Chung-Sheng Lin

A modified Coomassie Brilliant Blue G 250 staining method for the detection of chitinase activity and molecular weight after polyacrylamide gel electrophoresis

A modified Coomassie Brilliant Blue G 250 staining method for detecting chitinolytic enzymes in chitin-containing polyacrylamide gel electrophoresis (PAGE) is presented. The staining formed achromatic zones at the locations of the migrated enzyme. Using Streptomyces griseus chitinase, we have demonstrated that our method is more sensitive and less complicated than the conventional Calcofluor white M2R staining.

The chitinolytic activities of Streptomyces sp. TH-11.

Chitin is an abundant biopolymer composed of units of N-acetyl-D-glucosamine linked by β-1,4 glycosidic bonds. Chitin is the main component of the shells of mollusks, the cell wall of fungi and yeast and of the exoskeleton of crustaceans and insects. The degradation of chitin is catalyzed by chitinases that occur in a wide range of organisms. Among them, the chitinases from microorganisms are extremely important for the degradation and recycling of the carbon and nitrogen trapped in the large amount of insoluble chitin in nature. Streptomyces sp. TH-11 was isolated from the sediment of the Tou-Chien River, Taiwan. The chitinolytic enzyme activities were detected using a rapid in-gel detection method from the cell-free preparation of the culture medium of TH-11. The chitinolytic enzyme activity during prolonged liquid culturing was also analyzed by direct measurement of the chitin consumption. Decomposition of the exoskeleton of shrimps was demonstrated using electron microscopy and atomic force microscopy.

Efficacy and Safety of Olmesartan in the Treatment of Mild-to-Moderate Essential Hypertension in Chinese Patients

AbstractBackground and objective: Hypertension is very prevalent in the Chinese population in Taiwan. Chinese people frequently experience bothersome cough when receiving angiotensin-converting enzyme (ACE) inhibitors, and angiotensin II (AT1) receptor antagonists are thus relatively more frequently used in this context. In this trial we studied the effectiveness of a new AT1 receptor antagonist, olmesartan, in the treatment of Chinese patients with mild-to-moderate essential hypertension. Patients and methods: The present study was a double-blind, randomised, multicentre trial to compare the efficacy and safety profiles of two AT1 receptor antagonists, olmesartan and losartan, in the treatment of Chinese patients with mild-to-moderate essential hypertension. 126 adults were randomised to receive either once-daily olmesartan 20mg or once-daily losartan 50mg for 12 weeks. There were 49 evaluable patients in the olmesartan group and 57 in the losartan group. Results: At baseline, neither diastolic (DBP) nor systolic (SBP) blood pressures were significantly different between the two study groups. Trough blood pressures were measured and recorded for the evaluation of treatment effect. After drug treatment for 4, 8 and 12 weeks, SBP and DBP values were significantly decreased in both groups of patients. However, both SBP and DBP were significantly lower in the olmesartan group than in the losartan group after treatment. At the end of treatment, DBP values were 87.0 ± 8.6mm Hg versus 91.6 ± 8.7mm Hg (p < 0.001) and SBP values were 129.5 ± 12.6mm Hg versus 135.4 ± 12.1mm Hg (p < 0.001) in the olmesartan and losartan groups, respectively. After 4 weeks of treatment, the reduction in BP values was larger in the olmesartan group than in the losartan group (decreases in DBP of 12.1 ± 8.4mm Hg vs 7.2 ± 6.8mm Hg [p < 0.005] and in SBP of 15.1 ± 13.0mm Hg vs 10.3 ± 10.1mm Hg [p < 0.05] for the olmesartan and losartan groups, respectively). Patients treated with either drug experienced only mild adverse reactions, such as dizziness, cough, headache and neck pain, all of which occurred at low frequencies. There were no significant changes in laboratory parameters. Conclusion: Both olmesartan and losartan are effective and safe in the treatment of Chinese patients with mild-to-moderate essential hypertension. Olmesartan 20mg once daily is more potent and has a more rapid antihypertensive effect than losartan 50mg once daily in the treatment of mild-to-moderate hypertension in Chinese patients.

An eight-week, multicenter, randomized, double-blind study to evaluate the efficacy and tolerability of fixed-dose amlodipine/benazepril combination in comparison with amlodipine as first-line therapy in chinese patients with mild to moderate hypertension.

Aims. This study sought to compare the antihypertensive efficacy and tolerability of a fixed‐dose combination with amlodipine/benazepril with that of amlodipine monotherapy in Chinese hypertensive subjects. Results. This multicenter, double‐blind, 8‐week study randomized 111 patients to fixed‐dose amlodipine besylate/benazepril HCl (2.5/5 mg/day titrated to 5/10 mg/day as needed at week 4 to reach goal blood pressure (BP) <140/90 mmHg) or amlodipine besylate monotherapy (5 mg/day titrated to 10 mg/day as needed). At week 8, patients randomized to combination therapy compared with monotherapy had a comparable BP control rate (56.0% vs 46.2%; p = 0.32). Fixed‐dose combination resulted in similar reductions in sitting systolic (SBP) and diastolic BP (DBP) compared with monotherapy (SBP: −19.3±12.5 vs −20.9±13.3 mmHg; DBP: −9.2±10.4 vs −11.3±9.3 mmHg; both p = NS). Safety profiles did not differ between groups, but cough was more common in the combination group (11.0% vs 0%; p = 0.013). Conclusions. In this group of patients, comparable antihypertensive effects were seen with the fixed‐dose combination therapy, compared with amlodipine monotherapy. Both treatments appeared well tolerated in the studied population, but cough was more common in the fixed‐dose combination group.

Nifedipine gastrointestinal therapeutic system: an overview of its antiatherosclerotic effects

Atherosclerosis is the main underlying pathology of cardiovascular disease. Experimental studies in animal models provided early evidence of the antiatherosclerotic effects of nifedipine in reducing and reversing plaque formation and improving endothelial function. Over the past decade, clinical trials, including ‘Intervention as a Goal in Hypertension Treatment’, ‘Prospective Randomized Enalapril Study Evaluating Regression of Ventricular Enlargement’, ‘Evaluation of Nifedipine and Cerivastatin on Recovery of Coronary Endothelial Function’ and ‘A Coronary Disease Trial Investigating Outcome with Nifedipine Gastrointestinal System’, have further demonstrated that nifedipine gastrointestinal therapeutic system can slow the progression of various markers of atherosclerosis, restore endothelial function, and reduce the incidence of coronary events and the need for coronary interventions. These results are reviewed here, along with the impact they have had on therapy guidelines for patients with hypertension and symptomatic stable angina.

Downregulated cardiac annexin VI mRNA and protein levels in chronically fibrillating human atria.

Objectives: We compared the expression and distribution of atrial annexin VI between patients with atrial fibrillation (AF) or sinus rhythm (SR). Methods: Atrial appendages were obtained during cardiac surgery from 20 patients with chronic AF and 34 matched controls in SR. The expression and distribution of annexin VI were analyzed using semiquantitative RT-PCR, Western blotting and immunoconfocal microscopy. Results: In the AF group, compared to SR, the mRNA was reduced to <35% and the protein to <50% in amount (for each atrium, all p < 0.01). Immunoconfocal microscopy confirmed the downregulation of annexin VI protein in AF and demonstrated the colocalization of annexin VI with both Na+/Ca2+ exchangers and L-type Ca2+ channels in the sarcolemma, but not with ryanodine receptors in the sarcoplasmic reticulum. Conclusions: Atrial annexin VI, spatially colocalized with both Na+/Ca2+ exchangers and L-type Ca2+ channels in the myocyte membrane, is downregulated during chronic AF.

Depression in Patients with Congestive Heart Failure

Purpose: There is increasing number of patients with congestive heart failure(CHF) which is the major cause of disability, hospitalization, and mortality in the elderly. Depression is a relatively common condition among individuals with CHF. CHF with depression also had additional risks of adverse outcomes, including increased mortality, a higher rehospitalization rate, decreased quality of life and higher costs of care. This study investigated prevalence of depression and related factors in CHF patients and explored associations between symptoms of depression and subjects’ baseline characteristics. Methods: In this cross-sectional survey, 75 clinically stable, ambulatory CHF patients were consecutively recruited from outpatient cardiology clinics at Chung Shan Medical University Hospital. We used the World Health Organization Quality Of Life-BREF (WHOQOL-BREF) to examine quality of life profiles and the Hamilton Rating Scale for Depression (HAM-D) to screen patients for depression. Patients with high HAM-D scores(≧12) were interviewed by psychiatrists who used the Mini international Neuropsychiatric Interview (MINI) to diagnose major depressive disorder(MDD). Results: Of 75 subjects who completed the study, average age was 65.3±10.7 years. Based on New York Heart Association (NYHA) criteria, patients were class II (82.7%, n=62) or class III (17.3%, n=13). MDD prevalence was 4% (n=3). Bivariate analysis among subjects with (n=3) and without MDD (n=72) indicated that patients with MDD were more likely to lack social support (p=0.02). Higher HAM-D scores were significantly associated with NYHA class III (p=0.015) and weakness (p=0.000). Conclusions: Treatment of CHF patients needs to address the fact that depression is a common clinically important illness in CHF patients. Although our findings need to be replicated, they indicate that MDD were significantly more likely in CHF patients who lacked social support

Exercise Related Sudden Cardiac Death in Young Adults- A Patient Report

Exercise-related sudden cardiac death (SCD) is defined by symptoms that arise within 1 hour of participation in an athletic event. The major mechanisms involved in exercise-related SCD are related to hemodynamic and electrophysiological changes caused by exercise in the susceptible individual. Fatal ventricular arrhythmia is the most common mechanism of death. In young adults (＜35 years old), the majority of SCDs are caused by defined and hereditary cardiovascular disorders. Among other etiologies, hypertrophy cardiomyopathy and coronary artery anomalies are the most common. But different ventricular tachyarrhythmias may cause syncope or cardiac arrest in patients without known heart diseases. Few exercise-related sudden cardiac deaths due to ventricular tachycardia originated from irregular muscle arrangement in left ventricle myocardium had been reported. We described a 19 years old male without history of heart disease who developed sudden cardiac death during exercise. Ventricular tachycardia was noted at that time and ECG pattern at the beginning was the same as the pattern of ”idiopathic left ventricular tachycardia” in electrophysiological study. Post mortem diagonosis revealed irregular muscle arrangement in left ventricle myocardium was the only specific. Exercise related sudden cardiac death of young adult without history of heart disease, ventricular tachycardia was always the etiology and some of which were very likely related to irregular muscle arrangement in left ventricle myocardium.

Acute Myocardial Injury and Ventricular Arrhythmia in Organophosphate Intoxication - A Case Report

Organophosphate poisonings are common in Taiwan. Most of these poisonings are due to insecticide exposure. Cardiac complications are rare in organophosphate intoxications but are potentially fatal. Herein, we described a 48 year old man admitted to Chung-Shan Medical University hospital because of accidental intake of organophosphate. Diffuse ST-T change was noted on ECG during the next day following admission, followed by ventricular tachycardia. Acute myocardial injury with pulmonary edema ensued. Cardiac catherization revealed left ventricular global hypokinesia and normal coronary arteriography. He was treated with inotropic agents, anti-arrhythmic agents and IABP in addition to the antidote for organophosphate (Atropine and Pralidoxime). This patient discharged two weeks later with complete recovery.

Matrix Metalloproteinase Activity Following Cardiac Catheterization

Matrix metalloproteinase (MMP) activity is related to atherosclerosis and vascular remodeling. In this report, we studied 50 patients with angina pectoris who underwent elective PTCA. They were divided into Group I (POBA group) and Group II (stent group). In Group I, there were no significant changes in serum MMP-2 activity; MMP-9 activity decreased 24 hours after the procedure. In Group II, no significant changes in either MMP-2 or MMP-9 occurred. These findings suggest that changes in MMP-9 may be related to lumen dilatation and stent placement. Future studies are needed to clarify this relationship.