Y H Wang

National Taiwan University, Taipei, Taipei, Taiwan

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Publications (16)33.43 Total impact

  • T S Huang, Y H Wang, S Y Chen
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    ABSTRACT: To investigate the relations among serum leptin, body mass index (BMI), and various hormone levels in men with spinal cord injury (SCI). Cross-sectional. University hospital that is a tertiary referral center. Forty-seven men with traumatic neurologically complete SCI and 47 age- and BMI-matched male controls. Baseline levels of various hormones were measured in subjects with SCI. Serum leptin and cortisol levels and BMI were measured in both groups. Serum leptin was significantly higher in the group with SCI than in the control group. A linear relation was found between serum leptin and BMI in both groups separately. A polynomial relation was found between serum leptin level and BMI in the group with SCI. A "J" phenomenon is noted at the lowest BMI. Serum cortisol correlated significantly with serum leptin level in the group with SCI. Sympathetic denervation, peripheral nerve palsy, recurrent infections, and possible central neurotransmitter alterations after SCI may contribute to the elevation of serum leptin level in men with SCI.
    Archives of Physical Medicine and Rehabilitation 01/2001; 81(12):1582-6. · 2.36 Impact Factor
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    ABSTRACT: Liquid chromatography/tandem mass spectrometry (LC/MS/MS) is a state-of-the-art method of structural analysis of peptides/proteins. Here, using activating transcription factor-2 (ATF2) as an example, we report how LC/MS/MS data were processed to generate selected ion tracings for identification of phosphorylated peptides based on their parallel elution behavior with their nonphosphorylated analogs. Via this approach, we verified that amino acid residues Thr-69, Thr-71, and Ser-90 of ATF2 were the in vitro targets for c-Jun kinase. Selected ion tracing method was also used to quantitatively determine phosphorylation states of peptides. We demonstrated that the phosphorylation of Thr-69/Thr-71 was increased in response to ultraviolet irradiation specifically in subconfluent but not in confluent cultures. About 24% of Thr-69/Thr-71-containing segment were singly phosphorylated in subconfluent cultures, while minimal phosphorylation occurred in confluent cultures. In contrast, Ser-112 phosphorylation remained unaffected by cell densities. This strategy could be applied to the studies of a variety of modifications seen in various regulated cellular processes.
    Analytical Biochemistry 01/2001; 287(1):55-64. · 2.58 Impact Factor
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    ABSTRACT: To assess the alterations of autonomic nervous functions and sympathovagal balance of the subjects with spinal cord injuries (SCIs) in different levels by heart rate variability analysis. Prospective, observational study. All participants were recruited from the outpatient clinic from National Taiwan University Hospital, which is a tertiary referral center. Thirty-one patients with traumatic chronic complete SCI (more than 6 months): 14 with paraplegia (Group A), and 17 with tetraplegia (Group B). Heart rate variability assessed by 24-hour Holter monitoring. Two patients in Group A and 1 in Group B were excluded from final data analysis because of poor recording data. Two time domain variables, the standard deviation (SD) of all normal RR intervals (SDNN) and the mean of the SDs of all normal RR intervals for all 5-minute intervals (SDNNi), over 24 hours were decreased in Group B. All time domain variables, SDNN, SDNNi, root mean square of the successive normal RR interval difference (rMSSD), and the percentage of RR intervals differing >50msec from the preceding one (pNN50), were decreased during the nighttime recordings (all p < .05) in Group B. The very-low-frequency, low-frequency (LF), and high-frequency (HF) components of the power spectrum of the RR intervals were also decreased in Group B (p < .05), irrespective of the daytime and nighttime recordings. The LF-to-HF ratio did not differ significantly in these two groups, indicating the maintained sympathovagal balance in the chronic SCI patients. These findings suggested that the autonomic nervous system activity was depressed in the patients with chronic tetraplegia, but the autonomic nervous system still maintained homeostasis.
    Archives of Physical Medicine and Rehabilitation 09/2000; 81(9):1181-4. · 2.36 Impact Factor
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    ABSTRACT: Replication of hepatitis delta virus (HDV) RNA occurs in the nuclei of infected cells. The replication is mediated by cellular factors containing an RNA polymerase II-like enzyme activity through a double rolling-circle mechanism and is regulated by delta antigens. In this study, UV cross-linking experiments were carried out to examine interactions between HDV RNA and proteins present in HeLa nuclear extract. Cellular proteins with molecular mass of 23 (p23), 36 (p36), 38 (p38), and 58 (p58) kDa bound to full-length HDV RNA of both genomic and antigenomic strands. Deletion analysis on the antigenomic strand mapped the interacting domain within a 79-nucleotide fragment but not at the ends of the rod-shaped viral RNA structure. The specificity of the RNA-protein interactions was demonstrated by competition experiments and the specific HDV RNA-binding proteins were purified through column chromatography. Electrophoresis mobility shift assay with the purified fractions demonstrated that the interaction between p36 and HDV RNA was relatively stable even in the presence of 0.5 M NaCl. Biochemical analysis including protein microsequencing identified the p36 as glyceraldehyde 3-phosphate dehydrogenase (GAPDH). RNase footprinting indicated that the UC-rich domain between nucleotides 379 and 414 of the HDV antigenomic RNA was involved in the GAPDH binding. Functional studies further demonstrated an enhancing effect of GAPDH on the ribozyme activity of HDV antigenomic RNA. In addition, in the presence of HDV RNA cellular GAPDH relocalized from the cytoplasm to the nucleus where HDV replication occurs. These results suggest that GAPDH is involved in the replication of HDV.
    Virology 06/2000; 271(1):46-57. · 3.37 Impact Factor
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    ABSTRACT: The purpose of this study was to compare the cough threshold between people with and without spinal cord injury (SCI). The effect of smoking on cough threshold was also investigated. The participants were 26 people with SCI (15 smokers, 11 nonsmokers) and 18 people without SCI (9 smokers, 9 nonsmokers). Aerosols of citric acid were delivered with incremental doubling concentration from 62.5 mmol to 2 mol. Cough threshold was defined as the first concentration of citric acid that induced at least 2 coughs, which is associated with large chest excursion and concurrently acoustic response. The mean cough thresholds of smokers and nonsmokers with SCI (209 and 417 mmol, respectively) were lower than those of smokers and nonsmokers without SCI (467 and 1,072 mmol, respectively). The mean citric acid cough thresholds decreased in smokers with and without SCI when compared with nonsmokers with and without SCI. The cough sensitivity increased in subjects with SCI, and smoking could also increase the cough sensitivity. Training about the frequency and technique of cough in patients with SCI should be carefully monitored.
    Physical Therapy 12/1999; 79(11):1026-31. · 2.78 Impact Factor
  • Y H Wang, T S Huang
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    ABSTRACT: To use low- and high-dose adrenocorticotropin (ACTH) tests to assess adrenal reserve in men with spinal cord injury (SCI). After an overnight fast, 1 microg and 200 microg ACTH were injected intravenously at time 0 and 60 minutes between 8 AM and 9 AM. Blood was withdrawn at 30-minute intervals from time 0 to 120 minutes. All participants were recruited from the outpatient clinic of a university hospital that is a tertiary referral center. Forty-two men with traumatic neurologically complete SCI that had occurred more than 1 year before the study. Serum cortisol response to ACTH at times 0, 30, 60, 90, and 120 minutes. Twenty subjects had a serum cortisol response of <20 microg/dL 30 minutes after a 1-microg ACTH injection; 10 of these remained at this level at 30 minutes after a 200-microg ACTH injection. There is a high prevalence of impaired adrenal reserve in persons with chronic SCI. The 1-microg (low dose) ACTH test is more sensitive for detecting subclinical adrenal insufficiency than is the 200-microg (high dose) ACTH test.
    Archives of Physical Medicine and Rehabilitation 09/1999; 80(8):863-6. · 2.36 Impact Factor
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    ABSTRACT: To compare the ventilatory response to hypercapnia and the mouth occlusion pressure measured at 0.1 second following inspiration (P0.1) in hypercapnia between chronic tetraplegic and normal subjects. A case-control study with an uneven sample size for the study of clinical disorders. Patients were recruited from the outpatient clinic of a rehabilitation department. Seven normal men and 9 men with tetraplegia who had cervical cord injuries (C5-C8), with a mean injury duration of 9.7 yrs. Pulmonary function tests were performed during resting, whereas minute ventilation (VE) and P0.1 were measured during CO2 rebreathing. The maximal voluntary ventilation (MVV), vital capacity (VC), and maximal respiratory muscle strength in the tetraplegic subjects were significantly less than in the normal subjects. Both the ventilatory and P0.1 responses to hypercapnia were significantly reduced in tetraplegic as compared with normal subjects, but the reductions were eliminated by normalizing with maximal ventilatory performance (MVV or VC) and maximal inspiratory muscle strength (PImax), respectively. Chronic tetraplegic persons have diminished ventilatory and P0.1 responses to hypercapnia. Respiratory muscle weakness may be a primary factor contributing to the diminished ventilatory response observed in these patients.
    Archives of Physical Medicine and Rehabilitation 08/1998; 79(7):795-9. · 2.36 Impact Factor
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    ABSTRACT: We explored the effect of an abdominal binder, with or without electrical stimulation, on peak expiratory flow rate (PEFR) in 12 paraplegics with complete thoracic cord (T2-T12) injury (mean age 36.0 +/- 1.5 yr) and 12 quadriplegics with complete cervical cord (C4-C8) injury (mean age 36.2 +/- 1.9 yr). The cough was assessed by measuring the PEFR during forceful expiration in a sitting position. The subjects underwent the following experimental maneuvers in a random order with a 10-minute interval between any two maneuvers: 1) voluntary coughing, 2) voluntary coughing with an abdominal binder, and 3) voluntary coughing with an abdominal binder and electrical stimulation. The electrical stimulator (50 Hz with 300 microseconds pulse width) was applied to the abdominal wall. Data were analyzed using multivariate analysis of variance for repeated measures. The abdominal binder did not significantly increase PEFR in either paraplegics or quadriplegics; the abdominal binder combined with electrical stimulation significantly increased PEFR by 15% in the paraplegics and 18% in the quadriplegics. These results indicate that electrical stimulation combined with an abdominal binder improves the cough ability in patients with cervical or thoracic spinal cord injury.
    Journal of the Formosan Medical Association 05/1998; 97(4):292-5. · 1.00 Impact Factor
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    ABSTRACT: Anejaculation and poor semen quality are two major causes of infertility in men with spinal cord injury (SCI). The poor motility of retrieved sperm usually has low fertilization potential and is thought to be unfavorable for cryopreservation. This report describes a pregnancy after intracytoplasmic sperm injection (ICSI) with cryopreserved vasal-epididymal sperm from a man with SCI and anejaculation. An attempt was made to obtain sperm through electroejaculation, but no motile sperm were found in two trials. Therefore, the subject underwent vasal aspiration. The retrieved sperm had a concentration of 26 x 10(6)/mL and a motility of 3%. ICSI was considered to be the best choice for the couple, but the wife did not become pregnant in the first cycle of treatment. A successful pregnancy was achieved by ICSI in the second cycle using frozen-thawed sperm, supernumerary in the previous cycle, with a density of 5 x 10(6)/mL and 1% motility. A set of healthy twins, one boy and one girl, were delivered via cesarean section at 36 weeks of gestation. Complementary to other assisted reproductive techniques, ICSI may provide men with SCI a greater opportunity to father children. The supernumerary sperm, regardless of quality, should be cryopreserved to avoid the necessity and risk of repeated assisted ejaculations and aspirations of the genital tract.
    Archives of Physical Medicine and Rehabilitation 03/1998; 79(2):218-21. · 2.36 Impact Factor
  • T S Huang, Y H Wang, S H Lee, J S Lai
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    ABSTRACT: Twenty-five men with spinal cord injuries were studied for evaluation of the hypothalamus-pituitary-adrenal axis, using corticotropin-releasing hormone and insulin-induced hypoglycemia. Twenty-five age-matched healthy male volunteers served as controls. Three spinal cord-injured subjects had hyperprolactinemia, three had elevated basal follicle-stimulating hormone levels, one had an elevated basal luteinizing hormone level, and four had hypotestosteronemia. The mean plasma adrenocorticotropin response to corticotropin-releasing hormone of spinal cord-injured subjects was smaller than that of the healthy controls but did not reach a statistical significance. The cortisol response to corticotropin-releasing hormone of the spinal cord-injured subjects was significantly lower than that of healthy controls. However, the difference disappeared if a correction was made for baseline values. Six spinal cord-injured subjects did not have a cortisol response to insulin-induced hypoglycemia, and they had either a minimal or no adrenocorticotropin response. Another 11 spinal cord-injured subjects had a maximal cortisol response to insulin-induced hypoglycemia below the lowest limit of normal, i.e., 0.5 micromol/l. Among these spinal cord-injured subjects, three had a less than 50% increase of plasma adrenocorticotropin after insulin-induced hypoglycemia. These findings are consistent with the notion that spinal cord-injured subjects have an altered central neurotransmitter tone and substantiate the hypothesis that an afferent neural pathway exists between the adrenal and hypothalamus and may modulate stress-induced secretion of adrenocorticotropin. Long-term abnormal adrenocorticotropin secretion may cause mild adrenocortical atrophy and, thereby, a reduced cortisol response.
    American Journal of Physical Medicine & Rehabilitation 01/1998; 77(2):108-12. · 1.73 Impact Factor
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    ABSTRACT: To identify the clinical features and rehabilitation outcomes in spinal cord injury (SCI) patients with preexisting schizophrenia. A retrospective study conducted by reviewing the charts of all patients diagnosed with both SCI and schizophrenia hospitalized from 1987 throughout 1994 in 2 rehabilitation units. Rehabilitation wards of two hospitals in Taiwan. Seventeen traumatic SCI patients with schizophrenia, including 7 men and 10 women. Patients without neurological deficits were excluded. All subjects received psychiatric intervention and intensive rehabilitation programs during hospitalization. The injury pattern and psychiatric condition were described. Abilities of locomotion, management of activities of daily living, and bladder control were measured. Fifteen injuries caused by a voluntary fall subsequently resulted in thoracolumbar insult. Ten incomplete paraplegics were able to ambulate with or without a device on discharge. Four subjects had poor bladder control. The outcome of self-care skills was worse in those with high level injury. Psychiatric symptoms were one of the main obstacles during rehabilitation. Voluntary fall that caused thoracolumbar injuries was the main cause of injuries in these patients. Psychiatric symptoms were present in the majority and might hinder the prognosis of treatment. Nevertheless rehabilitation programs were found to benefit subjects after their psychiatric problems were under control.
    Archives of Physical Medicine and Rehabilitation 04/1996; 77(3):283-6. · 2.36 Impact Factor
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    ABSTRACT: Syncope as an initial presentation of pulmonary embolism is unusual. A 16-year-old girl, with T7 paraplegia after a traumatic spinal cord injury, developed syncope on the 33rd hospital day. The episode occurred approximately 3 hours after her first tilting table training and just after her attendant had assisted passive range-of-motion exercise. Subsequent studies showed pulmonary embolism at the left lower branch of the left pulmonary artery, and the branch to lower segment of the lingual lobe. Doctors should be alert to possible diagnosis of pulmonary embolism in such high-risk patients, especially when new onset symptoms or signs appear.
    Archives of Physical Medicine and Rehabilitation 05/1995; 76(4):387-90. · 2.36 Impact Factor
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    ABSTRACT: Ice water test (IWT) and cystometrography (CMG) were performed on 51 in patients with spinal cord injuries (SCI) to evaluate the sensitivity and specificity of the IWT in detecting detrusor reflex. A three-step grading system as established by Balmaseda et al was applied to determine the presence of detrusor activity on IWT. The test was considered 3+ when the catheter was expelled from the bladder within one minute following instillation of 90 mL of ice water; a 2+ test indicated voiding around the catheter after instillation of 90 mL of ice water; and a 1+ IWT was defined as voiding around the catheter or expelling the catheter after instilling another 210 mL of ice water into the bladder. The results showed that the sensitivity of IWT in detecting the presence of detrusor reflex in patients with neurogenic bladder dysfunction was 96% and the specificity was 79%. Among the four patients having false positive IWT, three of them were diagnosed with poor-compliance bladders. One patient with false negative IWT was found to have severe detrusor-sphincter dyssynergy. There was a significant difference in the strength of detrusor activity among the patients with 3+ IWT, with 2+ IWT, and with 1+ IWT. IWT is a useful technique to predict the existence of detrusor reflex in SCI patients. Its use as a supplement method to cystometrogram could be helpful in the bedside evaluation of patients with neurogenic bladder dysfunction.
    Journal of the Formosan Medical Association 10/1994; 93 Suppl 2:S115-9. · 1.00 Impact Factor
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    ABSTRACT: Twenty-five spinal cord-injured (SCI) males and 25 normal volunteers were studied for their scrotal and thigh temperatures by using contact liquid crystal thermography. The initial temperature was recorded after transfer and disrobing which took about 2 minutes. Later temperature was recorded 10 minutes after exposing the genitalia to room air (20-22 degrees C). The initial scrotal and thigh temperatures of SCI subjects were significantly higher than those of normal volunteers (32.8 +/- 0.8 degrees C v 31.6 +/- 0.4 degrees C; 32.9 +/- 0.8 degrees C v 31.7 +/- 0.4 degrees C, respectively, P < 0.001), although their rectal temperatures were not different. The scrotal and thigh hyperthermia of SCI subjects disappeared after 10 minutes of exposure to room air. There was no significant difference between scrotal and thigh temperatures in either the SCI subjects or the normal volunteers in the later temperature reading. Sitting in a wheelchair for 2 hours results in an increase of average 0.8 degrees C of scrotal and thigh temperature in five normal volunteers. Our study suggests that scrotal hyperthermia of SCI subjects is mainly the result of local factors such as a prolonged sitting position, adduction of the thighs, the cushion's insulating effect and infrequent movement of the buttocks. Adequate ventilation of the scrotal area can overcome the impaired scrotal heat dissipation of SCI subjects. Liquid crystal thermography is a useful, noninvasive method for detecting hyperthermia in SCI subjects.
    American Journal of Physical Medicine & Rehabilitation 02/1993; 72(1):6-9. · 1.73 Impact Factor
  • Y H Wang, T S Huang, I N Lien
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    ABSTRACT: The steady state profiles of 63 men with traumatic spinal cord injuries (24 quadriplegics and 39 paraplegics; average age of 31.2 +/- 6.8 yr; 18-44 yr) were studied. The average length of post-traumatic period was 6.2 +/- 5.0 yr, ranging from 8 months to 20 yr. It was found that all the subjects had normal serum thyroxine, thyrotropin, cortisol, growth hormone and plasma adrenocorticotropic hormone. Seven cases (11.1%) had low serum triiodothyronine and eight cases (12.7%) had low serum testosterone. On the other hand, 17 cases (27.0%) had hyperprolactinemia; 9 cases (14.3%) had elevated serum testosterone level; 6 cases (9.5%) had elevated serum follicle-stimulating hormone; and 4 cases (6.3%) had elevated serum luteinizing hormone. The level of spinal cord injury, injury period and patient age had no correlation with other serum hormone changes except that quadriplegic subjects had lower serum triiodothyronine than the paraplegic, with a mean of 1.42 +/- 0.30 v 1.70 +/- 0.36 nmol/liter (P < 0.005). Of the eight subjects who had low serum testosterone, none had elevated gonadotropin. There were also eight subjects with elevated follicle-stimulating hormone and/or luteinizing hormone, six of them had normal serum testosterone and two had elevated serum testosterone. This suggested their hypogonadism did not result primarily from classic primary gonadal failure. It could be speculated that other testicular paracrine factors and/or alteration of hypothalamus-pituitary-testicular axis are involved in the pathogenesis of hypogonadism. Further studies in this field will provide information regarding male reproductive physiology and may have impact on fertility enhancement options for men with spinal cord injuries.
    American Journal of Physical Medicine & Rehabilitation 01/1993; 71(6):328-32. · 1.73 Impact Factor
  • Y H Wang, H S Chiang, C H Wu, I N Lien
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    ABSTRACT: Electroejaculation is a newly developed method to retrieve sperm in anejaculatory spinal cord injured (SCI) males. We studied 25 completely traumatic SCI males from August 1990 to May 1991. The patients' ages ranged from 18.7 to 43.3 years, and the interval since injury ranged from four months to 14.1 years. The level of injury varied from C5 to T12. Bi-directional emission was found in 12 patients, antegrade in nine, retrograde in one and failure in three. Electroejaculatory stimulation parameters were 434 +/- 54 mA for mean maximum current, 21.7 +/- 2.7 volts for mean maximum voltage and 35.9 +/- 3.1 degrees C for mean maximum probe temperature. The antegrade semen obtained showed wide variations in sperm quality and quantity between subjects. The total sperm count was 478 +/- 809 x 10(6) in the antegrade portion, and the sperm motility was below 5% in most cases. The retrograde portion was usually worse. There was no correlation between sperm quality and quantity with patient age, injury level or injury period. Bladder management had no effect on the results of electrical stimulation. Epididymitis had a negative impact on the success of retrieval. Low-level injury victims needed analgesia or anesthesia to complete the stimulation. The major side effects were minimal autonomic dysreflexia and mild rectal mucosal change. Repeated stimulation may improve sperm counts, but semen quality deteriorates if the procedure is performed once a week. As a whole, electroejaculation is a safe, effective and simple procedure to retrieve sperm in anejaculatory persons, especially SCI patients.
    Journal of the Formosan Medical Association 05/1992; 91(4):413-8. · 1.00 Impact Factor

Publication Stats

199 Citations
33.43 Total Impact Points

Institutions

  • 1998–2000
    • National Taiwan University
      • College of Medicine
      Taipei, Taipei, Taiwan
  • 1992–1998
    • National Taiwan University Hospital
      • Department of Internal Medicine
      T’ai-pei, Taipei, Taiwan
  • 1995–1996
    • Taipei Medical University
      • Department of Physical Medicine and Rehabilitation
      T’ai-pei, Taipei, Taiwan