Biomedical subjects

H C Hsu

Publications and source records attributed to H C Hsu.

At least 235 records · Page 13Linked to original sources

PubMed1990

Hemoglobin H disease complicated iron overload and HLA expression in Chinese.

HLA-A,B antigens were typed in 15 patients with Hemoglobin H disease; 10 of them had iron overloading. No significant HLA antigen specificity was identified to be at risk as compared with 170 controls. However, HLA-A11 was suggested to have significant negative risk, and may have a protective effect. (RR = 0.1, p = 0.0015). It seems that increased iron absorption in Hemoglobin H disease is not genetically associated with idiopathic hemochromatosis and certain HLA antigen expressions.

Adult↗

PubMed1990

Hemoglobin H disease--ten years' experience.

Eighty-eight patients with Hemoglobin (Hb) H diagnosed in our hospital in the past decade were reviewed. Among them, 37 were males and 51 were females, and their age ranged from 10 to 77 years. In physical examination, 43.3% of them showed to have jaundice, 47% had splenomegaly, 14% had hepatomegaly and 19.3% had gall stone. Hb electrophoresis revealed the presence of Hb H (1.4-40%), Hb F (23/88, range: 0.5-7.5%) and decreased Hb A2 (mean = 1.23 +/- 1.2%). The study of iron status showed increased serum ferritin concentration (mean = 421.4 +/- 343.7 ug/dl) and transferrin saturation ratio (53.9% +/- 20.5%). Hemosiderosis was found in three out of four patients received liver biopsy. Although most patients did not receive blood transfusion frequently, iron overload was not uncommon in the patients with Hb H disease. Further study would be needed to explore the true relationship between iron overload and Hb H disease.

Adolescent↗

PubMed1990

Intratumor injection of OK-432 for the treatment of small hepatocellular carcinoma.

Intratumor injection of OK-432, a biological response modifier, in the treatment of small HCC was studied in 7 inoperable patients. After evaluation with ultrasound (US), computed tomography (CT), angiography and US-guided biopsy, implantation of a steel coil in the tumor, intratumor injection was performed under US guidance. After completion of the treatment, liver biopsy and image studies were again done to evaluate the extent of tumor necrosis. One patient was alive and well without recurrence 19 months after treatment. Four had recurrent tumors at different site of the liver 4 months, 9 months, 9 months and 8 months later. Two died of progressive malignancy 3 months and 8 months later. In the 6 patients with elevated serum alpha-fetoprotein (AFP) levels, 4 had decreased AFP after treatment, and the 2 mortalities had steadily increased AFP. The most common side effects are fever and chills. Transient abdominal pain with elevated transaminase activities, cough with hemoptysis, and vomiting were seen in 1 case each. After treatment, the biopsy specimens showed total necrosis of HCC. Although the T4/T8 ratio of peripheral blood was increased as compared with that before treatment in 4 cases, peritumoral cytotoxic T lymphocyte and monocyte infiltration were seen in one specimen only, and another 7 examined specimens showed negative staining with monoclonal antibodies of T cells. We conclude that intratumor injection of OK-432 is an alternative treatment for small HCC in inoperable cases. The effectiveness may be due to the direct tumoricidal mechanism of OK-432.

Aged↗

PubMed1990

Secondary polycythemia associated with membranous nephropathy.

A 61-year-old male patient had secondary polycythemia associated with idiopathic nephrotic syndrome. Renal biopsy revealed membranous nephropathy. Polycythemia did not change in spite of partial remission of proteinuria. Serum erythropoietin determined by an enzyme-linked immunosorbent assay was 7.2 mU/ml. His serum erythropoietin maintained at a constant level during polycythemia was higher than it was before the appearance of renal ischemia, so he was kept in a polycythemic state. Whether decreasing proteinuria can improve renal ischemia requires future study. We must observe the patient for the occurrence of thromboembolism. Renal ischemia possibly induced by nephrotic syndrome is likely to cause secondary polycythemia.

Biopsy, Needle↗

PubMed1989

Maternal transmission of hepatitis B virus in childhood hepatocellular carcinoma.

Fifty-one children, aged between 3 and 16 years, were diagnosed to have hepatocellular carcinoma (HCC) in the last 15 years. Serum hepatitis B surface antigen (HBsAg) was positive in all the latter 34 HCC children checked by radioimmunoassay, and was positive in five of the 17 earlier HCC children studied by double immunodiffusion method. Serum HBsAg was studied in 31 mothers of the latter 33 HCC children, including two pairs of affected siblings and was positive in 29 (94%). The positive rate was much higher than that (50%) of the mothers of control HBsAg carrier children (P less than 0.001). The serum HBsAg positive rate was also higher in the siblings of HCC children than that of the control group. On the contrary, the serum HBsAg positive rate was not different between the fathers of HCC children and that of the control group. Our observation demonstrated that transmission of hepatitis B virus from the mothers during the perinatal period or early childhood is the most important mode of hepatitis B virus infection in HCC children in Taiwan.

Adolescent↗

PubMed1989

Biologic significance of the detection of HBsAg and HBcAg in liver and tumor from 204 HBsAg-positive patients with primary hepatocellular carcinoma.

Hepatitis B virus surface and core antigens (HBsAg, HBcAg) were examined in the resected primary hepatocellular carcinoma from 204 patients who had HBsAg in serum. Ninety patients had small (less than 5 cm) and 114 had large hepatocellular carcinoma (greater than 5 cm). HBsAg was detected in hepatocellular carcinoma in 65 cases (32%) and HBcAg in 30 cases (14.7%); hepatitis B virus antigens were more frequently detected in small (HBsAg in 42.2% and HBcAg in 20%) than in large hepatocellular carcinoma (HBsAg 23.7% and HBcAg 10.5%). These results suggest that replicative forms of hepatitis B virus DNA may exist in hepatocellular carcinoma more frequently than previously believed and that the malignant hepatocytes can support hepatitis B virus replication. A lymphocytic infiltration in hepatocellular carcinoma was more often observed in hepatocellular carcinoma expressing HBsAg (71%) or HBcAg (63%) than in hepatocellular carcinoma with no detectable HBsAg (26%) or HBcAg (37%), p less than 0.01. The reaction was mild in the majority (85%) of the cases. These findings suggest that hepatitis B virus antigen expression in hepatocellular carcinoma can provoke a local immune response. The most striking finding was that patients with hepatitis B virus antigens in small hepatocellular carcinoma had a 5-year survival rate (13%) lower than that (50%) of the antigen-negative patients (p less than 0.05). In contrast, patients with a marked local immune response in hepatocellular carcinoma, regardless of the viral antigen status, had significantly better 5-year survival rates (43%) than those with no or a mild lymphocytic reaction (18%). These findings indicate that a marked immune response in hepatocellular carcinoma is a favorable prognostic sign.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Hepatocellular↗

PubMed1989

Pleural effusion coinciding with acute exacerbations in a patient with chronic hepatitis B.

A 28-yr-old man had pleural effusions coinciding with two separate episodes of acute exacerbation of chronic type B hepatitis. In both episodes, the pleural effusion was exudative with lymphocyte predominance, and there was no ascites. Hypocomplementemia was evident in the second episode when the complement level was determined, but immune complexes were not detected in the serum. The hepatitis itself was thought to be directly responsible for the pleural effusions because of meticulous exclusion of other causes and the fact that, without specific treatment, the effusions resolved completely as the hepatitis subsided.

Adult↗

PubMed1989

Clonal origin of recurrent hepatocellular carcinomas.

Recurrence of hepatocellular carcinoma after treatment is frequent. To study the clonal origin of the recurrent tumors, we examined five pairs of hepatocellular carcinomas resected from individual hepatitis B surface antigen carriers. Using integrated hepatitis B virus DNA as a marker, tumor clonality was determined by Southern blot analysis. In 2 cases the second tumor contained the same integrated viral DNA as the first one. In the other 3 cases, the clonality of the second cancer differed. We conclude that recurrent hepatocellular carcinomas originate from the first tumor in some cases but represent de novo neoplasms in others.

Base Sequence↗

PubMed1989

Membranous nephropathy in 52 hepatitis B surface antigen (HBsAg) carrier children in Taiwan.

To elucidate the prognosis and the causative viral antigens of hepatitis B virus (HBV)-associated childhood membranous nephropathy (MN), the clinical course and glomerular HBV antigens were studied in 52 HBsAg carrier children with MN (40 boys, 12 girls). With Fab fragments of monoclonal antibodies, hepatitis Be antigen (HBeAg) was detected in the glomerular deposits in 41 (95%) of 43 cases but HBsAg and hepatitis B core antigen (HBcAg) in none. HBeAg was detected in sera from 43 (93%) of 46 children examined. These results suggest that HBeAg plays an important role in the development of MN in HBsAg carrier children. During the follow-up period (mean, 4 years), complete remission was found in 64% and 92% of the patients followed for one and seven years, respectively; only one child had mild renal function impairment. These findings suggest a favorable outcome of HBsAg-associated childhood MN. The patient's age, disease duration, amount of glomerular deposit, focal sclerosis and disease stage appeared to affect the clinical course. HBsAg seroconversion to HBsAg-negative occurred in seven cases, and all (100%) had quick remission in two years. In patients with persistent HBsAg carriage, serum HBeAg status alone did not correlate with remission rate and remission occurred usually before the HBeAg seroconversion to anti-HBe. These findings, together with the predominant horizontal infection in these children in contrast to the frequent vertical (perinatal) transmission from HBsAg carrier mothers in HBsAg carriers in Taiwan, suggest that factors other than HBeAg per se may also play important roles.

Carrier State↗

PubMed1989

Improvement of histological and immunological change in steroid and immunosuppressive drug-resistant lupus nephritis by high-dose intravenous gamma globulin.

From July 1984 to December 1987, 9 patients with lupus nephritis did not respond to the administration of two courses of methylprednisolone pulse therapy and cyclophosphamide treatment for 56 days. Therefore, high-dose intravenous human gamma-globulin (IVIG) was administrated. Before IVIG therapy, renal biopsy showed class IV lupus nephritis in 5 cases, class V in 2 cases, and class IV with V in 2 cases. Immunofluorescence of the renal biopsy showed heavy IgG deposits along the glomerular capillary walls. These heavy glomerular IgG deposits were dissociated after in vitro incubation of the cryostat kidney sections with plasmin-treated, PEG-treated, sulfonated human gamma-globulin and a human Fc fragment, as evidenced by a dramatic decrease or even absence of fluorescent intensity. After high-dose IVIG treatment, 3 out of 5 cases of class IV lupus nephritis had a good response with decreased proteinuria and creatinine; serum C3, C4 levels and CH50 hemolytic activity also increased. The glomerular IgG deposits decreased in the follow-up biopsy. Pathologically, 2 of them transformed into class IIb. The capacity to synthesize immunoglobulin after pokeweed mitogen stimulation was reduced and the circulating immune complexes (CIC) lowered after high-dose IVIG treatment. In the others there was partial response. These clinical and immunological improvements after high-dose IVIG therapy are probably related to the modulation of macrophage-T cell function and enhancement of suppressor T cell function. The toxicity of high dose IVIG was minimal, but the cost is high, search for an optimal dosage is warranted.

Antigen-Antibody Complex↗

PubMed1989

Expression of class I and class II major histocompatibility antigens on human hepatocellular carcinoma.

Previous reports indicate that human hepatocytes do not express class I and class II MHC antigens. Our analyses on 10 human hepatocellular carcinoma (HCC) cell lines by immunofluorescence tests and RIA, demonstrate that all the human HCC cell lines tested express class I MHC antigens and among them, three poorly differentiated human HCC cell lines also express class II MHC antigens. Results of immunoprecipitation and/or Western blotting experiments indicate similarity in the chemical nature of both the class I and class II MHC antigens expressed by the human HCC cell lines and by a human B lymphoblastoid cell line Raji. Furthermore, a new variant form of class I antigen was detected in some of these HCC cell lines. Immunohistochemical studies of HCC tissues using the peroxidase-antiperoxidase staining method indicated that class I and class II antigens were detectable in 7 out of 11 and 3 out of 11 HCC tissues from patients, respectively. The availability of MHC class I antigen-positive cultured HCC cell lines, including the poorly differentiated lines that also express MHC class II antigen, has provided us with interesting models to study the relationship between expression of MHC antigen and transformation and differentiation of human hepatocytes. These studies will also allow us some insight into the role of MHC class I and class II antigen in the immunosensitivity and immunogenicity of HCC cells to the host-immune response.

Blotting, Western↗

PubMed1989

Combined cold- and warm-antibody autoimmune hemolytic anemia--review of the literature and a case report.

This report described the second case in the literature of Waldenstrom's macroglobulinemia with combined cold- and warm- antibody autoimmune hemolytic anemia (CCW-AIHA). Both IgG and IgM red cell auto-antibodies (auto-Abs) were present in the patient's serum. The IgM auto-Abs had a high thermal amplitude and anti-I blood group specificity. The IgG auto-Abs did not reveal blood group specificity. This patient depended on steroids to control hemolysis, but responded well to chemotherapy and plasmapheresis. CCW-AIHA has rarely been reported. In this study, the literature is reviewed and the characteristic serological and clinical features of this rare category of autoimmune hemolytic anemia (AIHA) are discussed.

Adolescent↗

PubMed1989

[Diagnostic value of serum total bile acid in hepatobiliary diseases].

The purpose of this study was to evaluate the clinical diagnostic value of serum total bile acid (STBA) in hepatobiliary diseases. Fasting STBA was measured using the enzymatic colorimetric method in 44 normal control cases and 153 cases of hepatobiliary disease, and then abnormal rates were compared to other conventional liver function tests. These 153 cases of hepatobiliary diseases included acute viral hepatitis (10 cases), chronic persistent hepatitis (32 cases), chronic active hepatitis (16 cases), liver cirrhosis (15 cases), alcoholic hepatitis (11 cases), alcoholic fatty liver (23 cases), alcoholic cirrhosis (17 cases), chronic liver diseases with slight fatty changes (10 cases) and hepatocellular carcinoma (6 cases). Except for 8 cases of acute viral hepatitis, the above cases were verified by liver biopsy. There were also 13 cases of biliary tract diseases. Fasting STBA and other conventional liver function tests were used in the above hepatobiliary diseases during the acute, exacerbated or decompensated stage, and the stable or compensated stage, and their abnormal rates compared. The results of this study revealed that the concentration of STBA is raised in various hepatobiliary diseases, which is related to the degree of hepatic cell injury and the various stages of liver. The concentration of STBA was higher in the acute, exacerbated or decompensated stage than in the convalescent, stable or compensated stage of liver diseases. When the abnormal rates of STBA were compared to other conventional liver function tests, the abnormal rates of STBA were not inferior to r-GT, GOT and GPT, and were more accurate than the other liver function tests.(ABSTRACT TRUNCATED AT 250 WORDS)

Bile Acids and Salts↗

PubMed1988

Evolution of expression of hepatitis B surface and core antigens (HBsAg, HBcAg) in resected primary and recurrent hepatocellular carcinoma in HBsAg carriers in Taiwan. Correlation with local host immune response.

Studies were conducted on the evolution of hepatitis B virus (HBV) surface and core antigens (HBsAg and HBcAg) in the tumors of both primary and recurrent hepatocellular carcinoma (HCC) in 27 HBsAg carriers; these were followed for up to 8 years after the resection of the primary tumor. Twenty-seven primary and 34 recurrent tumors were included. HBV antigens were detected in the tumor of the primary HCC in ten cases (37%): six (22.2%) had both antigens (Group I) and four (14.8%) had HBsAg alone (Group II). The remaining 17 cases were negative for both antigens (Group III). Intrahepatic tumor recurrence occurred in 17 cases; both HBcAg and HBsAg were found in the recurrent HCC in four of five HBcAg-positive cases (Group I). In contrast, HBcAg was detected in none of the other 12 cases (Group II, 0 of one; Group III, 0 of 11), and HBsAg in only one (Group II, 0 of one; Group III, one of 11), P less than 0.03 and P less than 0.02, respectively. Groups I, II, and III had extrahepatic recurrence in two, four, and seven cases, respectively. HBcAg was detected in none, while HBsAg was found in only one case (7.7%). The frequent detection of both antigens in the primary HCC and even in the intrahepatic recurrences suggests that HBV replication in HCC may occur more commonly than previously perceived, especially in the small HCC. Failure to detect HBV antigens in the extrahepatic recurrences suggests that the switch-off of the viral gene expression, particularly the core gene, may be an event related to the extrahepatic growth of HCC. HBV antigen expression in HCC is associated with more evident lymphocyte infiltration; this local host immune response may in turn result in a negative selection and expansion of the antigen-negative HCC cell clones. This suggestion is in accord with the fact that HBV antigens, particularly HBcAg, are rarely detected in advanced HCC.

Carcinoma, Hepatocellular↗

PubMed1988

Tumor invasiveness and prognosis in resected hepatocellular carcinoma. Clinical and pathogenetic implications.

In order to elucidate the biologic behavior of hepatocellular carcinoma (HCC), the long-term prognostic impact of the pathologic features of 143 surgically resected HCC were studied. Seventy-four were smaller than 5 cm in diameter (small HCC), and 69 were larger (large HCC). This study confirmed that tumor size was an important but not the only determining prognostic factor in HCC. Although cirrhosis could cause hepatic failure, patient mortality was mainly attributable to tumor recurrence, which, in turn, was strongly correlated with the invasive nature of HCC. Tumor invasion to the liver and the intraportal spread were very frequent and particularly extensive in large HCC. In both small and large HCC the noninvasive groups not only had high 4-year actuarial survival (84.6% and 90%, respectively), but there was also no patient mortality from intrahepatic tumor recurrence. Therefore, it was concluded that invasiveness of an HCC is the most crucial factor in determining the long-term outcome for the patient, and that the clinical course of resected HCC is predictable in a great majority of the cases. In our small HCC series only 2.4% of HCC were regarded as having true multicentric origin. These findings suggest that the majority of HCC occur unicentrically, and that multiplicity and tumor recurrence result mostly from intrahepatic dissemination. In both small and large HCCs invasive tumors were accompanied by high patient mortality from tumor recurrence even when the tumor was small, indicating that intrahepatic spread may start very early during the growth of HCC.

Carcinoma, Hepatocellular↗

PubMed1988

Status of hepatitis B virus DNA in hepatocellular carcinoma: a study based on paired tumor and nontumor liver tissues.

To investigate the hepatitis B virus (HBV) DNA status in the liver when hepatocellular carcinoma (HCC) has developed, 35 paired nontumorous and tumorous liver tissues from 27 hepatitis B surface antigen (HBsAg)-seropositive and 8 HBsAg-negative patients with HCC were studied by Southern blot analysis. The hybridization patterns of HBV DNA were different in the nontumor and tumor parts in 26 (96.3%) of the 27 HBsAg-positive patients. In the nontumor parts, integration of HBV DNA into the host genome was significantly less when compared to the tumor parts (15/27 vs. 25/27, P less than 0.05), whereas free replicative viral forms were significantly more frequent (17/27 vs. 7/27). The integrated HBV DNA in the nontumor parts showed discrete band patterns in the majority of cases (13/15). Hepatitis B e antigen (HBeAg) was significantly associated with the expression of free replicative forms of HBV DNA in the tumor tissues. An integrated HBV DNA sequence was detected in the tumor part of one HBsAg-negative patient, but not in her nontumor counterpart. Our observation that discrete integrated HBV DNAs are present in the nontumor part, representing subclinical clonal expansion that precedes the development of HCC, suggests the risk of future new tumor growth from these cell clones.

Carcinoma, Hepatocellular↗

PubMed1988

Keratitis, ichthyosis, and deafness (KID) syndrome with cerebellar hypoplasia.

A 6-year-old boy with features of the keratitis-ichthyosis-deafness (KID) syndrome and cerebellar hypoplasia is the second case in which abnormality of cerebellum was detected by computed tomography, but is the first report of KID syndrome with cerebellar hypoplasia. This finding, together with neurosensory deafness and other neuromuscular defects, may suggest that there is an underlying inborn error of nervous system in the KID syndrome. In vitro immunologic studies in this patient also showed a possible deficit in cellular immunity.

Cerebellum↗

PubMed1988

Rapid karyotyping in fetuses with abnormal sonogram.

Prenatal karyotyping of fetuses having an abnormal sonogram was undertaken in 27 pregnancies between 17 and 39 weeks, using fetal blood obtained by percutaneous umbilical cord blood sampling under ultrasound guidance. Eight chromosomal abnormalities (29.7%) were detected, including 45, X (2 cases), trisomy 21(1 case), 46, XY,-13,+t(13,13) (1 case), 47, XX,+18(3 cases), 47, XXY (1 case). Nineteen fetuses had a normal karyotype (46,XX:9 cases, 46,XY:10 cases). The fetal karyotype was available within 72 h and fetal management was planned accordingly. We concluded that in fetuses with an abnormal sonogram, rapid karyotyping using fetal blood obtained under ultrasound guidance had important implications in obstetric and neonatal management and would facilitate genetic counselling.

Adult↗