Acute renal failure due to ingestion of raw bile of grass carp (Clenopharyngodon idellus).
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Biomedical subjects
Publications and source records attributed to H C Hsu.
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A study of the tumor-host interaction was conducted in 30 patients with nasopharyngeal carcinoma (NPC). The local immune reaction was investigated by an immunoperoxidase technique using monoclonal antibodies. Eighteen patients who were clinically suspected to have NPC, but finally proved otherwise, served as controls. There was a significant difference between the number of NPC patients with interleukin-2 receptor (IL-2R)-positive cells (activated T lymphocytes) in the stroma compared with the control. IL-2R positive cells were found in 67% of NPC patients but in only 22% of controls (P less than 0.01). There was a greater infiltration of T lymphocytes in patients with a good outcome compared with patients with a poor outcome. This trend was observed in both the parenchyma (60.2 versus 29.4 x 10(4) cells/mm2) and the stroma (74.7 versus 44.8 x 10(4) cells/mm2). The levels of Leu-3 positive cells (helper/inducer) in the NPC parenchyma were inversely correlated to the extent of the primary tumor, but there was no correlation in the stroma. These findings demonstrate that a local host-immune reaction does exist and may be a useful prognostic indicator for NPC patients.
Monoclonal antibodies with selectivity for human hepatoma cell lines were produced by immunizing BALB/c mice with human hepatoma cell lines, HA22T/VGH or Hep 3B, and fusing sensitized mouse spleen cells with mouse myeloma cells. Two monoclonal antibodies recognizing antigens present only on human hepatoma cell lines were investigated. The monoclonal antibody IB1 was found to react with 3 of 9 hepatoma cell lines. Monoclonal antibody 9B2 reacted with all nine hepatoma cell lines. None of the other 20 cell lines tested was bound by IB1 and 9B2. The immunoperoxidase staining of monoclonal antibodies on frozen sections of paired hepatoma and normal liver tissues from the same individuals were studied. Antibody IB1 reacted with 3 of 13 hepatoma tissues, but with none of the normal liver and other tissues, and antibody 9B2 was reactive with antigens appearing on the bile canalicular domain of hepatoma and normal liver tissues. The antibody 9B2 stained no normal tissues with the exception of proximal tubules of kidney. Radioimmunoprecipitation tests identified two antigens reacting with 9B2. The major antigen had an apparent molecular weight of 140,000 and a minor one of 130,000. Therefore, antibody IB1 seems to be specific for antigens present on a group of human hepatoma cells and may be useful for classification and diagnosis of human hepatomas. Antibody 9B2 is quite specific to human liver cells and may be used to provide clues for the characterization of tumor cell lines, identification of metastatic tumors with hepatocytic origin, and study of the structure and function of bile canaliculi.
The nuclear DNA contents of 54 hepatocellular carcinomas were measured on cytologic smears using a scanning microdensitometer at a wavelength of 550 nm. The cellular materials were aspirated under ultrasonographic guidance and stained with modified Feulgen method. The DNA modal values, which could be defined in 51 cases, ranged from 2.2 to 9.8 ploidy, with 46.3% (25/54) in hypertetraploidy. The hepatocellular carcinomas in patients with higher serum levels of alpha-fetoprotein contained more hyperploid cells. The DNA modal values did not correlate with the age, HBsAg status, tumor size and histological grading of hepatocellular carcinoma. The S-phase fraction values, which could be estimated on the DNA histograms in 43 cases (79.6%), ranged from 1 to 35 (mean +/- S.D. = 10.6 +/- 8.1). The S-phase fraction values were higher in high grade hepatocellular carcinomas (13.4 +/- 8.5) than low grade hepatocellular carcinomas (6.1 +/- 4.4), p less than 0.01. The mean S-phase fraction values were also significantly higher in hepatocellular carcinomas with alpha-fetoprotein levels of more than 100 ng per ml than those of less than 100 ng per ml (12.9 +/- 8.0 and 7.8 +/- 5.6, respectively). The S-phase fraction values also did not correlate with the age, HBsAg status and tumor size.
Liver histologic findings were studied in 18 children who were 4 to 9 years old, and who had been HBsAg carriers since having been infected by their mothers in the perinatal period. All were born to HBeAg-HBsAg carrier mothers; the children were followed periodically from birth. Throughout their entire course, none developed symptoms or signs suggestive of liver disease. All of the 18 children showed mild but definite liver histologic changes: 15 had nonspecific histologic changes, and three had chronic persistent hepatitis. In 13 of 18 children, follow-up aminotransferase activities were abnormal, but none exceeded 100 KU. At the time of biopsy, ALTs on four children were above the upper limit of normal. All children were HBeAg-positive in early infancy, but five lost this antigen and developed antibody during follow-up. The histologic findings in HBeAg-positive children did not differ from those in children with antibody. Perinatal hepatitis B virus infection has been thought to play an important role in chronic liver disease, including hepatocellular carcinoma. This study indicates that some pathologic changes following perinatal infection begin very early.
The clinical, virologic and pathologic features of chronic hepatitis B virus infection were studied in 66 children, of whom 29 were symptomatic and 37 asymptomatic. The majority (79%) of symptomatic children had histologically aggressive diseases: 11 had chronic active hepatitis and 10 had cirrhosis. In contrast, most asymptomatic children had nonaggressive diseases (35 cases); only 2 had chronic active hepatitis. Nine of the 10 children with cirrhosis were under 6 years of age, and the cirrhosis was often advanced, indicating that hepatitis B virus infection can cause the rapid development of cirrhosis in early life. HBcAg was present in 71% of 62 cases examined and correlated well with the status of HBeAg in serum. Cytoplasmic HBcAg was more frequently associated with aggressive disease than was nuclear HBcAg expression alone or no detectable HBcAg in the liver. A male predominance (75%) was found, particularly in children with aggressive diseases (91%) compared to those with nonaggressive forms of disease (67%). Sera from mothers of 43 of these children were tested for HBsAg, and 51% were positive. HBsAg was particularly common among mothers of children with symptomatic disease (69%) or cirrhosis (100%). These findings suggest that male sex and perinatal infection are important factors in the development of overt chronic hepatitis B and cirrhosis in children.
To elucidate the biologic significance of hepatocyte HBsAg, its expression patterns were correlated with virus replication and liver pathology in 578 liver biopsies taken from chronic HBsAg carriers aged 1 to 80 years. Five major patterns of hepatocyte HBsAg were identified: homogeneous [intense and discrete, (Pattern A), faint and discrete, (Pattern B) and faint and grouped (Pattern C)]; globular or spotty (Pattern D), and marginal (Pattern E). Pattern A was always associated with viremia and also very frequently with membrane HBsAg expression, but rarely with active liver disease. It occurred most commonly in HBeAg-positive carrier children and young adults, reflecting an early immune tolerance phase with active virus replication. Pattern B was also usually associated with viremia, but very commonly associated with active disease (70%), reflecting active virus replication with enhanced immune response. Pattern E (marginal HBsAg), which was always in group distribution resembling a clonal expansion, predominated the HBeAg-negative phase and was associated with absence of viremia and occurred mostly in older adults with inactive bipolar disease spectrum (normal liver/mild disease or cirrhosis/hepatocellular carcinoma); this reflects a late phase of inactive virus replication or integration. Patterns C and D did not correlate well with viremia, but also tended to have inactive diseases as did Pattern E. These findings suggest that hepatocyte HBsAg expression is closely related to the natural course of chronic hepatitis B virus infection.
Intensive postremission chemotherapy has produced disease-free survival comparable to that of bone marrow transplantation in patients with acute myelogenous leukemia (AML), but its efficacy was unknown in Taiwan. We assessed the efficacy of intensive postremission chemotherapy, consisting of high-dose arabinoside-C (HiDAC) with or without transplantation of peripheral blood stem cells, in 33 AML patients from a single institute in Taiwan. Toxic reactions, treatment outcome, prognostic factors, and the size of the peripheral blood stem-cell harvest after HiDAC were analyzed. After a median follow-up of 21 months, 18 patients remained in continuous complete remission. The actuarial leukemia-free survival at 4 years was 51%. Relapse occurred in 12 patients, at a median of 12 months after initial diagnosis. All 6 patients with acute promyelocytic leukemia remained disease free after HiDAC therapy. Age, sex, and number of remission-induction or intensive consolidation chemotherapy courses had no effect on the risk of relapse. Intensive postremission chemotherapy can effectively prolong the duration of remission in young (< 60 years of age) adults with AML.