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Articles by K. C Lai
Total Records ( 2 ) for K. C Lai
  S. C Chen , Y. T Lee , C. H Yen , K. C Lai , L. B Jeng , D. B Lin , P. H Wang , C. C Chen , M. C Lee and W. R. Bell

Background: pyogenic liver abscess (PLA) is a potentially life-threatening disease in middle-to-old aged persons.

Objective: to compare the differences in clinical features and outcomes between older and younger PLA patients, and to identify predictors of outcomes in older patients.

Design: retrospective chart review of all PLA patients between July 1999 and June 2007.

Setting: a 1,600-bed primary and tertiary care centre.

Subjects: in total, 339 patients were enrolled and included 118 ≥65 years of age (the elderly group) and 221 patients <65 years of age (the non-elderly group).

Methods: clinical features, laboratory, imaging and microbiologic findings, treatment and outcomes for each of the included patients were collected. The predictor of outcome was determined using logistic regression and purposeful selection of covariates.

Results: the elderly group had a higher APACHE II score on admission, a biliary abnormality, a malignancy, a pleural effusion, polymicrobial, anaerobic or multi-drug-resistant isolates, inappropriate initial antibiotics, a longer hospitalisation and a longer parenteral antibiotic treatment period than the non-elderly group, whereas the non-elderly group was more likely to be alcoholic men with cryptogenic origin of abscess and Klebsiella pneumoniae infection. There was no difference in case fatality between the elderly (13.6%) and non-elderly (8.6%) groups despite the elderly group having a poorer host status on admission. In multivariate analysis, age (P = 0.028) and APACHE II score at admission ≥15 (P = 0.001) were risk factors, but K. pneumoniae infection (P = 0.012) was a protective factor for fatality in older PLA patients.

Conclusions: these data suggest that older PLA patients wound have a fair outcome compared to younger patients, but require longer hospitalisations.

  M Mohan , H. M Herz , Y. H Takahashi , C Lin , K. C Lai , Y Zhang , M. P Washburn , L Florens and A. Shilatifard

Epigenetic modifications of chromatin play an important role in the regulation of gene expression. KMT4/Dot1 is a conserved histone methyltransferase capable of methylating chromatin on Lys79 of histone H3 (H3K79). Here we report the identification of a multisubunit Dot1 complex (DotCom), which includes several of the mixed lineage leukemia (MLL) partners in leukemia such as ENL, AF9/MLLT3, AF17/MLLT6, and AF10/MLLT10, as well as the known Wnt pathway modifiers TRRAP, Skp1, and β-catenin. We demonstrated that the human DotCom is indeed capable of trimethylating H3K79 and, given the association of β-catenin, Skp1, and TRRAP, we investigated, and found, a role for Dot1 in Wnt/Wingless signaling in an in vivo model system. Knockdown of Dot1 in Drosophila results in decreased expression of a subset of Wingless target genes. Furthermore, the loss of expression for the Drosophila homologs of the Dot1-associated proteins involved in the regulation of H3K79 shows a similar reduction in expression of these Wingless targets. From yeast to human, specific trimethylation of H3K79 by Dot1 requires the monoubiquitination of histone H2B by the Rad6/Bre1 complex. Here, we demonstrate that depletion of Bre1, the E3 ligase required for H2B monoubiquitination, leads specifically to reduced bulk H3K79 trimethylation levels and a reduction in expression of many Wingless targets. Overall, our study describes for the first time the components of DotCom and links the specific regulation of H3K79 trimethylation by Dot1 and its associated factors to the Wnt/Wingless signaling pathway.

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