Biomedical subjects

Chun-Hsiung Huang

Publications and source records attributed to Chun-Hsiung Huang.

At least 19 recordsLinked to original sources

PubMed2004

Association between vitamin D receptor polymorphisms and prostate cancer risk in a Taiwanese population.

Recent molecular epidemiological studies have shown that the inherited polymorphisms of VDR gene may be linked to prostate cancer risk and its aggressive phenotypes. However, the findings remain inconclusive. In this study, we investigated the association of the BsmI, ApaI and TaqI polymorphisms of VDR gene with prostate cancer risk in a Taiwanese population. In total, 160 prostate cancer patients and 205 age-matched male controls were studied between December 2000 and February 2003. No significant associations were found between the ApaI and TaqI polymorphisms and the risk of prostate cancer. However, the control group was found to have a significantly higher frequency of the BsmI 'BB' and 'Bb' genotypes (15.6%) than prostate cancer patients (8.1%). After adjustment for age, patients with BsmI 'BB' or 'Bb' genotypes were associated with a twofold decreased risk (OR = 0.50; 95% CI = 0.25-0.98; P = 0.045) for developing prostate cancer than those with 'bb' genotypes. This effect was particularly significant among men below the median age of 72 years (P = 0.017). Moreover, stronger associations were found in the advanced stages (T3/T4/N1/M1) and poorly differentiated disease (Gleason score >/= 7) ('BB' and 'Bb' vs 'bb': OR = 0.25; 95% CI = 0.07-0.83; P = 0.024 and OR = 0.25; 95% CI = 0.07-0.85; P = 0.026, respectively). Our findings suggest that the VDR BsmI polymorphism may play a significant role in the development of prostate cancer.

Alleles↗

PubMed2004

Endoscopic carpal tunnel release using a new median nerve protector.

PURPOSE: We designed a reusable median nerve protector for endoscopic carpal tunnel release (ECTR) and prospectively evaluated its safety and efficacy. TYPE OF STUDY: Therapeutic study--Investigating the results of treatment. METHODS: Seventy-two patients (97 palms) with carpal tunnel syndrome were operated on endoscopically with the new median nerve protector. Patients were followed-up at 1, 3, 6, 12, and 24 weeks postoperatively. Evaluation included the symptom severity scale, functional status scale, wound pain and scar tenderness, monofilament sensory mapping, grip strength measurement, and pin strength gauge. RESULTS: No patients sustained iatrogenic neurovascular injury or hematoma, but 3 developed superficial wound infections postoperatively. The symptom severity score decreased from 3.8 points preoperatively to 2.3 at 1 week, 1.9 at 3 weeks, and 1.3 at 6 weeks, and remained at 1 point at 12 and 24 weeks postoperatively. The functional status score dropped from 3.8 points to 2.8 at 1 week, 2 at 3 weeks, 1.5 at 6 weeks, and 1 at 12 weeks and thereafter. Semmes Weinstein monofilament mapping improved in all operated hands (59) of the 44 patients not lost to follow-up by 24 weeks. Tip pinch testing and grip strength showed gradual improvement as early as 3 weeks postoperatively. The mean value of the postoperative scar tenderness score dropped from 2.4 points at 1 week to 1.7 points at 3 weeks, 1.3 at 6 weeks, 1.2 at 12 weeks, and 1 point after 12 weeks. CONCLUSIONS: This new median nerve protector provides clear visualization of neurovascular structures and is a safe and reliable tool for single-portal ECTR. LEVEL OF EVIDENCE: Level IV.

Adolescent↗

PubMed2004

Aberrant expression and possible involvement of the leptin receptor in bladder cancer.

OBJECTIVES: To explore the expression patterns and possible involvement of leptin and its receptor in the pathogenesis of urinary bladder cancer, with a focus on transitional cell carcinoma. METHODS: Using reverse transcription-polymerase chain reaction, immunoblotting, and immunohistochemistry techniques, we correlated the expression patterns of leptin and its receptor with the occurrence of transitional cell carcinoma. We also applied transient transfection followed by BrdU labeling and immunofluorescent staining to address the effect of the leptin receptor on bladder cancer cell growth. RESULTS: Although leptin was not detected in the bladder tissue specimens, a decreased expression of the leptin receptor was observed in most cancer tissue specimens we analyzed. Furthermore, the forced expression of the leptin receptor in T24 bladder cancer cells prevented them from entering the S phase. CONCLUSIONS: Our data demonstrated for the first time that the leptin receptor is aberrantly expressed in bladder cancer tissue and is possibly involved in the carcinogenesis of bladder cancer.

Aged↗

PubMed2004

Testicular sparing surgery for bilateral epidermoid cysts of the testes: a case report.

We report the case of a 12-year-old boy with bilateral epidermoid cysts of the testes diagnosed preoperatively from ultrasonography, magnetic resonance imaging, and negative tumor markers. The cysts were treated using bilateral testicular sparing surgery through a scrotal approach after intraoperative frozen section. We also discuss the diagnosis and management of epidermoid cyst of the testis and briefly review the literature.

Chorionic Gonadotropin↗

PubMed2004

Foreign body stone in the urinary bladder: a case report.

Bladder calculi rarely form spontaneously and are usually a manifestation of an underlying pathologic condition of the lower urinary tract, including voiding dysfunction, urinary infection, obstruction, or foreign body retention. However, a ruptured Foley balloon-induced bladder stone is an unusual complication of an indwelling Foley catheter. We report a case of spinal cord injury with paraplegia and bladder stone induced by a fragment of a ruptured Foley balloon. The bladder stone and the Foley balloon fragment were successfully removed by cystoscopy. The stone was composed of calcium oxalate and calcium phosphate. We report this unusual case to raise awareness that it is important to check the integrity of the Foley catheter after removal of the tube.

Adult↗

PubMed2004

Relationships between American Urological Association symptom index, prostate volume, and disease-specific quality of life question in patients with benign prostatic hyperplasia.

The American Urological Association (AUA) symptom index is both valid and reliable in identifying the need to treat patients with benign prostatic hyperplasia (BPH) and in monitoring their response to therapy. We evaluated the relationships between AUA symptom index, disease-specific quality of life question, and prostate volume in patients with BPH. A total of 100 patients who came to Kaohsiung Medical University Hospital, Taiwan, for help due to lower urinary tract symptoms (LUTS) and who were diagnosed with BPH between October 2002 and June 2003 were included in the study. All patients were evaluated using transrectal ultrasonography, AUA symptom index, and disease-specific quality of life question. The disease-specific quality of life question showed good correlation with AUA symptom score (r = 0.815, p < 0.01), but weak correlation with prostate volume (r = 0.225, p < 0.05) and age (r = 0.274, p < 0.05). Prostate volume had weak correlation with AUA symptom score (r = 0.251, p < 0.05) and age (r = 0.472, p < 0.01), but good correlation with prostate specific antigen (r = 0.638, p < 0.01). In addition to AUA symptom index, we suggest using the disease-specific quality of life question to evaluate the influence on quality of life and response to treatment in clinical practice. Moreover, we should assess the impact of BPH symptoms rather than the increase in prostate volume during the management of BPH.

Adult↗

PubMed2004

Atypical slipped capital femoral epiphysis after radiotherapy and chemotherapy.

Atypical slipped capital femoral epiphysis after radiotherapy and chemotherapy is uncommon. Only 32 cases have been reported in the literature. Because patients may have slippage at atypical ages, we report two cases of slipped capital femoral epiphysis in children and review the 32 cases previously reported to heighten clinicians' awareness of this condition in patients who have received radiation and chemotherapy for pelvic tumors. The controversy over prophylactic pinning of the uninvolved hip in radiotherapy-associated slipped capital femoral epiphysis is unresolved. It may be justifiable to fix the nonslipped epiphysis if possible prodromal signs of abnormal radiographic findings are detected. Because radiotherapy and chemotherapy were used in the two children reported, it is not possible to state whether one or both forms of treatment were responsible for the atypical slipped capital femoral epiphysis.

Antineoplastic Agents↗

PubMed2003

Association of HLA class I with severe acute respiratory syndrome coronavirus infection.

BACKGROUND: The human leukocyte antigen (HLA) system is widely used as a strategy in the search for the etiology of infectious diseases and autoimmune disorders. During the Taiwan epidemic of severe acute respiratory syndrome (SARS), many health care workers were infected. In an effort to establish a screening program for high risk personal, the distribution of HLA class I and II alleles in case and control groups was examined for the presence of an association to a genetic susceptibly or resistance to SARS coronavirus infection. METHODS: HLA-class I and II allele typing by PCR-SSOP was performed on 37 cases of probable SARS, 28 fever patients excluded later as probable SARS, and 101 non-infected health care workers who were exposed or possibly exposed to SARS coronavirus. An additional control set of 190 normal healthy unrelated Taiwanese was also used in the analysis. RESULTS: Woolf and Haldane Odds ratio (OR) and corrected P-value (Pc) obtained from two tails Fisher exact test were used to show susceptibility of HLA class I or class II alleles with coronavirus infection. At first, when analyzing infected SARS patients and high risk health care workers groups, HLA-B*4601 (OR = 2.08, P = 0.04, Pc = n.s.) and HLA-B*5401 (OR = 5.44, P = 0.02, Pc = n.s.) appeared as the most probable elements that may be favoring SARS coronavirus infection. After selecting only a "severe cases" patient group from the infected "probable SARS" patient group and comparing them with the high risk health care workers group, the severity of SARS was shown to be significantly associated with HLA-B*4601 (P = 0.0008 or Pc = 0.0279). CONCLUSIONS: Densely populated regions with genetically related southern Asian populations appear to be more affected by the spreading of SARS infection. Up until recently, no probable SARS patients were reported among Taiwan indigenous peoples who are genetically distinct from the Taiwanese general population, have no HLA-B* 4601 and have high frequency of HLA-B* 1301. While increase of HLA-B* 4601 allele frequency was observed in the "Probable SARS infected" patient group, a further significant increase of the allele was seen in the "Severe cases" patient group. These results appeared to indicate association of HLA-B* 4601 with the severity of SARS infection in Asian populations. Independent studies are needed to test these results.

Adult↗

PubMed2003

Relationship between air pollution and daily mortality in a tropical city: Kaohsiung, Taiwan.

Air pollution has been associated with daily mortality in numerous studies over the past decade. However, most of these studies were conducted in the United States and Europe, with relatively few done in Asia. In this study, the association between ambient air pollution and daily mortality in Kaohsiung, Taiwan, a large industrial city with a tropical climate, was investigated for the period 1994-2000 using a case-crossover analysis. This design is an alternative to Poisson time-series regression for studying the short-term adverse health effects of air pollution. The air pollutants examined included particulate matter (PM10), sulfur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2), and carbon monoxide (CO). No significant effects were found between PM10 and SO2 exposure levels and respiratory-related mortality. The well-established link between air pollution levels and daily mortality may not be as strong in cities in tropical areas, although other factors such as differences in pollutant mixtures or underlying health of the population may explain the lack of a strong association in this study. Further studies of this type in cities with varying climates and cultures are needed.

Air Pollution↗

PubMed2003

Penile verrucous carcinoma successfully treated by intra-aortic infusion with methotrexate.

OBJECTIVES: Penile verrucous carcinoma is characterized by aggressive local growth and a low metastatic potential. Lower abdominal aortic infusion chemotherapy has the main advantage of delivering a very high concentration of an anticancer drug to the whole pelvic area, including the penis, and is especially suitable to treat penile verrucous carcinoma. METHODS: From 1991 to 2000, 4 cases of penile verrucous carcinoma were treated by continuous intra-aortic infusion with methotrexate (50 mg) every 24 hours, for an average of 10 days. Citrovorum factor (6 mg) was given intramuscularly every 6 hours during the period of methotrexate infusion. RESULTS: After treatment, 3 patients achieved complete remission. They were living disease free 10 years, 10 months, 6 years, 9 months, and 1 year, 8 months after therapy. CONCLUSIONS: Intra-aortic infusion chemotherapy is a simple and effective method for penile verrucous carcinoma with the unique advantage of preserving cosmetic and functional integrity. It may be considered an effective alternative treatment for penile verrucous carcinoma. By using this simple method many unnecessary penectomies can be avoided.

Adult↗

PubMed2003

The influence of surgical malalignment on the contact pressures of fixed and mobile bearing knee prostheses--a biomechanical study.

OBJECTIVE: To investigate the effect of surgical malalignment on contact pressures of fixed and mobile bearing knee prostheses. DESIGN: An experimental set-up was used to measure contact pressure on the tibial component of fixed and mobile bearing knee prostheses subjected to a compression load and surgical malalignment situations were simulated. BACKGROUND: Mobile bearing knee prostheses were designed to decrease tibiofemoral contact pressure by providing both high congruity and mobility. It was also assumed to accommodate surgical malalignment. However, few studies have reported the effect of malalignment of the tibiofemoral joint on contact pressure of fixed and mobile bearing knee prostheses. METHODS: Surgical malalignment situations were simulated to evaluate contact characteristics of tibial component of fixed and mobile bearing knee prostheses. The simulated malalignment conditions include the medial-lateral translation (0.5 and 1 mm), anterior-posterior translation (2 and 4 mm) and internal-external rotation (1 degrees, 3 degrees, 5 degrees and 10 degrees ) of the femoral component relative to the tibial component. Fuji pressure sensitive film was used to measure the contact pressure. RESULTS: The greatest increase of maximum contact pressure in the anterior-posterior maltranslation was 7.63% and 7.62% relative to the neutral contact situation in the fixed and mobile bearing designs respectively. In the medial-lateral maltranslation, there was 23.3% in the fixed bearing design and was 22.0% in the mobile bearing design. In the internal/external malrotation, the greatest increase of maximum contact pressure in the fixed bearing design was 27.1%, which was much higher than the mobile bearing design (22.4%). CONCLUSIONS: The mobile bearing design can reduce maximum contact pressure more significantly than the fixed bearing design when malalignment conditions of the tibiofemoral joint occurs, especially in the internal/external malrotation. The mobile bearing design offers the advantage of self-adjusting over the fixed bearing design to accommodate surgical malalignment. RELEVANCE: This study revealed that the mobile bearing design has smaller maximum contact pressures than the fixed bearing design in knee prosthesis under malalignment biomechanical tests. This result indicates that there is an advantage for a mobile bearing design over a fixed bearing design to accommodate malalignment conditions caused by surgical technique or soft tissues imbalance in total knee arthroplasty.

Arthroplasty, Replacement, Knee↗

PubMed2003

Scrotal abscess originating from appendicitis: a case report.

There are numerous reports concerning the presentation of appendicitis as a urologic problem. However, scrotal abscess originating from appendicitis has rarely been described. We report a right scrotal abscess due to a preceding retroperitoneal abscess originating from retrocecal appendicitis. The scrotal abscess developed progressively following appendectomy. Scrotal exploration was carried out under the presumptive diagnosis of abscessed epididymo-orchitis. However, the patient remained febrile and had productive pus drained from the scrotum after exploration. Abdominal computerized tomography demonstrated that a large retroperitoneal abscess had accumulated at the appendectomy site. Percutaneous drainage of the retroperitoneal abscess resulted in resolution of the scrotal abscess. In cases of scrotal abscess following previous abdominal events (e.g. appendectomy), we recommend that abdominal origins should be carefully surveyed before scrotal exploration.

Abscess↗

PubMed2003

Transitional cell carcinoma of the renal pelvis with extension into the inferior vena cava: a report of two cases.

Of all primary malignant renal tumors, 10% to 15% originate from the renal pelvis, and 90% to 92% of these tumors are transitional cell carcinomas. Nonetheless, renal pelvis transitional cell carcinoma extending into the inferior vena cava is very rare. We report one confirmed case and one highly suspicious case of renal pelvis transitional cell carcinoma with a tumor thrombus in the inferior vena cava. Both of our patients died within 6 months of initial diagnosis, indicating the poor prognosis and advanced stage of transitional cell carcinoma with an inferior vena cava thrombus. Transitional cell carcinoma should be considered in patients with obstruction of the renal vein and the inferior vena cava.

Aged↗

PubMed2003

Bladder stone in a woman after cesarean section: a case report.

Urinary bladder calculi are rarely seen in women and any history of previous pelvic surgery must, therefore, raise suspicion of an iatrogenic etiology. According to the literature, fewer than 2% of all bladder calculi occur in female subjects and, thus, their presence should provoke careful assessment of the etiology. There have been a number of reports on bladder calculi in women with a history of gynecologic procedures. We report a case of bladder calculus after cesarean section that was treated successfully by open surgery.

Adult↗

PubMed2003

Current indications for transurethral resection of the prostate and associated complications.

Transurethral resection of the prostate (TURP) is the most common surgical procedure for relieving symptoms of benign prostatic hyperplasia. Here, we report our experience of current indications for TURP and their associated outcomes at Kaohsiung Medical University Hospital (KMUH). A total of 111 patients who underwent TURP at KMUH between May 2000 and December 2001 were included in this retrospective review. For each patient, the surgical indication was categorized into acute urinary retention, chronic complications (including renal impairment, recurrent urinary infection, bladder stone/diverticulum, post-void residue, and recurrent hematuria), and symptomatic prostatism. Thirty-five patients (31%) had acute urinary retention, 28 (27%) had chronic complications, and 48 (42%) had symptomatic prostatism. Most patients chose TURP only when medical treatment had failed to relieve symptoms, no matter what category they belonged to. Patients with acute urinary retention and chronic complications had larger prostates (p = 0.002) and more tissue resected (p = 0.05) than those with symptomatic prostatism. Patients with acute urinary retention seemed to be at greater risk of postoperative complications such as recurrent urinary retention and urinary tract infection. We suggest that urodynamic study may be necessary to rule out concomitant bladder dysfunction before surgery and that adequate prophylactic antibiotic treatment be used to decrease the risk of urinary tract infection during or after TURP, especially when pyuria is noted preoperatively in patients with acute urinary retention.

Aged↗

PubMed2003

Bilateral superselective arterial microcoil embolization in post-traumatic high-flow priapism: a case report.

Priapism is a prolonged penile erection unrelated to sexual stimulation. High-flow arteriogenic priapism is uncommon and usually occurs after genitoperineal trauma, which may damage a feeding cavernosal artery, leading to an arteriovenous fistula and, occasionally, to an associated pseudoaneurysm. The defects rarely occur bilaterally. Herein, we report successful treatment of high-flow priapism secondary to a traumatic pseudoaneurysm fed from the bilateral cavernosal artery. Diagnosis was made after cavernosal blood gas analysis, color Doppler ultrasonography, and superselective angiography. Treatment consisted of superselective arterial embolization using metallic microcoils and resulted in simultaneous detumescence of the penis with no complications. The patient regained morning erection on the second postoperative day and erectile function remained normal 8 months after treatment. This case shows that bilateral arteriocavernosal fistulae can be successfully treated with superselective arterial embolization without affecting potency and highlights the importance of warning men about the possibility of developing high-flow priapism following a perineal trauma.

Adult↗

PubMed2003

Double J stent forgotten for 7 years: a case report.

Ureteral stents are an integral part of urologic practices. Nonetheless, stents that migrate, fragment, or are forgotten pose management and legal dilemmas. We report the case of a "forgotten" stent, which migrated upward into the right renal pelvis, concomitant with a ureteral stone. The "forgotten" stent was placed 7 years previously during right ureteral stone treatment. The patient finally underwent nephroscopic stent retrieval and ureteroscopic ureteral stone removal. The final plain X-ray demonstrated no stone fragment or residual double J stent fragment. The patient withstood the procedure well and was free of symptoms thereafter.

Humans↗

PubMed2003

Management of low-flow priapism using the Winter procedure: a case report.

Priapism is a prolonged penile erection that is unrelated to sexual stimulation. Low-flow priapism has been associated with sickle cell disease and other hemoglobinopathies, neoplastic syndrome, anticoagulant therapy, psychotropic medication, and idiopathic causes. We report the successful treatment of idiopathic low-flow priapism using the Winter procedure. Initial treatment consisted of aspiration and intracavernous irrigation with iced saline and a vasoconstrictive agent, but in vain. We then performed the Winter procedure, in which fistulas between the corpora cavernosa and the glans penis were created. This resulted in the simultaneous detumescence of the penis, without complication. The erectile function of the penis was normal 1 year after the procedure. This case shows that idiopathic low-flow priapism can be successfully treated using the Winter procedure when conservative treatment fails.

Humans↗