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Biomedical subjects

E S Ho

Publications and source records attributed to E S Ho.

At least 55 records · Page 3Linked to original sources
PubMed1994

Termination of pathological pregnancy in second and early third trimesters with extraamniotic instillation of 16-phenoxy-omega-tetranor prostaglandin E2 methylsulfonylamide.

OBJECTIVES: To evaluate the efficacy, safety and influence on subsequent fertility of sulprostone, a prostaglandin E2 analog, in terminating pathological pregnancies via the extraamniotic route. METHODS: Forty pregnant women with intrauterine fetal death or major congenital anomalies were enrolled. Sulprostone was instilled into the extraamniotic space through a silicon Foley catheter. The instillation rate was 0.5-1 microgram/min. Instillation was discontinued when the catheter was expelled or when rupture of the membranes occurred. The duration of instillation and the time interval to completion of abortion was recorded. Information about subsequent fertility was collected by telephone or at outpatient clinic visits. RESULTS: The mean duration of instillation was 7.0 h and the mean dose of sulprostone was 314.8 micrograms. The mean induction-to-abortion interval (IAI) was 17.0 h. In two of the 40 patients, the cervix was not adequately ripened after 48 h and these pregnancies were ultimately terminated by alternative methods. The success rate of termination in 48 h was 92.5% (37/40). No severe side effects were encountered. CONCLUSION: To the best of our knowledge, this is the first report in the English literature of administration of sulprostone by extraamniotic instillation for termination of pathological pregnancies. The method is effective and safe and has an insignificant influence on subsequent fertility.

Abortifacient Agents, Nonsteroidal↗
PubMed1994

Concomitant chemoradiotherapy for advanced epidermoid carcinoma of the uterine cervix: a preliminary report.

BACKGROUND: Because the prognosis of advanced carcinoma of the uterine cervix is poor, and has improved very little in the last 20 years, a prospective study was initiated to evaluate the feasibility, response and toxicities of concomitant chemoradiotherapy for such cervical cancer. METHODS: From May 1992 to December 1992, 22 patients entered the study, 21 of them completed the entire treatment. Their ages ranged from 47 to 72 years, median 57. There were 16 FIGO stage IIIB, and 5 stage IIB. Radiotherapy was administered using 1.8 Gy/day, five days a week, to the whole pelvis (50.4 Gy/28 fractions) with or without parametrial boost according to the tumor response. Intracavitary brachytherapy 5 Gy x five to six times was given after one or two weeks of rest. Chemotherapy consisted of etoposide 100 mg/m2 day 1 + cisplatin 50 mg/m2 day 1 + bleomycin 25 mg/m2/day day 2-3, repeated every two weeks during external irradiation. RESULTS: All 21 eligible patients achieved complete response, sustaining during a median follow-up time of 12 months. All the initially elevated tumor markers (SCC, CEA, CA-125) returned to normal range after treatment. The toxicity was well tolerated. CONCLUSIONS: Concomitant chemoradiotherapy for advanced cervical carcinoma is both feasible and effective, with acceptable toxicities. Long-term follow-up is mandatory, and a randomized trial to confirm the superiority of this protocol will be started soon.

Adult↗
PubMed1994

Continuous epidural morphine and lidocaine for postoperative pain control in obstetric and gynecologic operation.

BACKGROUND: Postoperative wound pain is a remarkable distress and may precipitate major complication. We attempted to develop a reliable and effective technique for postoperative analgesia that is safe and simple enough to be provided in an ordinary ward of a rural hospital. MATERIALS AND METHODS: A retrospective study of continuous epidural infusion of morphine 7.5 mg in 60 mL diluted lidocaine for postoperative pain control in 156 patients in the past year was undertaken. Among the patients, one hundred and twelve patients had undergone. Cesarean Section, and 44 patients had uterine or adnexal operations. All patients received epidural anesthesia. RESULTS: Effective analgesia was achieved in all cases throughout the postoperative period. Pain relief was long lasting and there were only 5 patients (3.2%) who required some additional narcotics. The mean interval between completion of the operation and passage of flatus was 33.2 h. Only 48 patients (30.8%) complained of skin itching, 39 patients (25.0%) reported nausea and vomiting and 62 cases (39.7%) experienced constipation. Urinary retention after Foley catheter removal was noted in 9 cases (5.8%). No major complication pertaining to the technique was encountered. CONCLUSIONS: We concluded that continuous epidural infusion of morphine and diluted lidocaine is an effective, simple and safe technique for postoperative pain control in obstetric and gynecologic operation and it can be administered routinely even in a rural hospital.

Adolescent↗
PubMed1994

Analysis of oncogenic progression in a radiation leukemia virus model.

The mechanism by which non-oncogene-bearing, slowly transforming retroviruses induce leukemia is not well understood, but appears to represent a multi-step process. Cell lines have been isolated following in vitro infection of lymphoid cells with radiation leukemia virus (RadLV) and they have been used to develop a two-step model for leukemia development. Thymic tumors were induced when one of the cell lines, C1-V13D, was inoculated into CBA/H mouse thymus. Upon reisolation of C1-V13D cells after one, two and three passages through thymus, individual cloned cell lines displayed increased tumorigenic potential compared with the non-tumorigenic parental line. Southern analysis has been used to track any genetic changes occurring while cells undergo further transformation and become increasingly tumorigenic. Specifically, retrovirus integration has been monitored in clones derived from C1-V13D at the primary, secondary and tertiary passage through thymus using probes specific for long terminal repeat (LTR), gag, pol and env genes of RadLV. The data indicate multiple ecotropic retrovirus integration sites in C1-V13D cells. Primary thymic tumors also showed the integration of a new recombinant or defective virus. There was no evidence that new ecotropic retrovirus integration had occurred during subsequent passage of primary tumors through the thymus, i.e. during the progression to oncogenesis. All data indicate an important role for the thymic environment in the development of a fully transformed cell.

Animals↗
PubMed1993

Doppler echocardiographic diagnosis of intrauterine closure of the ductus arteriosus.

A case of in utero closure of the ductus arteriosus was detected by Doppler echocardiography at 31 weeks of gestation. It presented as a non-hydropic distressed fetus with ultrasound detection of tricuspid regurgitation. Pulsed Doppler ultrasound showed markedly decreased blood flow through the tricuspid and pulmonary valves and absent blood flow at the ductus arteriosus. These, as well as the resultant increased right-to-left shunting across the foramen ovale, were reaffirmed by colour flow mapping.

Adult↗
PubMed1993

T-cell differentiative capacity of haematopoietic stem cells immortalized in vitro with radiation leukemia virus.

The differentiative capacity of a unique haematopoietic cell type has been investigated. These cells have been found to be a common target in vitro to infection and immortalization by radiation leukemia viruses (RadLVs). Many continuous lines of these cells have been generated. Since RadLV retroviruses are known to be strictly T-cell-tropic in vivo, we have questioned whether these cells are precursors of T cells. To this end, the RadLV-induced C1-V13D cell line has been inoculated into thymus of sublethally irradiated syngeneic CBA/H mice and tested for capacity to proliferate and differentiate, i.e. express T-cell markers. When inoculated in high number, C1-V13D cells can induce a thymic tumour within 14 to 21 days. Expression of T-cell markers on these cells was determined by fluorescence-activated cell sorting (FACS) analysis, after gating out C1-V13D cells on the basis of their high 90 degree scatter and their high forward scatter. They can also be distinguished by their unique expression of RadLVgp70 envelope (env) protein, B220, CD44, and aberrant expression of a class I epitope. Explanted primary thymomas from many animals showed no evidence of T-cell marker expression on C1-V13D cells upon reisolation. However, when C1-V13D was further passaged intrathymically, there was clear expression of Thy-1, CD4, CD8, and TCR-alpha beta on C1-V13D cells reisolated from these tumours. Two-colour FACS analysis and fluorescent antibody staining have confirmed the acquisition of T-cell surface markers by C1-V13D cells growing in this environment. Northern analysis confirmed endogenous expression of T-cell receptor beta chain genes in C1-V13D cells isolated after the third passage. All data indicate that RadLV preferentially infects a unique haematopoietic precursor cell in spleen which can differentiate along the T lineage once located within the thymic environment. The cell lines described here represent valuable models for studying T-cell differentiation from lymphoid stem cells, and for dissecting the early events in leukemogenesis.

Animals↗
PubMed1993

Low back pain of women during pregnancy in the mountainous district of central Taiwan.

Two hundred women with apparently normal pregnancies were interviewed in the obstetric wards within 24 to 48 hours after delivery. Of the parturients, 54.5% had been bothered by low back pain in some degree during pregnancy; nine of them were unable to continue their daily work because of severe pain. The pain had reportedly begun mostly during the sixth to eighth month of pregnancy, and was related to strenuous work, previous symptoms of backache during menstruation or a history of low back pain attacks before pregnancy. About half reported pain radiating to the buttocks and lower extremities, where the severity may be affected by posture. Almost 95% of the patients ignored the symptom and considered it as a part of pregnancy. The pain ceased spontaneously in 62.4% of the cases within the first 48 hours postpartum.

Adult↗
PubMed1993

Prognostic significance of human papillomavirus detected with polymerase chain reaction in cervical cancer.

In order to investigate the prognostic factors of cervical cancer and its association with human papillomavirus (HPV), we analyzed 50 specimens of cervical cancer with a DNA polymerase chain reaction (PCR) mainly to detect HPV types 16 (HPV 16) and 18 (HPV 18). The result showed that at least 74% (37/50) of the specimens had HPV DNA. Among them, 54% (20/37) of the cases were HPV 16 and 32% (12/37) were HPV 18. These HPV DNA positive patients had poorer differentiation in histology than the HPV DNA negative patients. We draw no conclusion about the prognostic significance of HPV DNA in cervical cancer. Perhaps more cases should be analyzed.

Adult↗
PubMed1993

Triplet pregnancy in premature ovarian failure after oocyte donation and in vitro fertilization: a case report and review of literature.

Oocyte donation in premature ovarian failure patients has become an extended indication for In Vitro Fertilization (IVF) procedure. Here the first case report is presented in Taiwan, R.O.C. of a triplet pregnancy in a patient with premature ovarian failure. After an adequate hormonal replacement therapy with oral premarin and intramuscular progesterone for endometrium preparation, the transfer on D15 of four embryos (with donated oocytes and IVF) resulted in implantation of three. Pregnancy support was provided also by oral premarin and intramuscular progesterone until the tenth week of gestational age (GA). The patient received Caesarean section at 35 weeks GA with delivery of three healthy babies weighing 2530 gm, 2420 gm, and 1810 gm respectively on Aug. 17, 1990.

Adult↗
PubMed1992

Prenatal diagnosis of placenta previa/accreta with color Doppler ultrasound.

A case of placenta previa/accreta was diagnosed at 23 weeks' gestation using color Doppler ultrasound. Imaging showed an unusually intense blood flow within the placental sonolucent spaces and the hypervascularization patterns within the placental and the non-placental tissues. Highly pulsatile venous flow patterns were detected within the placental blood lakes and the subplacental venous complex. A strong association between the lacunar flow pattern and the abnormally adherent placentation was confirmed by the color Doppler sonographic findings.

Journal Article↗
PubMed1992

Early prenatal diagnosis of type III bilateral congenital cystic adenomatoid malformation of the lung.

We present a case of type III fetal cystic adenomatoid malformation with bilateral total involvement of the lungs. The characteristic sonographic findings are echogenic homogeneous lung mass, fetal ascites and placentomegaly. The early diagnosis at 16 weeks' gestation allows the elective termination of pregnancy because of the likely fatal prognosis. To our knowledge, this is the earliest reported case of congenital cystic adenomatoid malformation of the lung that has been detected prenatally.

Journal Article↗
PubMed1992

The sedative effect of intravenous injection of low dose midazolam during spinal anesthesia in cesarean section.

In a randomized blind study, we compared the neonate Apgar score, umbilical venous pH, incidence of maternal hypotension and intra-operative maternal discomfort in elective Cesarean section performed under spinal anesthesia in two groups of parturients with or without low dose midazolam as a sedative agent before the deliveries. Each group consisted of 20 parturients. Ninety percent of the mothers in the midazolam group fell asleep smoothly before the operations started. The neonates in the midazolam group were scored similar to saline control group on Apgar score and umbilical venous pH. The incidences of maternal hypotension during operation in both groups were 55%. However, the occurrence of intra-operative maternal discomfort was eleven fold more often in the saline control group. On the other hand, there existed a significant inverse correlation between uterine incision-delivery interval and Apgar score as well as umbilical venous pH. We concluded that low dose midazolam is a good sedative agent during spinal anesthesia in elective Cesarean section. It is also safe and effective even given before delivery.

Adolescent↗
PubMed1992

[Clinical experience of GDM screening program].

From Jan. 1985 to Jun. 1990, 2561 pregnant women attending our prenatal clinic were screened for gestational diabetes. A 50-gm, 1-hour glucose challenge test was given and 470 patients (18.4%) showed plasma glucose values greater than or equal to 140 mg/dl. These women were subjected to a further 3-hr 100-gm OGTT to diagnose diabetes using O'Sullivans' criteria. Of these 470 cases, 80 (3.1%) of total cases were shown to be diabetic. Strict glycemic control with a fasting plasma sugar under 105 mg/dl and postprandial sugar under 120 mg/dl was conducted using diet and insulin in all cases. We compared the perinatal outcome of GDM pregnant women with normal pregnant women. Statistically, there was no significant difference. This study clearly demonstrates that a GDM screening program should be recommended for every pregnant woman. Prompt glycemic control should be given for all diabetic mothers to optimize the perinatal outcome.

Adult↗
PubMed1992

Solitary metastasis of renal cell carcinoma to the ovaries: a case report.

Though renal cell carcinoma may metastasize to unusual sites via hematogenous spread, ovarian metastasis is very uncommon. This is explained by atrophy of the ovaries with decreased blood perfusion in most postmenopausal patients who are at the age of peak incidence of renal cell carcinoma. We report a 28-year-old woman with metastatic renal cell carcinoma to the ovaries. Special attention to the differential diagnosis and the management should be taken.

Adult↗
PubMed1992

Operative laparoscopy in benign cystic teratoma of ovary.

Eighteen women of reproductive age underwent laparoscopic management of unilateral ovarian benign cystic teratoma from 3 to 7 cm in diameter. Nine patients received pelviscopic enucleation of ovarian cysts and nine patients received unilateral oophorectomy or salpingo-oophorectomy. No major surgical complication was encountered and the hospital stay was short. Our series suggest that operative laparoscopy is a safe and effective method in the management of benign cystic teratoma.

Adult↗
PubMed1992

Incidence of hypotension induced by spinal anesthesia with xylocaine for cesarean section and postpartum tubal ligation.

The incidence of hypotension induced by spinal anesthesia in 154 ASA class I or II patients having Cesarean section and postpartum bilateral tubal ligation was studied. Xylocaine (2%) 60-65 mg was used for spinal anesthesia. There was 41.0% of patients in Cesarean section group developed hypotension induced by spinal anesthesia, and 13.5% in tubal ligation group. We found no correlation between the time after delivery and the occurrence of hypotension induced by spinal anesthesia. In addition, 20.3% of the patients in tubal ligation group required intravenous narcotics because of inadequate sensory blockade during skin incision, but only 9.0% in Cesarean section needed the same supplement which was due to visceral pain during intra-abdominal manipulation. We conclude that spinal anesthesia with 2% xylocaine is safe and effective in both Cesarean section and postpartum tubal ligation although a significant difference of spinal hypotension existed.

Adult↗
PubMed1992

Evaluation of anesthesia for obstetric and gynecologic intra-abdominal pelvic surgery in a rural hospital.

From March 1, 1990 to August 31, 1991, there were four hundred and forty eight female patients undergoing major lower abdominal obstetric and gynecologic operations in our hospital. The most frequently performed operation in our series was Cesarean section (80.8%). Besides, there were operations for ectopic pregnancy, ovarian cyst, fallopian tube problems and abdominal total hysterectomy as well as radical hysterectomy for cervical cancer. Most of the operations were done under spinal anesthesia (91.3%). The rest were performed under epidural anesthesia (2.2%), general anesthesia (4.9%) or a combined anesthetic technique (1.3%). On one occasion, a Cesarean section was done during cardio-pulmonary resuscitation in the emergency room. Another parturient developed cardiac arrest during spinal anesthesia for Cesarean section with successful resuscitation. Otherwise, only minor complications such as post dural puncture headache (6.4%), nausea and vomiting (13.51%) and hypotension (38.2%) were found. All complications responded to conservative therapy that no prolonged hospitalization or unacceptable Apgar score in the newborns was noted. In addition, intra-operative blood transfusion was a rare occurrence. Thus, spinal anesthesia is a safe, effective, simple and inexpensive anesthetic method for major obstetric and gynecologic operations particularly in a rural hospital.

Adolescent↗