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Biomedical subjects

C L Liu

Publications and source records attributed to C L Liu.

At least 145 records · Page 8Linked to original sources
PubMed1995

Hepatic resection for hepatocellular carcinoma. An audit of 343 patients.

OBJECTIVE: The authors summarize the results of patients who had hepatectomy for hepatocellular carcinoma over a 22-year period. SUMMARY BACKGROUND DATA: Recent reports showed improved perioperative results and long-term prognosis. METHODS: The perioperative outcome of 343 patients was studied according to three different time periods: before 1987 (n = 149); 1987 to 1991 (n = 128); and 1992 to present (n = 66). Survival analysis was made by stratifying patients into two categories--either before or after 1987. The majority of patients had large tumors (78%), cirrhosis (73%), and a major hepatectomy (73%). RESULTS: Besides an increased resectability rate (23%), there was a marked reduction of the recent morbidity (32%; p < 0.001), operative (4.5%; NS) and hospital (6%; p < 0.02) mortality rates. The recent surgical approach was identified as a significant contributory factor to the lowered hospital mortality rate. Patients in the latter part of the study had significantly better survival, with a 1-, 3- and 5-year survival rate of 68%, 45%, and 35%, respectively. Early detection and effective treatment of recurrences contributed to the improved prognosis. CONCLUSIONS: The recent management strategy and technological advances improved the results of surgical treatment for patients with hepatocellular carcinoma.

Adult↗
PubMed1995

Surgical treatment of extensive discovertebral destruction in ankylosing spondylitis: a report of two cases.

Extensive discovertebral destruction in ankylosing spondylitis is rare and difficult in diagnosis and management. We present two such cases who were treated with anterior decompression, autogenous strut iliac bone graft and fixed with anterior locking plate system (ALPS) instrumentation. After operation the patients' symptoms improved and the spinal deformities were corrected. Our experiences in these two patients emphasize the importance of early recognition, early detection and aggressive surgical treatment in the lesion.

Adult↗
PubMed1994

Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma.

BACKGROUND: Resection of hepatocellular carcinoma is associated with high rates of morbidity and mortality. Since intensive nutritional support can reduce the catabolic response and improve protein synthesis and liver regeneration, we performed a prospective study to investigate whether perioperative nutritional support could improve outcome in patients undergoing hepatectomy for hepatocellular carcinoma. METHODS: We studied 124 patients undergoing resection of hepatocellular carcinoma. Sixty-four patients (39 with cirrhosis, 18 with chronic active hepatitis, and 7 with no associated liver disease) were randomly assigned to receive perioperative intravenous nutritional support in addition to their oral diet, and 60 patients (33 with cirrhosis, 12 with chronic active hepatitis, and 15 with no associated liver disease) were randomly assigned to a control group. The perioperative nutritional therapy consisted of a solution enriched with 35 percent branched-chain amino acids, dextrose, and lipid emulsion (50 percent medium-chain triglycerides) given intravenously for 14 days perioperatively. RESULTS: There was a reduction in the overall postoperative morbidity rate in the perioperative-nutrition group as compared with the control group (34 percent vs. 55 percent; relative risk, 0.66; 95 percent confidence interval, 0.45 to 0.96), predominantly because of fewer septic complications (17 percent vs. 37 percent; relative risk, 0.57; 95 percent confidence interval, 0.34 to 0.96). There were also a reduction in the requirement for diuretic agents to control ascites (25 percent vs. 50 percent; relative risk, 0.57; 95 percent confidence interval, 0.37 to 0.87), less weight loss after hepatectomy (median loss, 0 kg vs. 1.4 kg, P = 0.01), and less deterioration of liver function as measured by the change in the rate of clearance of indocyanine green (-2.8 percent vs. -4.8 percent at 20 minutes, P = 0.05). These benefits were seen predominantly in the patients with underlying cirrhosis who underwent major hepatectomy. There were five deaths during hospitalization in the perioperative-nutrition group, and nine in the control group (P not significant). CONCLUSIONS: Perioperative nutritional support can reduce complications after major hepatectomy for hepatocellular carcinoma associated with cirrhosis.

Adult↗
PubMed1994

Preoperative endoscopic drainage for malignant obstructive jaundice.

The role of preoperative endoscopic drainage for patients with malignant obstructive jaundice was evaluated in a randomized controlled trial. A total of 87 patients were assigned to either early elective surgery (44 patients) or endoscopic biliary drainage followed by exploration (43). Thirty-seven patients underwent successful stent insertion and 25 had effective biliary drainage. Complications related to endoscopy occurred in 12 patients. After endoscopic drainage significant reductions of hyperbilirubinaemia, indocyanine green retention and serum albumin concentration were observed. Patients with hilar lesions had a significantly higher incidence of cholangitis and failed endoscopic drainage after stent placement. The overall morbidity rate (18 patients versus 16) and mortality rate (six patients in each group) were similar in the two treatment arms irrespective of the level of biliary obstruction. Despite the improvement of liver function, routine application of endoscopic drainage had no demonstrable benefit. Endoscopic drainage is indicated only when early surgery is not feasible, especially for patients with distal obstruction.

Aged↗
PubMed1994

Stent of shape-memory alloy for urethral obstruction caused by benign prostatic hyperplasia.

Dilation and positioning a stent in the prostatic urethra have become important alternatives for the management of benign prostatic hyperplasia (BPH), but both have significant drawbacks, namely the need to repeat the treatment in the former case and the conflict between the introducing means and the generation of sufficient expansile force in the latter case. A spiral of a Chinese titanium-nickel alloy with shape memory was implanted in 25 patients with BPH using a self-made coaxial sheath. With a follow-up of 3 to 20 months, the success rate is 92%. There has been no encrustation or migration of the spirals. We deem the spiral of this shape-memory alloy to be a good alternative in patients with BPH who are unfit for surgery.

Aged↗
PubMed1994

[Serum level of soluble interleukin-2 receptor and T-lymphocyte subpopulations in normal pregnancy].

Serum soluble interleukin-2 receptor (sIL-2R) levels and T lymphocyte subpopulations were measured in 87 cases of normal pregnancy and 109 normal non-pregnant women as control group. It was found that sIL-2R level and CD8 T subpopulation increased as compared with control group (214,600 +/- 70,400 U/L vs 162,100 +/- 84,100 U/L, P < 0.01; 37.6% +/- 5.3% vs 31.3% +/- 7.0%, P < 0.01), but the ratio of CD4/CD8 was lower than that of control group (1.2 +/- 0.2 vs 1.5 +/- 0.5, P < 0.01). No significant difference was found between CD3, CD4 subpopulations of pregnancy and that of control group (64.1% +/- 7.3% vs 66.0% +/- 9.9%, P > 0.05; 44.1% +/- 5.8% vs 43.8% +/- 9.0%, P > 0.05). And no significant relation was found between sIL-2R level and CD3, CD4, CD8 subpopulations, CD4/CD8 (r = 0.203 2, 0.207 7, 0.103 7, 0.121 4 respectly, P > 0.05). These results suggested that the changes of T lymphocytes and sIL-2R may play an important role in maintaining normal pregnancy and sIL-2R may be one of factors improving fetal survival.

Adult↗
PubMed1993

A rapid method for the measurement of cholesterol thermodynamic activity in bile salt-lecithin-cholesterol solutions.

Earlier work from this laboratory suggested that the cholesterol (Ch) thermodynamic activity is a more meaningful measure of the degree of Ch supersaturation in human bile than the widely known cholesterol saturation index. An early version of a method for determining thermodynamic activity based on Ch uptake from bile salt (BS)-lecithin (LE) solutions into silicone polymer particles, but requiring 12-24 h for reaching equilibrium, was considered unsatisfactory because Ch nucleation and crystal formation frequently occurred within a few hours. The aim of the present work was to develop a method that would reduce equilibration times to the order of 1 h. Changing the thickness of the silicone film alone did not result in the desired reduction of equilibration times and it was soon deduced that the uptake of Ch by the silicone film from the BS-LE solution was a surface-controlled transport process involving the transport of Ch by negatively charged BS and BS-LE micelles at the interface. Three different approaches were tried to modify the silicone film to make its surface positively charged, thereby reducing and/or eliminating the presumed electrical repulsion barrier for the interfacial transport of Ch. The film was treated with different concentrations of aminopropyl methyl-dimethylsiloxane (AMDS) in cyclohexane, octadecyldimethyl-[3-(trimethoxysilyl)-propyl] ammonium chloride (ODTOP) in methanol, and octadecylamine solution in ethanol. Films treated with 1-1.5% ODTOP and 5-10% AMDS reduced the Ch equilibration times for model BS-LE solutions to < 1 h.

Bile Acids and Salts↗
PubMed1993

Prostaglandin E2 suppresses phytohemagglutinin-induced immune responses of normal human mononuclear cells by decreasing intracellular glutathione generation, but not due to increased DNA strand breaks or apoptosis.

Prostaglandin E2 (PGE2) at concentrations more than 1 x 10(-8) M markedly suppressed the cell proliferation and release of soluble molecules of interleukin-2 receptor (sIL-2R), CD4 (sCD4) and CD8 (sCD8) from phytohemagglutinin (PHA)-stimulated normal human mononuclear cells (MNC) in a dose-related manner. To further elucidate the subcellular mechanism of the inhibitory effect of PGE2 on PHA-stimulated MNC, intracellular concentration of glutathione (GSH) in PHA-stimulated MNC was sequentially measured from day 1 to day 3 by enzymic method. Furthermore, the effect of PGE2 on nuclear DNA including DNA strand breaks in alkali treatment and DNA fragmentation (apoptosis) of PHA-stimulated MNC were also measured. We found intracellular GSH levels were significantly decreased in the early stage of lymphocyte activation (day 1), but no evidence of increased DNA strand breaks or apoptotic process appeared in 3-day culture. In addition, butathione sulfoximine (a specific GSH inhibitor) and dibutyryl cyclic AMP also exhibited both proliferation inhibition and GSH-decreasing effects on PHA-stimulated MNC as well as PGE2. These results suggest that the immunosuppressive effect of PGE2 is mediated by the decreased generation of intracellular GSH, but not by the increased DNA strand breaks or apoptotic mechanism in the cells.

Antimetabolites↗
PubMed1993

Adenomyoma of the papilla of Vater: a case report.

Adenomyoma of the papilla of Vater is exceedingly rare. Histologically, the adenomyoma is characterized by locules of ducts with interlacing bundles of smooth muscle. A 63-year-old male patient is presented who had developed abdominal pain, progressively darker urine and light color stool, jaundice and dyspepsia over the past two-month period. Impression from radiologic study was neoplasm of the papilla of Vater, pathologic findings proved adenomyoma. This case, and review of the literature, suggest that local excision is the treatment-of-choice.

Ampulla of Vater↗
PubMed1992

Cholesterol (thermodynamic) activity determinations in bile salt-lecithin-cholesterol systems and cholesterol-rich liquid crystalline mesophase formation.

Previous in vitro studies have shown that tauroursodeoxycholate (TUDC)-lecithin (L) micellar solutions solubilize cholesterol (Ch) poorly compared to its 7 alpha-epimer, taurochenodeoxycholate (TCDC). However, in clinical studies ursodeoxycholic acid (UDC) has been found to be as effective as chenodeoxycholic acid (CDC) in Ch gallstone dissolution, and it has been suggested that, during UDC therapy, liquid crystalline mesophase formation may be involved in enhancing micellar Ch dissolution and dispersion. The purpose of the present study was to investigate whether measurements of the Ch thermodynamic activity (A(T) would provide new insights into the problem of Ch solubilization and mesophase formation in bile salt-lecithin-Ch systems. Using the silicone polymer uptake method developed in this laboratory, A(T) was measured as a function of Ch concentration in the TUDC-L-Ch and TCDC-L-Ch model bile systems. In the TCDC systems Henry's law was obeyed almost up to unit activity (i.e., A(T) was proportional to Ch concentration almost up to A(T) = 1.0). However, in many of the TUDC-containing systems negative deviations from Henry's law were observed well below unit activity and these systems became visibly turbid before saturation with respect to cholesterol monohydrate (ChM) was reached. The effects of varying the TCDC/TUDC ratio upon the A(T) behavior were also studied. With increasing TCDC/TUDC ratio, the onset of mesophase formation was shifted to higher A(T) values. A(T) measurements were also conducted in BS-L-Ch mixtures simulating biles of patients undergoing UDC therapy. The results obtained suggest that mesophase formation may not always occur in biles of patients undergoing UDC therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Bile↗
PubMed1992

Effect of hypercalcemia on renal sympathetic nervous system activity.

Since calcium plays a modulatory role in the activity of the sympathetic nervous system (SNS), in these studies, we have tested the hypothesis that hypercalcemia may alter renal SNS activity, and, consequently, renal function. Acute hypercalcemia was induced in Sprague-Dawley rats by infusion of calcium 30 mg/kg/2 h in 0.45% saline. A control group of rats received only 0.45% saline. Two more groups of rats received either calcium or 0.45% saline 7-10 days after total renal denervation. Calcium infusion increased serum calcium by 1.8 +/- 0.23 mg/dl in rats with intact renal nerves and by 2.7 +/- 0.48 mg/dl in renal denervated rats. Mean arterial pressure and inulin clearance did not change during calcium or 0.45% saline in rats with intact renal nerves. Renal sympathetic nerve activity (RSNA) decreased by 44% in rats infused with calcium, but it did not change in control animals. Calcium caused a significantly greater rise in urine volume, sodium excretion and fractional excretion of sodium than the infusion of 0.45% saline. Rats with renal denervation manifested greater baseline urine volume, sodium excretion and fractional excretion of sodium than rats with intact renal nerves. Infusion of calcium, however, caused no further rise in urine sodium excretion in these animals. alpha-Methyltyrosine, an inhibitor of norepinephrine (NE) synthesis, also increased natriuresis in rats. Calcium reduced by 27% the NE content in the kidney but not in the heart. Methyltyrosine, on the other hand, reduced NE content in both the heart and the kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1991

An immunocytochemical study of effects of light deprivation on prolactin cells in the adenohypophysis of the golden hamster.

Population ratio and morphology of prolactin cells were studied by employing immunohistochemical methods in the adenohypophysis of normal and experimental golden hamsters of both sexes at 16 weeks of age. Prolactin cells occupied 29% of the total adenohypophyseal cells in the intact males exposed to 14/10 h light/dark schedule. After stimulation of the pineal activity by binding or exposure of males to continuous darkness for eight weeks, prolactin cells became atrophic and were reduced in population to 17% and 13%, respectively. Pinealectomy prevented to some extent the effects of the above treatments; thus, prolactin cells constituted 27% in the pinealectomized and blinded hamsters, and 19% in the pinealectomized and darkness-treated group; and their morphology was comparable with that of the intact controls. Prolactin cells in the normal females were apparently larger in size and more numerous as compared with those of the normal males, comprising 47% of cell population in the anterior pituitary. In response to light deprivation, prolactin cells were atrophic with a diminished cytoplasm and decreased in cell number as reflected in the population ratio of 27% in the blinded and 21% in the darkness-treated groups. In pinealectomized females combined with binding or darkness-treatment, prolactin cells contained an abundance of secretory granules in the cytoplasm and maintained the population ratio comparable to that in the intact females. The present study revealed that light deprivation exerts an inhibitory effect on the secretory activity of prolactin cells and also causes hypoplasia of prolactin cells in the hamster adenohypophysis, the effects being mediated by the pineal gland.

Animals↗
PubMed1990

An immunoelectron microscopic study of corticotrophs in the golden hamster.

The ultrastructure of corticotrophs in the pituitary of golden hamsters was studied by immunocytochemistry. Corticotrophs were classified into three types according to the different size of the secretory granules. Type A and B cells were oval or polygonal in shape containing small (158 +/- 38 nm) and medium-sized (250 +/- 53 nm) secretory granules, respectively. Type C cells were usually pyramidal or irregular in shape, and contained large secretory granules (380 +/- 78 nm). The cytoplasmic organelles of type B and C cells were fairly well developed. In all types of corticotrophs, the secretory granules varied in electron density, and were either arranged in a single row along the cell membrane, or concentrated in the vascular pole of the cytoplasm. Many of the corticotrophs sent processes to encircle neighboring somatotrophs. In the female, the proportions of type A and B cells were higher than those in the male, whereas that of the type C cells was lower. All three types of corticotrophs were observed in the early postnatal stage. The population of type A cells decreased with the advancement of postnatal development, with a concomitant increase of that of the type C cells. Thus, type A cells might represent the immature type of corticotrophs which would evolve to become the type C cells. One to 2 weeks after adrenalectomy, the number of type C cells was drastically increased. This was accompanied by their prominent changes in ultrastructure as in the type B cells. The cytoplasm became hypertrophic with extensive dilated cisternae of rough endoplasmic reticulum.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenalectomy↗
PubMed1990

Equilibrium dialysis studies on aqueous taurocholate-lecithin solutions: further validation of the method.

Since the 1980 publication by Mazer, Benedek and Carey on the concept of the simple micelle-mixed micelle coexistence phenomenon in the bile salt-lecithin systems, it became apparent that a reliable method was needed for measuring the coexisting species concentrations. We recently published a method based on membrane dialysis equilibrium, and the purpose of this report is to review and to validate this previous work. In the present studies, two dialysis membranes with molecular weight cut-off of 8,000 and 12,000 to 14,000 Da, respectively, and two sets of solution volume conditions were investigated with the taurocholate-lecithin system. Coexistence data were obtained over a wide range of lecithin concentrations and the results were found to be in good agreement with those from the previous studies. The bile salt/lecithin molar ratios for the mixed micelles were also deduced from the data. The principal conclusion of this study is that although there is a moderate amount of variability (10% to 15%), the method is both satisfactory and useful in studying bile salt-lecithin equilibria and dynamics.

Bile Acids and Salts↗
PubMed1989

An acrylic head appliance for craniomaxillary fixation.

An acrylic head appliance for the treatment of LeFort fractures is described. The appliance remains stable and effective during the course of treatment. When immobilization is no longer needed, it may be removed without anesthetizing the patient.

Equipment Design↗
PubMed1988

In vitro effects of magnesium on ionized calcium concentration in serum.

Hypermagnesemic neonates, born to mothers receiving magnesium (Mg) sulfate before delivery, have elevated ionized calcium (iCa) concentrations in serum. We hypothesized that this elevation might be due in part to competition of Mg with calcium (Ca) bound to proteins or complexed to salts. Serum and its ultrafiltrate were obtained from five placental blood samples. The iCa concentration was measured in both serum and its ultrafiltrate at five incremental Mg concentrations (delta Mg) up to 6.58 mmol/L. In both serum and ultrafiltrate, incremental iCa (delta iCa) correlated significantly with delta Mg. By multiple regression analysis, delta ica in serum correlated positively with delta Mg in serum and negatively with albumin concentration in serum. Thus, iCa concentration in serum is increased in vitro by hypermagnesemia; it appears that Mg may compete with Ca bound to albumin and complexed to salts.

Blood↗