Search PubMed⌕ Search

Biomedical subjects

C T Liew

Publications and source records attributed to C T Liew.

At least 55 records · Page 3Linked to original sources
PubMed1995

Resection of hepatocellular carcinoma with diaphragmatic invasion.

Fourteen consecutive patients with hepatocellular carcinoma (HCC) and diaphragmatic invasion found during operation and confirmed histopathologically were studied. They were treated by resection of the liver tumour en bloc with part of the diaphragm. Eight of the 14 patients had a diaphragmatic hump on chest radiography. Preoperative ultrasonography, computed tomography and hepatic angiography were unable to diagnose diaphragmatic invasion in these patients. A control group of 14 closely matched patients were selected from 98 undergoing curative resection for HCC during the period of the study. No evidence of a diaphragmatic hump was found in the control patients (P < 0.001). There was no significant difference in survival, operative morbidity or mortality rates between the two groups. In patients with HCC situated in the dome of the liver, the presence of a diaphragmatic hump on chest radiography strongly suggests invasion of the diaphragm. There was no difference in outcome in patients with or without diaphragmatic invasion; the tumour should be resected if the patient is fit for operation.

Carcinoma, Hepatocellular↗
PubMed1995

Acute monoblastic leukaemia with conjunctival tumours.

We describe an unusual occurrence of bilateral conjunctival tumours in a 25-year-old woman. This was the first sign of relapse of acute monoblastic leukaemia. There was also both marrow relapse and subsequent skin infiltration. No central nervous system involvement was detected. The tumours appeared as pink raised lesions in the upper conjunctivae of both eyes. They were not associated with pain or visual impairment. Conjunctival tumour biopsy revealed a dense mononuclear cell infiltration. Complete remission (conjunctival tumours, skin infiltration and bone marrow) was attained following systemic chemotherapy in combination with intrathecal chemotherapy.

Adult↗
PubMed1995

Establishment and characterization of a human cell line from a squamous carcinoma of the tongue.

A human squamous carcinoma cell line, PWH-S1, has been established from the metastatic lymph node of a Chinese patient with a squamous cell carcinoma of the tongue. The fibroblast-free culture has been propagated in DMEM supplemented with 10% fetal bovine serum for more than 100 passages. PWH-S1 cells showed anchorage-independent growth in 0.3% agar solution. PWH-S1 cell line exhibited a monolayer growth and loss of contact inhibition. The in vitro doubling time of the PWH-S1 cell line was approximately 28 h. PWH-S1 was tumourigenic after inoculation into nude mice. Karyotype analysis showed the chromosome abnormality with a modal number of 69. Electron microscopy demonstrated poorly differentiated neoplastic cells with some features of squamous cell differentiation. No human papillomavirus (type 6, 11, 16, 18, 31) was detected in the PWH-S1 cell line by the polymerase chain reaction.

Adult↗
PubMed1995

The association of the amoebic colitis and chronic ulcerative colitis.

Three patients with idiopathic ulcerative colitis and infection of Entamoeba histolytica were reviewed. They represented three different relationships between the two conditions, vis asymptomatic carrier, coexisting infection and superinfection causing exacerbation of colitis. A two-way relationship between amoebic colitis and ulcerative colitis has been discussed and the possible mechanisms in the literature have been reviewed. In patients with a short history of diarrhoea and in tropical countries where amoebic infection is endemic, it is important to role out amoebic colitis before commencing steroid therapy for inflammatory disease.

Adrenal Cortex Hormones↗
PubMed1994

Anti-neutrophil cytoplasmic antibodies (ANCA) and inflammatory bowel diseases in Chinese.

Inflammatory bowel diseases are uncommon in the Chinese, but the incidence is rising. Their differentiation from infective colitis is often not clear-cut and diagnosing inflammatory bowel diseases can be difficult in Asia. We have studied Chinese patients with ulcerative colitis (N = 19) and Crohn's disease (N = 12) for anti-neutrophil cytoplasmic antibodies (ANCA) by indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assays (ELISA). Patients with enteric fever (N = 29) and irritable bowel syndrome (N = 24) were recruited as controls. Seventy-three percent of ulcerative colitis patients exhibited either p-ANCA (31%) or c-ANCA (42%) by IIF. Twenty-five percent of Crohn's disease patients were found to be p-ANCA positive. However, these ANCA were nonreactive to anti-alpha granule, antiproteinase 3, antimyeloperoxidase, or antilactoferrin. All positive patients had extensive colitis. Sera collected from patients suffering from enteric fever and irritable bowel syndrome were negative for ANCA by IIF and ELISA. We concluded that the detection of ANCA is helpful in diagnosing inflammatory bowel diseases. Further attempts to characterize these autoantibodies are needed.

Adult↗
PubMed1994

Crohn's disease in the Chinese population. An experience from Hong Kong.

PURPOSE: Crohn's disease was extremely rare among Chinese. We reviewed all cases diagnosed as having Crohn's disease during a five-year period. METHODS: A diagnosis of Crohn's disease was made only if all of the following criteria were fulfilled: 1) clinical symptom(s) and sign(s) compatible with chronic inflammatory bowel disease; 2) exclusion of intestinal infection by repeated stool cultures; 3) macroscopic features of small and/or large intestinal inflammation with skip lesion, stricture, and fistula formation; 4) histologic features of Crohn's disease, i.e., focal lymphoid aggregate, focal cryptitis, and granuloma formation; 5) clinical response to conventional therapy for inflammatory bowel disease. RESULTS: Fifteen ethnic Chinese patients were diagnosed as having Crohn's disease in this period. All patients had colitis, whereas small intestine inflammation was documented in only 47 percent of patients. Extraintestinal manifestations were uncommon except for arthropathy: ankylosing spondylitis (2), sacroiliitis (1), juvenile rheumatoid arthritis (1), and colitic arthritis (1). The majority of our patients responded to medical therapy. Surgery was undertaken in 33 percent of patients. CONCLUSION: Although there is a general increased incidence of Crohn's disease in the Western world, we too are beginning to see more cases in the Far East. Nevertheless, gastrointestinal infection with bacteria and/or parasites should still be carefully excluded in these countries.

Adolescent↗
PubMed1993

Ulcerative colitis and antineutrophil cytoplasmic antibodies in Hong Kong Chinese.

Inflammatory bowel diseases are known to be rare among the Chinese. The diagnosis of ulcerative colitis has been difficult in some of the Asian countries where infective colitis is more prevalent. Twenty-three Hong Kong Chinese patients diagnosed to have ulcerative colitis were reviewed. The symptoms were relatively mild and extraintestinal manifestation had been rare. Patients responded well to steroid therapy and sulfasalazine. Three patients in this series were found to have cyst and/or trophozoites of Entamoeba histolytica in stool. In this series, 19 patients were tested for antineutrophil cytoplasmic antibody (ANCA). Fourteen patients (73.5%) were positive, of which six (31.5%) showed a perinuclear staining pattern and eight (42%) demonstrated a cytoplasmic pattern. Five patients (26.5%) were negative for any ANCA, and none was positive for both. Sera of these patients were also tested for anti-alpha granules, anti-myeloperoxidase, and anti-lactoferrin activities. None was positive. Control sera collected from 16 patients with irritable bowel syndrome were all negative for the tests. In conclusion, testing of ANCAs may help in making the diagnosis of idiopathic inflammatory bowel disease in difficult situations.

Adult↗
PubMed1990

The clinicopathological spectrum of alcoholic liver disease--an autopsy survey of 441 cases.

An autopsy survey of 441 cases of alcoholic liver disease from the first year of each of the last three decades in the Los Angeles area of the United States was studied. This study includes 326 cases of cirrhosis, 57 cases of fatty liver, 27 cases of alcoholic hepatitis, and 31 cases of fibrosis associated with excessive alcoholic use. Criteria for the histologic classification and the clinical features of alcoholic liver disease are discussed. This survey shows a trend of slight increase in the frequency of alcoholic liver disease and a threefold increase in alcohol related deaths in women in the autopsied population in the early 1980s. Overall, almost half of the patients with alcohol related death showed hypertrophic livers in each subcategory of alcoholic live disease. The whole spectrum of alcoholic liver disease is observed in this series. All the cases with hepatocellular carcinoma are cirrhotic and these patients expired 10 years older than the alcoholic hepatitis group. This study indicates alcohol is probably not carcinogenic but alcohol is cirrhogenic with malignant potentials which could lead to the development of hepatocellular carcinoma in the cirrhoto-regenerative process.

Adult↗
PubMed1990

Alpha-1-antitrypsin in the renal tubular epithelium in patients with or without alpha-1-antitrypsin deficiency.

Alpha-1-antitrypsin (AAT) globules were incidentally demonstrated in the kidney tubules from the autopsy material in patients with PiMZ, PiZZ and PiMM phenotypes in our laboratory. This study was designed to study the pathological significance of this phenomenon. A total of nine cases were selected from the autopsy file, two patients with AAT PiZZ, four with PiMZ and three with PiMM were studied. Sections of liver and kidney were stained for AAT by indirect immunoperoxidase method. All of the PiMM patients showed positive reactions in most of the proximal and some of the distal tubular epithelium. Of the six cases with abnormal Pi, one failed to show any reaction, four showed weak positive staining in some of the proximal tubules and one with high serum AAT revealed relatively strong activity in most of the proximal tubules. These findings suggest that AAT is present in the renal tubular epithelium. Whether AAT globules are produced in the renal tubular cells or secondarily absorbed from the glomerular filtrate is unclear. The significance of stainable renal tubular AAT in normal subjects, in patients with abnormal protease inhibitor types and in patients with renal disorders, needs further clarification and study.

Aged↗
PubMed1990

A comparative histopathological study of hepatic venous outflow obstruction in veno-occlusive disease and Budd-Chiari's syndrome.

Forty-two cases of hepatic venous outflow obstruction with biopsied and autopsied specimens were studied. The morphological changes in the liver and the value of liver tissue in the diagnosis among the different subgroups of this conditions were evaluated. Seven cases in the group with veno-occlusive disease (VOD) showed prominent changes in the sublobular veins and terminal hepatic venules and were characterized by acute disruption of the vessel walls. Two cases showed thrombosis in which there were history of chemotherapy. In the group with Budd-Chiari's syndrome (BCS), in addition to the involvement of the large veins, thrombosis was observed in the small hepatic vein radicles in five out of six cases with myeloproliferative related disorders. Thrombosis was rarely present in cases associated with idiopathic and web lesions in BCS but frequent large vessel tumor thrombosis was noted in the group with malignant tumors. The hepatic parenchymal changes in the VOD group and the tumor related cases in BCS group were acute perivenular congestion, hemorrhage and coagulative necrosis, whereas the histological changes in other subgroups of BCS were perivenular scarring, dilatation of the sinusoids and rarely, reversed lobulation. Subtle differences were noted in the vascular system and the liver parenchyma between each subgroup. If good clinical information is available, it is possible to differentiate the various etiologies in hepatic venous outflow obstruction in the liver by morphology.

Adult↗
PubMed1989

Fatal hemorrhage from an arterio-portal-peritoneal fistula after percutaneous liver biopsy.

Exsanguinating hemorrhage complicated a percutaneous needle biopsy in a 64-yr-old woman with a probable collagen vascular disease. Angiography performed before Gelfoam embolization demonstrated a hepatic arterio-portal venous-peritoneal fistula, a lesion not previously described, to be a cause of the hemorrhage. Although surgery remains the treatment of choice, the role of selective hepatic arteriography and Gelfoam embolization in patients with serious hemorrhage who are poor surgical risks needs evaluation.

Arteriovenous Fistula↗
PubMed1986

Alpha-1-antitrypsin deficiency in adults.

A clinicopathological examination was carried out on eight adult patients with alpha-1-antitrypsin (ATT) deficiency. Phenotyping confirmed five patients with PiMZ, two patients with PiZ-, and one patient with PiZZ. Cirrhosis was found in six of the patients, four of whom had a history of excessive ethanol consumption. Hepatitis B surface antigen was positive in two patients with cirrhosis. Dysplastic change was present in four patients, although no neoplasia in the liver was found in all patients. All patients had periodic acid-Schiff positive and diastase resistant inclusions of hepatocytes, which were identified as ATT by indirect immunoperoxidase stain. The possibility of the combined effects of ATT inclusions and such harmful stimuli such as alcohol or viral hepatitis infection may render the hepatocytes more susceptible to damage, and may contribute to development of cirrhosis.

Adult↗
PubMed1986

Pathologic features of the liver in acquired immune deficiency syndrome (AIDS).

The livers of 26 adult males with acquired immune deficiency syndrome (AIDS) were reviewed. The occurrence of portal tracts with diminished lymphocytes, probably reflecting generalized exhaustion of the lymphoid system, was a characteristic morphologic change, and was found in all cases. Kupffer cell hyperplasia was also a frequent finding and probably reflected generalized infection(s). Punched-out clusters of foamy histiocytes filled with acid-fast bacilli, typical for infection with Mycobacterium avium intracellulare (MAC), were found in three patients. In addition, MAC was cultured from two livers without the foamy histiocytic changes. Chronic viral hepatitis (three cases) and deposition of polarizable materials (one case) in the liver might be related to unusual habits of patients with AIDS. In conclusion, livers from patients with AIDS disclosed several kinds of lesions reflecting underlying or associated conditions in AIDS, but these did not contribute to the cause of death in our patients.

Acquired Immunodeficiency Syndrome↗
PubMed1980

Nonimmunologic binding of horseradish peroxidase to hepatitis B surface antigen. A possible source of error in immunohistochemistry.

In the process of establishing the specificity of direct immunoperoxidase staining of liver tissue for hepatitis B surface antigen (HBsAg), an affinity of free horseradish peroxidase (HRP) for HBsAg in hepatocytes (ground-glass cells) was found. Of 95 patients, the horseradish peroxidase reaction was only positive in the livers of the 35 who were chronically HBsAg seropositive and not in the livers from 60 control patients with alcoholic cirrhosis who were HBsAg seronegative. Comparison studies using the orcein technic and immunoperoxidase methods confirmed the observation that both free horseradish peroxidase (not conjugated to an antibody) and HRP conjugated to an antibody unrelated to HBsAg had an affinity to the cytoplasm of hepatocytes containing HBsAg. The precise nature of this affinity is not known, but it is probably due to a reaction between an activated carbohydrate moiety of horseradish peroxidase and the free amino group of HBsAG.

Hepatitis B Surface Antigens↗