohydrate, 4.5% ethanol diet. This diet also allowed for the lowest rate of withdrawal seizures despite an ethanol intake that was as high as on the lower calorie diets. Essentially, no differences were noted among ADH activities for the dietary treatments studied and thus, did not explain the differences observed among blood ethanol levels. When the alcohol concentration in the high-carbohydrate, high-calorie diet was raised to 6.2% from 4.5% to provide 34% of total calories, the rats responded by decreasing their food (and alcohol) intake to the same level as did the animals receiving a much lower calorie diet, but with 37% of caloric alcohol content. This suggests that at a diet alcohol concentration of 34-37%, one or more nutrient metabolites become limiting in the utilization of ethanol, resulting in food intake adjustments that maintain similar amounts of alcohol consumption.

Alcohol Drinking

Amphetamine and fenfluramine suppress ethanol intake in ethanol-dependent rats.

Alcohol intake or preference for alcohol has been attributed to concomitant dopamine and serotonin dysfunction in rats. Amphetamine and fenfluramine, administered alone, have been shown to reduce food and fluid intake as well as alcohol consumption while acute coadministration of these agents has been shown to suppress audiogenic seizure in rats withdrawn from alcohol. The present study was designed to assess the effectiveness of chronic amphetamine and fenfluramine coadministration on reducing alcohol intake. Chronic coadministration of amphetamine (2 mg/kg) and fenfluramine (8 mg/kg) reduced alcohol consumption during choice trials in both alcohol-dependent and alcohol-nondependent rats while not affecting water intake. The findings indicate that coadministration of amphetamine and fenfluramine, a treatment effective in reducing alcohol withdrawal seizures, also selectively attenuates alcohol consumption.

Alcohol Drinking

Alcohol utilization and dependence with special reference to protein level in a liquid diet for rats.

Experiments were carried out with a nutritionally balanced diet to test the response of rats to levels of ethanol between 0% and 6%, and to different levels and sources of protein and amino acid supplements in relation to alcohol utilization and withdrawal seizures. The high-calorie/high-carbohydrate liquid diet was well tolerated when the alcohol level was less than 30% of total calories, or 4.5% of diet. When alcohol was provided at 6% of diet, or 33% of total calories, growth and withdrawal seizure rates were negatively affected in comparison with the lower ethanol levels, even though ethanol consumption (in g/kg/day) was not different. The 6% alcohol diet was then altered through the addition of more protein calories, from 13% to 20%. This supplementation improved growth rate of the animals and reduced the rate of withdrawal seizures. The improvement from the additional protein was observed with both casein and soy protein, and was not attributable to any one or even several amino acids that might serve as transmitter precursors. A mixture of all essential amino acids representing the difference in amino acids between 13% and 20% casein protein calories was an effective as the equivalent amount of intact protein. The nonessential amino acids equivalent to 7% casein protein calories, when added to the 13% protein calories diet, increased the rate of withdrawal seizures, presumably by exacerbating the protein deficiency in the 13% protein diet. It was concluded that a 1000-1200 kcal/kg diet with 20% kcal from protein and 50% kcal from carbohydrate provides an optimal nutrient balance for efficient utilization of a 6% ethanol liquid diet for rats.

Alcoholism

If a well-stabilized epileptic patient has a subtherapeutic antiepileptic drug level, should the dose be increased? A randomized prospective study.

In an attempt to determine whether the dose of an antiepileptic drug should be increased in epileptic patients who were seizure-free and had subtherapeutic serum levels, 79 patients with idiopathic generalized tonic-clonic seizures treated with monotherapy [phenytoin (PHT) or phenobarbital (PB)] and with a subtherapeutic serum level were prospectively studied. Their last seizure was at least 3 months prior to entry, and no patient had any clinical evidence of toxicity. They were randomized to study arm A (keeping the level in the subtherapeutic range) or study arm B (increasing the dose until the level reached and stayed at the therapeutic range). Over a mean follow-up period of 24 months, there was no significant difference between the two study arms in the occurrence of seizures, but arm B patients had an increased incidence of neurotoxic side effects from the dose increment. These results confirm the clinical impression that it is unnecessary to increase the dose of the antiepileptic drug despite a subtherapeutic serum concentration in a relatively well-stabilized patient, thus minimizing the frequency of dose adjustment and the need for expensive therapeutic drug monitoring.

Adult

Novel HLA-DR2-related haplotypes in Hong Kong Chinese implicate the DQB1*0602 allele in susceptibility to multiple sclerosis.

Multiple sclerosis (MS) is strongly associated with the HLA-Dw2 haplotype DRw15.DQw6 in Caucasoids, although the relative contributions of DR and DQ loci to disease susceptibility are unknown. The situation is further complicated by the apparent lack of an association between DR2 and MS in Orientals. This study examined 42 DR2-positive chromosomes in healthy Chinese and 12 DR2-positive chromosomes in MS patients from Hong Kong, using oligonucleotide hybridizations of DQA1, DQB1, DRB1, and DRB5 polymerase chain reaction (PCR) products. There was marked heterogeneity in DR2-related haplotypes in controls (ten types), where the most frequent haplotype, confirmed in one family, involved the novel arrangement DRB1*1501, DQB1*0601. Another common haplotype had the unusual combination of DRB1*1602, DRB5*0101 as confirmed by DNA sequencing of the DRB5 allele. In contrast, the most common DR2-related haplotype in MS patients was the 'classical' Dw2 haplotype DRB1*1501, DQB1*0602, with a frequency of 50% compared with 12% in controls (P = 0.01). Novel DR,DQ linkage disequilibrium relationship in Hong Kong Chinese have permitted recognition of DQB1*0602 as a susceptibility allele in DR2-positive MS patients, although a role for the DRB1*1501 allele in MS pathogenesis has not been excluded by this study.

Alleles

Cerebral haemorrhage in a urban Chinese population.

A prospective study of Chinese patients aged 20-70 years reveals that at least 30.5% of all strokes are due to cerebral haemorrhage. Compared to previous studies in Caucasians, there is both a proportional and absolute increase in cerebral haemorrhage amongst all strokes, alert strokes, or those who presented with just a lacunar syndrome. The cause for this increase is unclear but genetic, dietary, and other environmental factors may be involved.

Adult

Cord shape and measurements in cervical spondylotic myelopathy and radiculopathy.

A combined clinical myelographic and computed myelographic study was performed in 30 patients with cervical spondylotic myelopathy; computed myelography was also performed in 16 control patients. Good correlation was found between degree of deformity of cross-sectional shapes of the cord and the outcome of surgery, and measurements of anteroposterior diameter and area of the cord seemed helpful in this preliminary study. There was also reasonably good correlation between the clinical features when grouped according to specific tract involvement, and the pattern of deformity shown by the abnormal cross-sectional cord shapes.

Adult