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Biomedical subjects

Y Lo

Publications and source records attributed to Y Lo.

At least 19 recordsLinked to original sources
PubMed2006

Abnormal glucose metabolism among older men with or at risk of HIV infection.

OBJECTIVES: To determine factors associated with diabetes, insulin resistance, and abnormal glucose tolerance in older men with or at risk of HIV infection. METHODS: Diabetes was assessed by self-report in 643 men >or=49 years old with or at risk of HIV infection. In a subset of 216 men without previously diagnosed diabetes [including 90 HIV-uninfected men, 28 HIV-infected, antiretroviral-naive men, 28 HIV-infected men taking non-protease inhibitor (PI)-containing highly active antiretroviral therapy (HAART), and 70 HIV-infected men taking PI-containing HAART], an oral glucose tolerance test with insulin levels was performed. HIV serology, CD4 cell count, weight, height and waist circumference were measured. Antiretroviral use, drug use, family history of diabetes, physical activity and sociodemographic data were obtained using standardized interviews. RESULTS: Of 643 participants, 116 (18%) had previously diagnosed diabetes. With the oral glucose tolerance test, 15 of 216 men (7%) were found to have undiagnosed diabetes and 40 (18%) impaired glucose tolerance. Factors independently associated with previously diagnosed diabetes included use of non-PI-containing HAART, methadone treatment, positive CAGE test for alcoholism, obesity and family history of diabetes. Factors independently associated with greater insulin resistance included waist circumference and heroin use. Factors independently associated with abnormal glucose tolerance (impaired glucose tolerance or diabetes) included age >or=55 years and Hispanic ethnicity. CONCLUSIONS: HIV-infected men with diabetes risk factors should undergo screening for diabetes regardless of HAART use. Interventions targeting modifiable risk factors, including overweight and physical inactivity, are warranted. The potential impact of opiate and alcohol abuse on glucose metabolism should be recognized in clinical care, and addressed in future research studies of HIV-infected persons.

Antiretroviral Therapy, Highly Active↗
PubMed2006

Increased serum lipids are associated with higher CD4 lymphocyte count in HIV-infected women.

OBJECTIVE: Highly active antiretroviral therapy (HAART) has been associated with dyslipidaemia; however, the roles of immune status and non-HIV-disease risk factors remain unclear. METHODS: A cross-sectional analysis of fasting lipids was carried out for 231 women, of whom 132 were HIV-infected and 99 were uninfected. The concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and apolipoprotein B (apo B) were measured. CD4 lymphocyte count, hepatitis C status, demographics, diet, and anthropometrics were also assessed. RESULTS: A total of 132 women were HIV-infected [30 were antiretroviral-naive, 68 were on protease inhibitors (PIs), and 34 were on non-PI HAART]. HIV infection was associated with higher triglycerides, lower HDL-C, and, among obese women, higher total cholesterol and LDL-C. Non-PI and PI HAART were each independently associated with higher total cholesterol, LDL-C, and apo B, compared with being ART-naive. Among HIV-infected women, after adjustment for HAART use, women with a CD4 lymphocyte count > or =500 cells/microL had total cholesterol 41.8 mg/dL (P = 0.002) and LDL-C 28.8 mg/dL (P = 0.01) higher, on average, than women with a CD4 count <200 cells/microL. Women with a CD4 count of 200-499 cells/microL had total cholesterol 26.31 mg/dL higher, on average, than those with a CD4 count <200 cells/microL (P = 0.04), although differences in LDL-C did not reach significance (15.51 mg/dL; P = 0.12). A higher CD4 count was also associated with higher apo B (P < 0.001). Active hepatitis C infection was associated with lower total cholesterol, LDL-C, triglycerides, and apo B. CONCLUSIONS: Higher CD4 lymphocyte counts were associated with higher lipid levels, suggesting that immune competence may independently affect the dyslipidaemia seen in the HAART era. In addition, it is important that hepatitis C status be assessed in studies of dyslipidaemia in the HIV-infected population.

Adult↗
PubMed2006

Serum prostate-specific antigen levels in older men with or at risk of HIV infection.

OBJECTIVES: The aim of the study was to determine the rate of, and factors associated with, elevated prostate-specific antigen (PSA) levels in older men with or at risk of HIV infection. METHODS: Using a cross-sectional analysis, we interviewed 534 men > or =49 years old at risk for HIV infection on demographics, behaviours and medical history. Laboratory testing included serum PSA level and HIV serology, and T-cell subsets for those who were HIV seropositive. Elevated PSA level was defined as >4.0 ng/mL, and men with elevated PSA levels were referred for urological evaluation. RESULTS: Fifteen per cent of men were white, 55% black, and 23% Hispanic; median age was 53 years (range 49-80 years); 74% were sexually active; 65% currently smoked cigarettes; and 16% had taken androgens. Among 310 HIV-positive men, CD4 counts were >500 cells/microL in 31%, 200-500 cells/microL in 51%, and <200 cells/microL in 19%. Twenty men (4%) had elevated PSA. On univariate analysis, only older age was significantly associated with elevated PSA, and there was no significant difference in the number of men with elevated PSA between HIV-positive and HIV-negative men (nine of 310 vs 11 of 224; P = 0.28). On multivariate analysis, older age remained the only variable associated with elevated PSA level [reference group < or =50 years; adjusted odds ratio (OR(adj)) 1.0 for age 51-60 years; OR(adj) 5.9 (95% confidence interval 1.2-30.1) for age > or =61 years] adjusted for HIV status, family history of prostate cancer, and androgen use. CONCLUSIONS: Among older men, PSA levels increased with age but did not differ by HIV status. The clinical use of PSA levels in older men currently do not need to be modified for those with HIV infection.

Aged↗
PubMed2005

Epidural abscess in an obstetric patient with patient-controlled epidural analgesia--a case report.

We present the case of a 37-year-old pregnant woman who underwent a cesarean section due to previous cesarean delivery. Spinal anesthesia was performed at the L2-3 intervertebral space with an epidural catheter inserted at L1-2 for postoperative patient-controlled epidural analgesia. When the epidural catheter was removed on day three, an area of redness round the entry point was noted and the patient complained of low back pain, but was discharged from hospital. Later the same day, she felt backache so severe that she was unable to stand up or bend her body. She called for help and was sent to our emergency room. Physicians noted a small amount of discharge from the insertion site, and the body temperature was elevated to 38 degrees C. An anesthesiologist and an infectious disease specialist were consulted, and an epidural abscess was suspected. Urgent magnetic resonance imaging revealed an epidural abscess at L1-2. After five days of unsuccessful treatment with oxacillin, a 28-day course of vancomycin, followed by two months of oral fusidic acid, resulted in complete remission of the epidural abscess. The patient has remained free of neurologic deficit.

Adult↗
PubMed2004

The effect of promethazine on postoperative pain: a comparison of preoperative, postoperative, and placebo administration in patients following total abdominal hysterectomy.

BACKGROUND: Histamine receptors are involved in the development of inflammatory pain and hyperalgesia, and the use of antihistamines is advocated as an alternative for pain therapy and treatment of postoperative nausea and vomiting. We investigated the influence of timing of promethazine administration on postoperative pain outcomes. METHODS: Ninety female patients undergoing total abdominal hysterectomy were randomly divided into three groups. All individuals received infusions of promethazine and normal saline before anaesthesia induction, and postoperatively the Pre group received promethazine 0.1 mg kg(-1) before anaesthesia and saline postoperatively, and the Post group received saline before anaesthesia and promethazine 0.1 mg kg(-1) postoperatively, while the Control group received two equivalent volumes of saline. Patients were treated using patient-controlled intravenous analgesia (PCA). The primary endpoint was pain intensity and morphine consumption. The secondary endpoint was postoperative nausea and vomiting. RESULTS: Postoperative morphine usage was significantly lower in the Pre group (24.1 +/- 3.9 mg) relative to the Post (30.0 +/- 4.6 mg) and Control groups (32.1 +/- 4.8 mg) during the first 24 h postoperatively (P<0.05). The number and incidence of patients suffering from postoperative nausea in the first 24 h was six (21%), seven (23%), and 15 (47%) in the Pre, Post, and Control groups, respectively (P<0.05). The number and incidence of patients vomiting in the first 24 h was three (10%), two (7%), and 10 (32%) in the Pre, Post, and Control groups, respectively (P<0.05). The number of patients asking for rescue antiemetic in the first 24 h was one (3%), two (7%), and seven (22%) in the Pre, Post, and Control groups, respectively (P<0.05). CONCLUSIONS: Our results suggest that preoperative administration of promethazine 0.1 mg kg(-1) reduces postoperative morphine consumption compared with postoperative and placebo administration, and that use of promethazine reduces PONV and the number of patients asking for rescue antiemetic in the first 24 h after surgery when compared with placebo.

Adult↗
PubMed2001

Effect of PSC 833 liposomes and Intralipid on the transport of epirubicin in Caco-2 cells and rat intestines.

Clinical applications of first-generation multidrug resistance (MDR) modulators, such as cyclosporin A (CsA) have been hampered because of their severe side effects in vivo. Recent investigations have led to the development of a more potent and less toxic modulator, PSC 833, which is a nonimmunosuppressive analogue of CsA. However, adverse pharmacokinetic interactions between anticancer drugs and PSC 833 have resulted in increased toxicity as compared to the individual toxicity. Our study evaluated the MDR reversing effect of PSC 833 in free, liposomal or Intralipid formulations on the uptake and transport of epirubicin in Caco-2 cells and everted gut sacs of rats. The results showed that PSC 833 in free or liposomal formulations significantly enhanced the intracellular accumulation of epirubicin in a dose-related manner in Caco-2 cells. The optimum in enhancement was observed at the concentration of 2 microM PSC 833. These formulations markedly increased the apical to basolateral absorption of epirubicin in Caco-2 cells and substantially improved the mucosal to serosal absorption of epirubicin in rat jejunum and ileum. PSC 833 in free, liposomal or Intralipid formulations all significantly reduced basolateral to apical efflux of epirubicin across Caco-2 monolayers. However, PSC 833 in liposomes showed greater enhancement than other formulations. In conclusion, PSC 833 and PSC 833 liposomes have the function as MDR reversing agents for the inhibition of intestinal P-glycoprotein. Liposomal preparations of PSC833 may provide a useful alternative dosage form for intravenous administration of PSC 833 to be combined with anticancer drugs to circumvent drug resistance in cancer chemotherapy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2001

The anti-anginal drug fendiline increases intracellular Ca(2+) levels in MG63 human osteosarcoma cells.

The effect of fendiline, an anti-anginal drug, on cytosolic free Ca(2+) levels ([Ca(2+)](i)) in MG63 human osteosarcoma cells was explored by using fura-2 as a Ca(2+) indicator. Fendiline at concentrations between 1 and 200 microM increased [Ca(2+)](i) in a concentration-dependent manner and the signal saturated at 100 microM. The Ca(2+) signal was inhibited by 65+/-5% by Ca(2+) removal and by 38+/-5% by 10 microM nifedipine, but was unchanged by 10 microM La(3+) or verapamil. In Ca(2+)-free medium, pre-treatment with 1 microM thapsigargin (an endoplasmic reticulum Ca(2+) pump inhibitor) to deplete the endoplasmic reticulum Ca(2+) store inhibited fendiline-induced intracellular Ca(2+) release. The Ca(2+) release induced by 50 microM fendiline appeared to be independent of IP(3) because the [Ca(2+)](i) increase was unaltered by inhibiting phospholipase C with 2 microM U73122. Collectively, the results suggest that in MG63 cells fendiline caused an increase in [Ca(2+)](i) by inducing Ca(2+) influx and Ca(2+) release in an IP(3)-independent manner.

Calcium↗
PubMed2001

Intrathecal bupivacaine with morphine or neostigmine for postoperative analgesia after total knee replacement surgery.

PURPOSE: To compare the postoperative analgesic efficacy and safety of intrathecal (IT) neostigmine and IT morphine in patients undergoing total knee replacement under spinal anesthesia. METHODS: Sixty patients scheduled for elective total knee replacement under spinal anesthesia were randomly divided into three equal groups which received IT 0.5% hyperbaric bupivacaine 15 mg with either normal saline 0.5 mL, neostigmine 50 microg, or morphine 300 microg. The maximal level of sensory block, duration of analgesia, time to use of rescue analgesics, the overall 24-hr and four-hour interval visual analogue scale (VAS) pain score, and the incidence of adverse effects were recorded for 24 hr after administration. RESULTS: There was no significant difference in maximal level of sensory block among the three groups. The morphine group had a later onset of postsurgical pain and longer time to first rescue analgesics than the neostigmine group (P <0.05). Overall 24-hr VAS pain scores were significantly higher in the saline group vs the morphine and neostigmine groups (P <0.05). Motor block lasted significantly longer in the neostigmine group than in the morphine and saline groups (P <0.05). The incidence of adverse effects was similar in the neostigmine and morphine groups except for pruritus (70%) occurring more frequently in the morphine group than in the neostigmine and saline groups (0%; P <0.05). Overall satisfaction rates were better in the neostigmine group than in the morphine and saline groups (P <0.05). CONCLUSIONS: IT neostigmine 50 microg produced postoperative analgesia lasting about seven hours with fewer side effects and better satisfaction ratings than IT morphine 300 microg.

Aged↗
PubMed1999

Ventricular excitation maps using tissue Doppler acceleration imaging: potential clinical application.

OBJECTIVES: The purpose of this study is to validate the use of tissue Doppler acceleration imaging (TDAI) for evaluation of the onset of ventricular contraction in humans. BACKGROUND: Tissue Doppler acceleration imaging can display the distribution, direction and value of ventricular acceleration responses to myocardial contraction and electrical excitation. METHODS: Twenty normal volunteers underwent TDAI testing to determine the normal onset of ventricular acceleration. Two patients with paroxysmal supraventricular tachycardia and 30 patients with permanent pacemakers underwent introduction of esophageal and right ventricular pacing electrodes, respectively, and were studied to visualize the onset of pacer-induced ventricular acceleration. Eight patients with dual atrioventricular (AV) node and 20 patients with Wolff-Parkinson-White (WPW) syndrome underwent TDAI testing to localize the abnormal onset of ventricular acceleration, and the results were compared with those of intracardiac electrophysiology (ICEP) tests. RESULTS: The normal onset and the onset of dual AV node were localized at the upper interventricular septum (IVS) under the right coronary cusp within 25 ms before the beginning of the R wave in the electrocardiogram (ECG). In all patients in the pacing group, the location and timing of the onset conformed to the positions and timing of electrodes (100%). In patients with WPW syndrome, abnormal onset was localized to portions of the ventricular wall other than the upper IVS at the delta wave or within 25 ms after the delta wave in the ECG. The agreement was 90% (18 of 20) between the abnormal onset and the position of the accessory pathways determined by ICEP testing. CONCLUSIONS: These results suggest that TDAI is a useful noninvasive method that frequently is successful in visualizing the intramural site of origin of ventricular mechanical contraction.

Adolescent↗
PubMed1998

Elimination of hypercapnia may postpone the clinical presentation of malignant hyperthermia: a case report.

Malignant hyperthermia is a rare complication in clinical anesthesia, especially associated with the administration of succinylcholine or inhalation anesthetics. A 19-year-old patient, suffering from traumatic mandible fracture, underwent open reduction under general anesthesia. Unfortunately, following administration of succinylcholine, he also suffered severe facial twitch and the first episode of hypercapnia. After adequate management, the symptoms subsided. However, two hours later, the hypercapnia recurred, combined with progressive elevation of body temperature. After administration of intravenous dantrolene 120 mg, the patient's condition became stable and the procedure was completed without sequelae. As the muscle contracture test is not available in Taiwan, the clinical grading scale is presented as an alternative diagnostic method for malignant hyperthermia.

Adult↗
PubMed1997

The responses of rat trigeminal ganglion neurons to capsaicin and two nonpungent vanilloid receptor agonists, olvanil and glyceryl nonamide.

Capsaicin, the pungent ingredient in hot pepper, activates and subsequently desensitizes a subset of polymodal nociceptors. Because its initial application to skin produces pain, nonpungent analogs such as olvanil and glyceryl nonivamide (GLNVA) were synthesized to enhance its clinical use. To explore how these nonpungent analogs differ from capsaicin, whole-cell patch-clamp recordings were performed on cultured rat trigeminal ganglion neurons. In neurons held at -60 mV, capsaicin, olvanil, and GLNVA were found to activate one or two kinetically distinct inward currents. Two inward currents were also activated when extracellular Ca2+ was replaced with Ba2+ and also when intracellular chloride was replaced by aspartate. The reversal potentials of the rapidly and slowly activating currents were 15.3 +/- 6 and -4.0 +/- 2.5 mV, respectively. These data provide strong evidence for subtypes of vanilloid receptors. One difference among these agonists is that, on average, the activation kinetics of the currents evoked by 1 microM olvanil and 30 microM GLNVA are considerably slower than those evoked by 1 microM capsaicin. Measurements of the peak current, Ip, versus agonist concentration were fit to the Hill equation to yield values of the half maximal concentrations (K1/2), and the Hill coefficients (n). For capsaicin, olvanil, and GLNVA, K1/2 = 0.68, 0.59, and 27.0 microM and n = 1.38, 1.32, and 1.24, respectively. We propose that olvanil and GLNVA are nonpungent because they activate different subtypes of receptors and/or because of their activation kinetics (compared with capsaicin) are, on average, slower than the rate they inhibit action potentials from polymodal nociceptors.

Animals↗
PubMed1997

Organic delusional disorder in psychiatric in-patients: comparison with delusional disorder.

Organic delusional disorder (ODD) is rarely diagnosed in psychiatric in-patients, and may be misdiagnosed as delusional disorder (DD) from a similar clinical presentation. The aim of the present study was to investigate the characteristics of ODD and to make a comparison with those of DD patients. Patients who conformed to DSM-III-R criteria for ODD were recruited from an 8-year psychiatric in-patient database. Matching controls were DD patients admitted over the same time period. The prevalence of ODD according to DSM-III-R criteria was 0.4% of total admissions and 2.9% of organic mental disorders. Compared to DD patients, ODD patients less often had a family psychiatric history, and had an older age of onset of psychiatric disorder, longer hospital stays and lower treatment dosage of antipsychotic drugs. It is suggested that a detailed medical history and examination are needed in patients with delusion, especially in patients with a late onset of psychiatric symptoms and no family psychiatric history.

Adult↗
PubMed1997

Capgras' syndrome in a patient with vascular dementia: a case report.

Capgras' syndrome is characterized by a subjective certainty that a familiar person has been replaced by an identical double. This syndrome has been observed in psychiatric and neurological diseases, and has been reported in several cases of dementia of the Alzheimer type. Here, we present a patient with vascular dementia in whom Capgras' syndrome developed in the early stages of dementia, and who exhibited violence. This case suggests that Capgras' syndrome can occur in vascular dementia. In older patients with this syndrome, dementia should also be considered in its differential diagnosis. In addition, patients with Capgras' syndrome should be evaluated for violent potential.

Aged↗
PubMed1997

Effect of preoperative transdermal ketoprofen on post-hysterectomy pain.

BACKGROUND: In an attempt to reduce central sensitization after tissue injury, the concept of "pre-emptive analgesia" was evolved. The aim of the present study was to evaluate the analgesic effect of pre-incisional transdermal ketoprofen on post-hysterectomy pain. METHODS: Sixty patients scheduled for elective trans-abdominal total hysterectomy were divided into three groups. The day before surgery, patients in Group 1 received transdermal ketoprofen 30 mg over the proposed surgical area twice; patients in Group 2 received a placebo patch under a similar design; patients in Group 3 received transdermal ketoprofen 30 mg over right thigh twice. Operations were performed under general anesthesia. Postoperatively, patients received patient-controlled analgesia with morphine for pain relief, and pain was assessed by visual analogue pain scale (VAS). Hemodynamic parameters, respiratory rate, sedation scale, morphine consumption and associated side effects were also recorded. RESULTS: There was no significant difference among groups with respect to VAS, sedation scale, blood pressure, respiratory rate or morphine consumption within 24 hours postoperatively. The mean time for first morphine demand was significantly delayed in Group 1 patients (p < 0.05). The incidence of nausea and vomiting among the three groups showed no significant difference. CONCLUSIONS: It seems that pre-incisional transdermal ketoprofen (30 mg, twice the day before surgery) has only a limited pre-emptive effect on post-hysterectomy pain as indicated by delayed first morphine request. Further, it had no effect on postoperative VAS, morphine consumption or incidence of nausea and vomiting.

Administration, Cutaneous↗
PubMed1997

[Experimental study on nerve growth factor in protecting injured spinal cord].

Thirty-five SD rats were divided into 3 groups, in which 5 rats were served as control. The other 2 groups, 15 rats in each received either NGF solution or normal saline. The injury at the level of T8 spinal segment of the rat in these two groups were made by dropping a weight of 10 g from a height 2.5 cm after a total laminectomly from T7-11 segments. A thin plastic tube was inserted into the subarachnoid space below the injured segments. NGF was introduced through the tube at intervals of 1, 2, 3, 4, 8, 12, 24, 48 hours in the NGF group, and normal saline in the normal saline group. At 4, 8, 24 hours following surgery, 5 rats in each group were sacrificed and the injured segments were resected for examination. The contents of water and calcium were measured by dry-wet method and atomic absorption spectroscopy. The result showed that total calcium and water contents in normal saline group were markly increased, however, the changes of these two parametere were not so prominent in NGF group. It was suggested that NGF play a role in protecting the spinal cord by maintaining the calcium level of the injured segment.

Animals↗
PubMed1996

Splenectomy for suspected malignant lymphoma in two patients with loiasis.

Intrasplenic lesions can cause diagnostic difficulties because malignant diseases can be excluded only by histologic examination. We present the cases of two patients with splenic manifestations of loiasis. Both patients had visited central Africa. Several years later, intrasplenic lesions were found during routine examinations (for chest trauma and employment, respectively). Both patients underwent splenectomies because malignant lymphoma was suspected. In both cases, histologic examination of the spleen showed eosinophilic granulomata with multiple Loa loa microfilariae.

Adult↗
PubMed1996

Measurement of airborne 218Po--a Bayesian approach.

The standard mathematical treatment of the buildup and decay of airborne radionuclides on a filter paper uses the solutions of the so-called Bateman equations adapted to the sampling process. These equations can be interpreted as differential equations for the expectation of an underlying stochastic process, which describes the random fluctuations in the accumulation and decay of the sampled radioactive atoms. The process for the buildup and decay of airborne 218Po can be characterized as an "immigration-death process" in the widely adopted, biologically based jargon. The probability distribution for the number of 218Po atoms, accumulated after sampling time t, is Poisson. We show that the distribution of the number of counts, registered by a detector with efficiency epsilon during a counting period T after the end of sampling, is also Poisson, with mean dependent on epsilon, t, T, the flowrate and N(o), the number of airborne 218Po atoms per unit volume. This Poisson distribution was used to construct the likelihood given the observed number of counts. After inversion with Bayes' Theorem we obtained the posterior density for N(o). This density characterizes the remaining uncertainty about the measured number of 218Po atoms per unit volume of air.

Air Pollution, Radioactive↗