2.Molecular Epidemiology of Integron-Associated Antimicrobial Gene Cassettes in the Clinical Isolates of Acinetobacter baumannii from Northern Taiwan.
Ming Feng LIN ; Ming Li LIOU ; Chi Chao TU ; Hui Wen YEH ; Chung Yu LAN
Annals of Laboratory Medicine 2013;33(4):242-247
BACKGROUND: The aims of this study were to understand the molecular epidemiology of integron-associated gene cassettes in Acinetobacter baumannii across four hospitals in northern Taiwan and to clarify the relationship between the presence of integrons and antibiotic-resistant phenotypes. METHODS: Sixty-five A. baumannii isolates, collected from the patients of four regional hospitals in northern Taiwan in 2009, were tested for the presence of integrons and their associated gene cassettes. The susceptibility difference between integron-positive and integron-negative A. baumannii strains was analyzed. Antibiotic-resistant phenotypes among A. baumannii with different types of gene cassette array combinations were also compared. RESULTS: Around 72% of the A. baumannii isolates carried class 1 integrase genes. Despite this, only three gene cassette arrays were found in the integrons. Integron-positive strains were significantly more resistant to all the tested antibiotics than the integrase-negative strains. All the four types of A. baumannii with different gene cassette array combinations were multidrug-resistant in nature. Gene cassette array aacA4-catB8-aadA1 existed in all the integron-positive A. baumannii isolates. Repetitive-sequence-based PCR (rep-PCR) results revealed the prevalence of one major cluster of imipenem-resistant A. baumannii strains (84%) in the four regional hospitals. CONCLUSIONS: The presence of integrons with associated antimicrobial resistance gene cassettes can be used as a representative marker of multidrug resistance in A. baumannii. Some prevalent gene cassette arrays may exist among epidemiologically unrelated A. baumannii strains.
Acinetobacter Infections/epidemiology/*microbiology
;
Acinetobacter baumannii/drug effects/*genetics/isolation & purification
;
Anti-Bacterial Agents/pharmacology
;
Bacterial Proteins/genetics
;
DNA, Bacterial/analysis
;
Drug Resistance, Bacterial
;
Humans
;
Imipenem/pharmacology
;
Integrases/genetics
;
Integrons/*genetics
;
Microbial Sensitivity Tests
;
Multiplex Polymerase Chain Reaction
;
Taiwan/epidemiology
3.Magnetic Resonance Imaging of Infarcted Liver Induced by Selective Ligation of Right Portal Vein in Rabbits.
Won Jae LEE ; Byung Ihn CHOI ; Jin Wook CHUNG ; Jae Hyung PARK ; Joon Koo HAN ; Jin Mo GOO ; Man Chung HAN ; Kyung Mo YEON ; In Kyu YU ; Chu Wan KIM ; Sung Wook CHOO ; Dae Young YOON
Journal of the Korean Radiological Society 1994;31(1):99-108
PURPOSE:To investigate the changes of abnormal signal intensity of liver infarction in scheduled intervals after ligation of portal vein in rabbit livers with histopathologic correlation. MATERIALS AND METHODS:Liver infarction were induced by selective ligation of the posterior branch of right portal vein in 12 rabbits. T1- and T2-weighted MRI at 2.0T with spin-echo techniques as well as contrastenhanced Tl-weighted MRI with Gd-DTPA(0.1 mmol/kg) were performed 3 hours, 6 hours, 1 day, 3 days, 1 week, and 2 weeks after ligation using two rabbits at each interval. Histopathologic specimens were prepared from six removed livers for comparing the MR findings with the histopathologic findings. The other six rabbits were sectioned transversely in frozen state for comparing MR findings with the macroscopic findings of pathologic areas of the liver. RESULTS: The signal intensity of pathologic hepatic segment showed more hyperintense signal than that of normal segments of the liver on TI-, proton density-, and T2-weighted MR images at every interval after ligation, except both T2WI of 3 hours interval and one T1WI of 2 weeks interval. Main histopathologic findings 3 hours, 6 hours, 1 day, 3 days, and 1 week after ligation were congestion, hemorrhage with necrosis, coagulation necrosis, complete necrosis, and necrosis with scar tissues, respectively. Microscopic specimens with Prussian blue stain 6 hours, and 1 week after ligation showed bluish hue indicating the existence of methemoglobin, and blue particles in giant cells and monocytes indicating engulfing hemosiderin, respectively. CONCLUSION: Changes of the signal intensities on sequential MR images of acutely induced hemorrhagic liver infarction might be due to the rapid oxidative denaturation of hemoglobin in hemorrhages and high signal intensity on Tl-weighted images from the hyperacute stage of a hemorrhagic liver infarction could be due to methemoglobin. Therefore, acutely induced hemorrhagic liver infarction should be included in the differential diagnoses of the hyperintense liver lesions on Tl-weighted images.
Cicatrix
;
Diagnosis, Differential
;
Estrogens, Conjugated (USP)
;
Giant Cells
;
Hemorrhage
;
Hemosiderin
;
Infarction
;
Ligation*
;
Liver*
;
Magnetic Resonance Imaging*
;
Methemoglobin
;
Monocytes
;
Necrosis
;
Portal Vein*
;
Protons
;
Rabbits*
4.Induction of heme oxygenase-1 with dietary quercetin reduces obesity-induced hepatic inflammation through macrophage phenotype switching.
Chu Sook KIM ; Hye Seon CHOI ; Yeonsoo JOE ; Hun Taeg CHUNG ; Rina YU
Nutrition Research and Practice 2016;10(6):623-628
BACKGROUND/OBJECTIVES: Obesity-induced steatohepatitis accompanied by activated hepatic macrophages/Kupffer cells facilitates the progression of hepatic fibrinogenesis and exacerbates metabolic derangements such as insulin resistance. Heme oxyganase-1 (HO-1) modulates tissue macrophage phenotypes and thus is implicated in protection against inflammatory diseases. Here, we show that the flavonoid quercetin reduces obesity-induced hepatic inflammation by inducing HO-1, which promotes hepatic macrophage polarization in favor of the M2 phenotype. MATERIALS/METHODS: Male C57BL/6 mice were fed a regular diet (RD), high-fat diet (HFD), or HFD supplemented with quercetin (HF+Que, 0.5g/kg diet) for nine weeks. Inflammatory cytokines and macrophage markers were measured by ELISA and RT-PCR, respectively. HO-1 protein was measured by Western blotting. RESULTS: Quercetin supplementation decreased levels of inflammatory cytokines (TNFα, IL-6) and increased that of the anti-inflammatory cytokine (IL-10) in the livers of HFD-fed mice. This was accompanied by upregulation of M2 macrophage marker genes (Arg-1, Mrc1) and downregulation of M1 macrophage marker genes (TNFα, NOS2). In co-cultures of lipid-laden hepatocytes and macrophages, treatment with quercetin induced HO-1 in the macrophages, markedly suppressed expression of M1 macrophage marker genes, and reduced release of MCP-1. Moreover, these effects of quercetin were blunted by an HO-1 inhibitor and deficiency of nuclear factor E2-related factor 2 (Nrf2) in macrophages. CONCLUSIONS: Quercetin reduces obesity-induced hepatic inflammation by promoting macrophage phenotype switching. The beneficial effect of quercetin is associated with Nrf2-mediated HO-1 induction. Quercetin may be a useful dietary factor for protecting against obesity-induced steatohepatitis.
Animals
;
Blotting, Western
;
Coculture Techniques
;
Cytokines
;
Diet
;
Diet, High-Fat
;
Down-Regulation
;
Enzyme-Linked Immunosorbent Assay
;
Fatty Liver
;
Heme Oxygenase-1*
;
Heme*
;
Hepatocytes
;
Humans
;
Inflammation*
;
Insulin Resistance
;
Liver
;
Macrophages*
;
Male
;
Mice
;
NF-E2-Related Factor 2
;
Obesity
;
Phenotype*
;
Quercetin*
;
Up-Regulation
5.A Case of Granulomatous Hepatitis Associated with Common Variable Immunodeficiency.
Tae Hoon OH ; Han Chu LEE ; Tae Yoon LEE ; Byung Cheol SONG ; Young Hwa CHUNG ; Yung Sang LEE ; Eun Sil YU ; Dong Jin SUH
The Korean Journal of Hepatology 2001;7(1):95-99
A granuloma is a compact, organized collection of chronic inflammatory cells, predominantly consisting of mature mononuclear phagocytes. Clinical manifestations of hepatic granulomas vary widely from asymptomatic elevation of serum alkaline phosphatase activity to liver cirrhosis. The hepatic granuloma is nonspecific and represents a pathologic reaction induced by any of a number of factors. Although the causes of hepatic granuloma vary considerably according to geographic site, sarcoidosis and tuberculosis are the two leading causes. Here we present a 20-year-old female with a long history of recurrent otitis media, upper respiratory infection, and unexplained hepatosplenomegaly. A diagnosis of common variable immunodeficiency was made, based on the decreased levels of serum immunoglobulins. A liver biopsy revealed chronic granulomatous inflammation, but neither caseous necrosis nor acid-fast bacillus was found. Her liver disease progressed despite a nine-month course of antituberculous medication. Hypogammaglobulinemia should be included in the differential diagnosis of granulomatous liver disease.
Agammaglobulinemia
;
Alkaline Phosphatase
;
Bacillus
;
Biopsy
;
Common Variable Immunodeficiency*
;
Diagnosis
;
Diagnosis, Differential
;
Female
;
Granuloma
;
Hepatitis*
;
Humans
;
Immunoglobulins
;
Inflammation
;
Liver
;
Liver Cirrhosis
;
Liver Diseases
;
Necrosis
;
Otitis Media
;
Phagocytes
;
Sarcoidosis
;
Tuberculosis
;
Young Adult
6.Efficacy of Lamivudine in Patients with HBeAg-Negative and HBV DNA-Positive Chronic Liver Disease.
Hye Seung YU ; Han Chu LEE ; Young Hwa CHUNG ; Yung Sang LEE ; Dong Jin SUH
The Korean Journal of Hepatology 2000;6(4):488-494
BACKGROUND/AIMS: The aim of this study was to evaluate the efficacy of lamivudine in patients with HBeAg-negative and HBV DNA-positive chronic liver disease. METHODS: Twenty-four chronic liver disease patients were enrolled whose serology had common characteristics of HBeAg (-), and anti-HBe (+) but HBV DNA (+). All had elevated alanine aminotransferase (ALT) levels. 150mg of lamivudine was given orally once daily for more than 6 months. The goal of this treatment was the elimination of HBV DNA in serum and normalization of ALT level. Once HBV DNA disappearance and ALT normalization were observed, lamivudine was continued for two additional months. HBeAg, anti-HBe, HBV DNA and ALT were followed up every 1-2 month during, and after, treatment. RESULTS: Median duration of treatment was seven months. HBV DNA became undetectable after a median one month of treatment and ALT activity was normalized in all 24 patients within six months. Among the sixteen patients who were followed for more than 12 months after cessation of treatment, six relapsed. The cumulative relapse rate at 12 months was 37.5%. CONCLUSION: Lamivudine suppresses HBV replication effectively and normalizes serum ALT in patients with HBeAg-negative and HBV DNA-positive chronic liver disease. The relapse rate after cessation of treatment seems to be relatively low.
Alanine Transaminase
;
DNA
;
Hepatitis B e Antigens
;
Hepatitis B virus
;
Humans
;
Lamivudine*
;
Liver Diseases*
;
Liver*
;
Recurrence
;
Withholding Treatment
7.The mRNA Expression of Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand (TRAIL) and Its Receptors in Hepatocellular Carcinoma and Surrounding Liver Tissues.
Saera JUNG ; Han Chu LEE ; Hee Gon SONG ; Young Hwa CHUNG ; Yung Sang LEE ; Ghil Sook YOON ; Eunsil YU ; Dong Jin SUH
The Korean Journal of Hepatology 2001;7(3):273-280
BACKGROUND/AIMS: TRAIL-induced apoptosis was believed to occur in tumor cell lines, while not in normal cells, which suggested that TRAIL might be safe as an antitumor therapy. Some authors advocate that this exclusive TRAIL-induced apoptosis depended on whether or not TRAIL-R3 mRNA was expressed. In this study we investigated the difference in the expression of TRAIL and its receptors mRNA between human hepatocellular carcinoma (HCC) and surrounding liver tissues. METHODS: Intra-operative sampling of HCC and paired surrounding liver tissue was performed in 12 patients who underwent hepatic resection due to HCC. After RT-PCR, using total RNA extracts from the tissues, amplified RT-PCR, products were analyzed qualitatively for the expression of TRAIL and its receptors mRNA. Both tissues were compared semi-quantitatively for the expression of TRAIL-R3 mRNA with beta-actin using the method of Nicoletti et al. RESULTS: 1) TRAIL mRNA was expressed in HCC and surrounding liver tissues in all cases. 2) TRAIL-R1, -R2, and -R3 mRNA were also expressed in HCC and surrounding liver tissues in all cases. 3) The ratio of the expression of TRAIL-R3 mRNA to beta-actin mRNA was 0.22+/-0.15 in HCC and 0.34+/-0.21 in surrounding liver tissues (p=0.124, paired t-test). 4) TRAIL, TRAIL-R1, -R2 and -R3 mRNA were expressed in all HCC cases irrespective of the degree of tumor cell differentiation. CONCLUSIONS: TRAIL, TRAIL-R1, -R2, and TRAIL-R3 mRNA were expressed in all of the HCC and surrounding liver tissues. There was no quantitative difference in the expression of TRAIL-R3 mRNA between both tissues.
Actins
;
Apoptosis
;
Carcinoma, Hepatocellular*
;
Cell Differentiation
;
Cell Line, Tumor
;
Humans
;
Liver*
;
Necrosis*
;
RNA
;
RNA, Messenger*
;
TNF-Related Apoptosis-Inducing Ligand
8.Correlation of respiratory syncytial virus infection with climate parameters and air pollution levels in Korean children during 2005–2012.
Ji Hyun JUNG ; Shou Yu CHU ; Je Yeon KIM ; Tae Hee HAN ; Sang Hun PARK ; Ju Young CHUNG ; Hyo Bin KIM
Allergy, Asthma & Respiratory Disease 2018;6(4):206-210
PURPOSE: Respiratory syncytial virus (RSV) is the major cause of acute lower respiratory tract infection (LRTI) in infants and children. We investigated the association of meteorological conditions and air pollution with the prevalence of RSV infection. METHODS: Between January 2005 and December 2012, a total of 9,113 nasopharyngeal swab specimens from children under 3 years of age who were admitted to the hospital with acute LRTI were tested for RSV antigens using a direct immunofluorescence kit. Meteorological data (mean temperature, precipitation, wind speed, and relative humidity) and air pollutant levels including PM₁₀ (particulate matter with a median aerodynamic diameter less than or equal to 10 µm in diameter), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and carbon monoxide (CO) in Seoul during the study period were collected from the national monitoring system. The correlations of the monthly incidence of RSV infection with climate factors and air pollutant levels were analyzed. RESULTS: RSV infection mainly occurred between October and February, and showed the peak in November. The prevalence of RSV infection had a moderate negative correlation with mean temperature (r=−0.60, P < 0.001), a weak negative correlation with relative humidity (r=−0.26, P=0.01), and precipitation (r=−0.34, P=0.001). Regarding air pollutants, RSV activity moderately correlated with NO₂ (r=0.40, P < 0.001), SO₂ (r=0.41, P < 0.001), and CO (r=0.58, P < 0.001). In the RSV peak season in Korea (between October and February), RSV epidemics showed a weak positive correlation with relative humidity (r=0.35, P=0.03) and precipitation (r=0.38, P=0.02). CONCLUSION: Meteorological factors and air pollutant levels may be associated with RSV activity. Therefore, further nationwide large-scaled intensive evaluations to prove factors affecting RSV activity are warranted.
Air Pollutants
;
Air Pollution*
;
Carbon Monoxide
;
Child*
;
Climate*
;
Fluorescent Antibody Technique, Direct
;
Humans
;
Humidity
;
Incidence
;
Infant
;
Korea
;
Meteorological Concepts
;
Nitrogen Dioxide
;
Prevalence
;
Respiratory Syncytial Viruses*
;
Respiratory Tract Infections
;
Seasons
;
Seoul
;
Sulfur Dioxide
;
Wind
9.Novel application of Influenza A virus-inoculated chorioallantoic membrane to characterize a NP-specific monoclonal antibody for immunohistochemistry assaying
Yang Chang TU ; Kuang Yu CHEN ; Chung Kung CHEN ; Ming Chu CHENG ; Shu Hwae LEE ; Ivan Chen CHENG
Journal of Veterinary Science 2019;20(1):51-57
Monoclonal antibodies (MAbs) are widely applied in disease diagnoses. Herein, we report a MAb, WF-4, against Influenza A virus nucleoprotein (NP), its broad response with Influenza A virus, and its application in an immunohistochemistry (IHC) assay. WF-4 was screened by immunofluorescence assay (IFA). The results showed that its reactivity with baculovirus-expressed full-length recombinant NP (rNP) in Western blot (WB), indicating its IHC applicability. Fifteen Influenza A virus (reference subtypes H1 to H15) infected chicken embryonated chorioallantoic membranes (CAM), fixed by formalin, were all detectable in the WF-4-based IHC assay. Also, the reactivity of the IHC test with NP from experimentally inoculated H6N1 and from all recent outbreaks of H5 subtype avian Influenza A virus (AIV) field cases in Taiwan showed positive results. Our data indicate that CAM, a by-product of Influenza A virus preparation, is helpful for Influenza A virus-specific MAb characterization, and that the WF-4 MAb recognizes conserved and linear epitopes of Influenza A virus NP. Therefore, WF-4 is capable of detecting NP antigens via IHC and may be suitable for developing various tests for diagnosis of Influenza A virus and, especially, AIV infection.
Animals
;
Antibodies, Monoclonal
;
Blotting, Western
;
Chickens
;
Chorioallantoic Membrane
;
Diagnosis
;
Disease Outbreaks
;
Epitopes
;
Fluorescent Antibody Technique
;
Formaldehyde
;
Immunohistochemistry
;
Influenza A virus
;
Influenza in Birds
;
Influenza, Human
;
Nucleoproteins
;
Taiwan
10.Abrupt Decline in Estimated Glomerular Filtration Rate after Initiating Sodium-Glucose Cotransporter 2 Inhibitors Predicts Clinical Outcomes: A Systematic Review and Meta-Analysis
Min-Hsiang CHUANG ; Yu-Shuo TANG ; Jui-Yi CHEN ; Heng-Chih PAN ; Hung-Wei LIAO ; Wen-Kai CHU ; Chung-Yi CHENG ; Vin-Cent WU ; Michael HEUNG
Diabetes & Metabolism Journal 2024;48(2):242-252
Background:
The initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) typically leads to a reversible initial dip in estimated glomerular filtration rate (eGFR). The implications of this phenomenon on clinical outcomes are not well-defined.
Methods:
We searched MEDLINE, Embase, and Cochrane Library from inception to March 23, 2023 to identify randomized controlled trials and cohort studies comparing kidney and cardiovascular outcomes in patients with and without initial eGFR dip after initiating SGLT2i. Pooled estimates were calculated using random-effect meta-analysis.
Results:
We included seven studies in our analysis, which revealed that an initial eGFR dip following the initiation of SGLT2i was associated with less annual eGFR decline (mean difference, 0.64; 95% confidence interval [CI], 0.437 to 0.843) regardless of baseline eGFR. The risk of major adverse kidney events was similar between the non-dipping and dipping groups but reduced in patients with a ≤10% eGFR dip (hazard ratio [HR], 0.915; 95% CI, 0.865 to 0.967). No significant differences were observed in the composite of hospitalized heart failure and cardiovascular death (HR, 0.824; 95% CI, 0.633 to 1.074), hospitalized heart failure (HR, 1.059; 95% CI, 0.574 to 1.952), or all-cause mortality (HR, 0.83; 95% CI, 0.589 to 1.170). The risk of serious adverse events (AEs), discontinuation of SGLT2i due to AEs, kidney-related AEs, and volume depletion were similar between the two groups. Patients with >10% eGFR dip had increased risk of hyperkalemia compared to the non-dipping group.
Conclusion
Initial eGFR dip after initiating SGLT2i might be associated with less annual eGFR decline. There were no significant disparities in the risks of adverse cardiovascular outcomes between the dipping and non-dipping groups.