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Biomedical subjects

C C Hsu

Publications and source records attributed to C C Hsu.

250 records · Page 14Linked to original sources

Clearance of Candida colonizing the urinary bladder by a two-day amphotericin B irrigation.

The minimum duration of continuous amphotericin B irrigation (50 mg/liter/day) required to clear the candida colonizing the urinary bladder was investigated. Eleven in vitro experiments revealed a consistent candidicidal effect within 48 hours with 25 and 5 mg/l of amphotericin B concentrations attainable in the bladder. Hospitalized nursing home patients with candiduria were treated with two-day irrigation according to the protocol. The protocol consists of the use of a newly inserted catheter for the irrigation, subsequent washout of the residual drug, and immediate sampling of urine for microscopic examination and culture after the procedure. In 47 of 65 (72.3%) cases yeast was cleared. In the remaining 18 the candida persisted. Of the latter, ten received additional irrigation for an average of 7.3 days (range: 4-12 days). In all ten cases funguria continued. Two-day irrigation saves time and expense, and is as effective as the five-day procedure in eradicating the yeast on bladder mucosa. Because of the relatively short irrigation time, the protocol may be useful in clinical evaluation of the site of urinary candidiasis.

Amphotericin B↗

Sonographic features of hepatic adenomas with pathologic correlation.

BACKGROUND: We compared the sonographic characteristics of hepatic adenomas with pathologic findings. METHODS: Information over 10 years was collected on 12 patients (six men, six women; mean age = 47 years) with surgically proven hepatic adenomas. Clinical data, sonographic features, and histopathologic findings were reviewed. RESULTS: The tumors in males were smaller and simpler than those in women (p < 0.05, Fisher's exact test). Four of the six larger tumors (>5 cm) showed mixed-echoic patterns corresponding with pathologically intratumoral hemorrhage and necrosis. Four homogeneously hypoechoic tumors had less change in tumor composition. Three homogeneously hyperechoic tumors had evident fatty changes inside. One isoechoic tumor had a hypoechoic rim, that correlated mostly to the tumor itself and compressed liver parenchyma. Seven of the 12 tumors had thin fibrous capsules that were not seen on sonography. CONCLUSION: Hepatic adenomas have variable sonographic appearances depending on changes in the tumor. Hypoechoic, hyperechoic, and mixed-echoic patterns represent simple adenoma, adenoma with fatty metamorphosis, and hemorrhagic necrosis, respectively, in tumors.

Adenoma, Liver Cell↗

Early development of Yu-Cheng children born seven to twelve years after the Taiwan PCB outbreak.

In Taiwanese children born seven to twelve years after their mothers' or fathers' intoxication of heat-degraded polychlorinated biphenyls (PCBs) (Yu-Cheng mothers or fathers), we measured the development and behavioral problems in 1991-2. The development was assessed with the Chinese Child Developmental Inventory (CCDI), and the behavioral problems with Rutter's Child Behavior Scale A. Children of Yu-Cheng mothers had delayed development on several subscales of CCDI and on the combined general development score. Girls were more affected than boys in their development. Children of Yu-Cheng fathers did not score differently from unexposed controls on this measurement. In Rutter's scale, the scores in Yu-Cheng mothers' children and Yu-Cheng fathers' children were not different from those of their unexposed controls. We conclude that children born seven to twelve years after mothers' exposure to degraded PCBs had delayed development, but they did not show more behavior problems when compared with unexposed controls.

Child Behavior↗

Cognitive development in Yucheng children.

We have been following up the biological and mental development of children exposed prenatally to polychlorinated biphenyls and their contaminants (Yucheng children). When we started this 12-year follow-up study in August 1985, 118 Yucheng children we assigned a non-exposed child matched by sex, age, locality of residence, mother's age, socio-economic status of the family. This article reports the cognitive aspect of the development of Yucheng children as compared to their matched controls. A consistent tendency which indicates that Yucheng children score lower in each kind of measurement tool at each age level has been observed. This seems to imply that congenitally exposure to PCBs and their contaminants has long-term adverse effects on the cognitive development of human being.

Child, Preschool↗

Disordered behavior in the early-born Taiwan Yucheng children.

Behavioral problems were evaluated in Taiwanese children who were born between July 1978 and June 1985 to women who had consumed rice oil that was contaminated by heat-degraded polychlorinated biphenyls (PCBs). One hundred and eighteen such children, referred to as 'the early-born Yucheng children', and matched controls were followed with the Chinese version of Rutter's Child Behavior Scale A annually from 1985 to 1991. At any fixed age, the early-born Yucheng children had mean Rutter behavior scores 1.75 to 2.40 points higher (14-38% worse) than that of their controls. The effects were similar in the health, habit, and behavioral subscores and persistent as the children aged.

Child↗

In utero PCB/PCDF exposure: relation of developmental delay to dysmorphology and dose.

In 1979, there was an outbreak of food poisoning in central Taiwan due to cooking oil contaminated with polychlorinated biphenyls and their thermal degradation products. Starting in 1985, we studied 128 children born to exposed women after the oil was removed from the market; the exposure of these children was transplacental or through breast milk. We also studied matched controls. The exposed children exhibited developmental delays as measured by parental report, by neurologic examination, and by standard cognitive tests; delay was seen at all ages and persisted over time. Delay was greater in children who were smaller in size and in children who had exhibited neonatal symptoms of intoxication. Children with a history of nail deformity also were delayed. However, there was little relationship between other physical findings or measures of maternal exposure and developmental delay. There was some indication that the child's prenatal exposure was more important to developmental delay than was exposure through breast milk.

Abnormalities, Drug-Induced↗

The immunologic evaluation of the Yucheng children.

The immunologic effects of in utero exposure to polychlorinated biphenyls (PCBs)/polychlorinated dibenzofurans (PCDFs) were evaluated in the Yucheng children in this study. The study subjects consisted of 105 Yucheng children and 101 control children. The Yucheng children were born, between July 1978 and June 1987, to women who had exposed to high dose of PCBs/PCDFs through consumption of contaminated rice bran oil in 1978-1979. These children had been reported to have higher frequencies of bronchitis than their controls in the first six months of life, and higher frequencies of respiratory tract and ear infection in a 6-year follow-up. The low resistance of the Yucheng children to infection suggested that their immune function was suppressed by the PCBs/PCDFs they had exposed to in utero. In the summer and fall of 1995, a thorough physical examination and blood draw were performed on the study children. The Yucheng children were reported by their parents to have higher frequencies of influenza attacks than the control children during the six months prior to the examination. The frequencies of other symptoms were similar between the two groups. The serum levels of various immunoglobulins were similar between the two groups. Fifty-one serum samples, 29 of Yucheng and 22 of control children, were available for cell-mediated immunologic analysis. The percentages of various T cell markers, CD3, CD4, and CD8, and B cell and NK cell markers were not different between the Yucheng and the control children. No dose-response relationship was found between 27 Yucheng children's serum PCB/PCDF levels and any of their immunologic markers. WE concluded that 16 years after the Yucheng incident, Yucheng children exposed to high dose of PCBs/PCDFs in utero did not show, with the serum immunologic marker analyses, suppressed immunity when compared to their controls. To explain the consistent higher frequencies of upper respiratory tract infection in the Yucheng children, immune functional tests such as delayed hypersensitive skin reaction, in vitro lymphocyte proliferation, and antibody synthesis following immunization may be necessary.

Adolescent↗

Middle-ear disease in children exposed prenatally to polychlorinated biphenyls and polychlorinated dibenzofurans.

During 1978 and 1979, an episode of poisoning from ingestion of rice oil contaminated with polychlorinated biphenyls and polychlorinated dibenzofurans occurred in central Taiwan. We followed-up children who had been born between June 1978 and March 1985, as well as matched unexposed children. The mothers of exposed children had consumed contaminated oils before the children were born. In 1993, otolaryngologists examined the middle ear of each child with a pneumatic otoscope, and they measured the middle-ear pressure by tympanometry with a Rion RS20 impedance audiometer. The exposed children had a significantly higher prevalence of middle-ear diseases than their matched controls. The exposed children who had ear diseases had higher serum levels of 2,3,4,7,8-pentachloro- and 1,2,3,4,7,8-hexachloro-dibenzofurans than the children who did not have similar diseases. Therefore, in this study, children exposed to polychlorinated biphenyls and polychlorinated dibenzofurans had a higher incidence of middle-ear diseases than their controls.

Benzofurans↗

Reducing lead exposure by surveillance system: the Taiwan experience.

To evaluate the performance of a lead-surveillance program in reducing blood lead levels of workers in Taiwan, the authors conducted prospective and cross-sectional studies. A total of 6 905 workers, whose job titles indicated a direct exposure to lead in 1995, were included in this surveillance system. In this study, the authors compared the mean blood lead levels in 1994 (i.e., year of onset of surveillance) with that in 1995 in workers of major industries. Lead-exposed workers had a statistically significant decrease (i.e., average of 1.8 microg/dl) in blood lead levels during this 1-y period. The decrease was particularly obvious in individuals who worked in chemical products manufacturing, ship building/repairing, and plastic products manufacturing. The significant decreases in blood lead levels in these workers indicated that this surveillance system was effective. Surveillance, combined with control measures, might be an important means by which occupational lead exposure can be reduced.

Adult↗

Effect of primary emulsions on microsphere size and protein-loading in the double emulsion process.

Incorporation of a protein drug in microspheres made of a hydrophobic polymer is commonly achieved via double liquid-liquid emulsification (w/o/w) or by dispersing a powdered protein in a polymer solution followed by liquid-liquid emulsification (s/o/w). This study focused on the effect of the first operating step in both processes on the size and protein-loading of the microspheres. Bovine serum albumin (BSA) was used as the model protein and poly(methyl methacrylate) (PMMA) was used as the model polymer. The w/o emulsion was characterized based on the degree of emulsion fineness which was controlled using rotor/stator homogenization. The s/o emulsion was characterized based on protein powder size and shape. Protein powders of different sizes and shapes were produced using different powder preparation methods. In both emulsification processes, the second operating step which produced the microspheres was conducted in either a continuously stirred tank reactor (CSTR) or a static mixer. The size of the microspheres thus prepared was found to increase with increasing size of the protein powder in the s/o/w system but increase with decreasing size of the liquid emulsion droplets in the w/o/w system. Empirical correlations can accurately predict the size of the microspheres if the size of w/o emulsion droplets and protein powder is 10 x less than the microsphere size. Protein loading in the microspheres decreased with respect to increases in w/o emulsion droplet size or in protein powder size. We propose that these phenomena are attributed to two mechanisms, fragmentation along the weak routes in the w/o/w system and particle redistribution as the result of terminal velocity in the s/o/w system. The role of protein powder shape was not significant until the protein powder size exceeded 5 microns. Irregular-shaped protein powders resulted in lower encapsulation efficiency than spherical-shaped protein powders.

Animals↗

[The coexistence of vesicoureteral reflux and ureteropelvic junction obstruction in children].

From January 1982 to December 1990, there were 229 cases with 337 ureters having vesicoureteral reflux (VUR). Thirteen of them (3.86%) were also found to have ureteropelvic junction (UPJ) obstruction in the same ureter. They were categorized into three groups based on the therapeutic implications. Group 1 (two ureters) underwent pyeloplasty. Group 2 (two ureters) received both pyeloplasty and reimplantation. The remaining nine ureters having VUR and pseudo-obstruction fell into group 3, and two of them became true UPJ obstruction eventually. We stressed the importance of evaluating upper urinary tract in all refluxed ureters with inappropriately dilated renal pelvis. By doing that we can avoid unnecessary surgery and prevent complications from wrong sequence of operation to a least extent.

Child↗

[Correlation between development indices and later intelligence quotients--the follow-up study of chlorinated biphenyls affected children].

All intelligence tests are for children old than two and a half years; we still do not have an intelligence assessment tool for children younger than this age. If we knew the relationship between the intelligence quotient and developmental indices as measured by the Bayley Scale of Infant Development (BSID), it would allow us to assess the mental development of young children earlier and to start adequate management sooner. The present study was designed to meet this need. We collected our data from a six-year follow-up study of Yu-Cheng (oil disease) children born to mothers who had a history of ingesting rice cooking oil contaminated with polychlorinated biphenyls (PCBs) in 1978-1979 and their matched controls. We analyzed the correlations between the developmental indices of the BSID assessed on 44 pairs of Yu-Cheng children and their controls in 1985 and the Stanford-Binet Intelligence Quotients (S-B IQ) assessed on the same group of children in 1987 and 1988. For the matched controls, we found practically no significant correlation between the BSID developmental indices and the S-B IQ (r = .04-.20, p = .23-.82). In the Yu-Cheng children, that is at-risk group, there was a significant correlation between the Mental Developmental Index (MDI) of BSID and the S-B IQ (r = .33-.43, p = .01-.05) and between the Psychomotor Developmental Index (PDI) of BSID and the S-B IQ (r = .31-.47, p = .00-.07). We conclude that the development indices of BSID has a better predictive power on the intelligence among the at-risk group such as Yu-Cheng children.

Child Development↗

Structure elucidation of norlaureline and puterine, new noraporphine alkaloids from Guatteria elata.

The structures of norlaureline (1) and puterine (4), new noraporphine alkaloids isolated from Guatteria elata (Annonaceae), were established by interpretation of the optical rotation, uv, ir, pmr, and mass spectral data of their N-acetyl derivatives. Proposed structures were confirmed by transformation of 1 and 4 to laureline (3) and pukateine methyl ether (6), respectively.

Aporphines↗

Choledochal cyst in infancy: report of two cases.

Choledochal cysts are malformations of the biliary ductal system, which rarely occur in infancy. In neonates and infants, choledochal cysts are congenital, may be associated with distal biliary atresia and typically presents with cholestatic jaundice and acholic stools characteristic of biliary obstruction. In older children and adults, it may be acquired in association with an anomalous pancreaticobiliary union and presents with any combination of intermittent jaundice, abdominal pain, and a palpable abdominal mass. Early detection of choledochal cysts is important in the prevention of the fatal complications of biliary obstruction. Here, we present two cases of congenital choledochal cyst in which the patients were 9 weeks old and 7 weeks old respectively. Both of them presented with jaundice, acholic stools, and hepatomegaly. Combined use of sonography, computed tomography and hepatobiliary scintigraphy demonstrated the presence of choledochal cysts. Thereafter, they underwent surgical excision of the cysts with Roux-en-Y reconstruction of the biliary tree; the results were successful.

Choledochal Cyst↗