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Biomedical subjects

H C Hsu

Publications and source records attributed to H C Hsu.

353 records · Page 20Linked to original sources

Detection of human papillomavirus in primary hepatocellular carcinoma.

Human papillomaviruses (HPV) have been linked causally to some human cancers such as cervical carcinoma. To determine whether any additional type of human malignancy contained HPV DNA, we examined 16 hepatocellular carcinoma (HCC) specimens by Southern blot technique and by polymerase chain reaction (PCR). One HCC contained HPV 16 DNA as demonstrated by both Southern blot and PCR. Two other HCC samples contained HPV 18-related nucleotide sequences by PCR but were negative by Southern blot of genomic DNA. HPV could have been carried via blood to the liver, thus indirectly supporting the presence of an HPV viremia. Our findings suggest that oncogenic HPV might constitute a cofactor acting synergistically with hepatitis B virus (HBV) in the development of the HCC in these patients. Alternatively, the presence of HPV in the tumor tissue might be the result of an opportunistic infection.

Autoradiography↗

Cytomegalovirus-associated neonatal hepatitis.

Fifty-five patients with cytomegalovirus (CMV)-associated neonatal hepatitis (NH) were followed for 12 to 90 months. Six patients (10.9%) died from either a fulminant course or a chronic liver disease. Among the remaining 49 patients, whose liver function was completely recovered, there were eight with retardation of developmental or growth status, and two with hearing impairment. Overall, 20.4% of the survivors suffered from a long-term impact. The unfavorable outcome was related to several clinical and pathological parameters. These included persistence of clay-colored stool, presence of splenomegaly, ascites or anemia, high peak total and direct bilirubin, low nadir albumin levels, diffuse giant cell transformation and cirrhosis of the liver. The seropositivity of CMV infection did not significantly correlate with the outcome.

Cytomegalovirus Infections↗

[Wilson disease presenting as fulminant hepatic failure, acute hemolytic anemia and renal failure: report of one case].

Wilson disease presenting as fulminant hepatic failure, severe hemolysis and renal failure is rare in the literature. A ten-year-old boy--complaining of abdominal pain, jaundice, tea-colored urine, and anemia was admitted to this hospital; examination showed Kayser-Fleischer rings, anemia associated with hemolysis, mildly elevated serum transaminases, extremely elevated bilirubin levels, low serum ceruloplasmin level, slightly elevated serum copper, excessive 24-hour urine copper excretion, and severe renal function insufficiencies. Under the impression of Wilson disease with fulminant hepatic failure, the patient was treated by oral D-penicillamine 1 gm per day, intravenous zinc sulphate (about 8 mg per day elemental zinc), and given other supportive treatment. Unfortunately, the patient died of hepatic failure complicated with septic shock 21 days after the onset of symptoms. Autopsy found liver copper content was 586.92 ug/gm dry weight and kidney copper content: 300.19 ug/gm dry weight, abnormally high as compared with normal tissue. A review of the literature led to conclusion that the best treatment for Wilson fulminant hepatic failure is liver transplantation.

Acute Disease↗

[Giardiasis with malabsorption syndrome: report of one case].

A 10-year-old mentally retarded girl was sent to our hospital due to generalized edema, vomiting and poor appetite for several days. Serum albumin level was low, but no proteinuria was detected. Her stool was bulky and foul. Stool examination for parasite with formalin-ether concentration method revealed negative result. Trypsin activity test of stool revealed low trypsin activity as compared with normal specimen. Daily fecal fat exceeded upper normal limit. The diagnosis of giardiasis was confirmed by duodenal juice examination. Intestinal histology revealed mild shortening of the villi with increased mononuclear cell infiltration in the lamina propria. The daily stool amount decreased markedly after treatment with metronidazole 250 mg three times a day for 7 days. The edema subsided during the treatment. Serum albumin bevel returned to normal after the treatment. Giardiasis with malabsorption syndrome has often been overlooked in Taiwan. It is advised that in case of malabsorption syndrome giardiasis should be included in the list of differential diagnosis.

Child↗

Focal glomerulosclerosis manifested with nephrotic syndrome.

To assess the long-term outcome for nephrotic children with focal glomerulosclerosis, 23 patients were studied. Twenty were male and three female; the mean age at onset was 7.2 +/- 4.0 years. Twenty of the 23 children had focal segmental glomerulosclerosis, and the other 3 showed focal global sclerosis in renal biopsy specimens. Hypertension (11/23) and hematuria (9/23) were frequent clinical features. Glycosuria (4/23) was occasionally noted. Of the patients studied 13 were initial steroid responders and 10, steroid nonresponders. The mean duration of follow-up for the entire group was 4.7 +/- 4.0 years (ranging from 1 to 13.5 years). From the total study group, 13% had renal deaths; 13% had decreased creatinine clearance, but not end-stage renal disease; 35% had persistent proteinuria; and 39% were in remission. None of the three patients with focal global sclerosis developed chronic renal failure. The data suggest that for children with focal glomerulosclerosis, clinical outcome is not too pessimistic. Except for glycosuria, no clinical or morphologic features were predictive of the development of chronic renal failure, in this study.

Adolescent↗

Childhood nephrotic syndrome and heavy proteinuria in Taiwan. A retrospective clinicopathologic study.

From April 1981 to November 1987, 347 children with either nephrotic syndrome (NS; 262 cases, 75.5%) or heavy proteinuria (85 cases, 24.5%) were studied to determine the clinicopathologic manifestation of these diseases among Taiwanese children. All of the children were less than 18 years of age and all had undergone renal biopsy. IgM mesangial nephropathy (IgMN; 93 cases, 26.9%) and minimal change nephrotic syndrome (MCNS; 62 cases, 17.8%) are the most frequently found pathologic lesions. The clinical course of MCNS is always responsive to steroids and less relapsive. However, IgMN is characterized by its good initial response to steroids and frequent relapses. As for secondary glomerulonephritis, lupus nephritis has the first position and comprises 18.4% (64 cases) of all cases. Membranous nephropathy associated with hepatitis B antigenemia (HBVMN; 34 cases, 9.8%) has the second position. Most cases of membranous nephropathy in children in Taiwan are HBVMN. The age of peak incidence is around 2-7 years old. Most of them had frequent relapses of NS or persistent heavy proteinuria. Membranoproliferative glomerulonephritis (MPGN) accounts for only 1.2% (4 cases) of all cases, relatively lower than reported elsewhere. The high incidence of IgMN, HBVMN and low incidence of MPGN are probably due to geographic or racial differences in Taiwan with respect to those in other countries.

Adolescent↗

Fine needle aspiration cytology of thymic carcinoid tumor.

Carcinoid tumors of the thymus are very rare, and their cytologic findings have not been reported previously in English. Retrospective study of fine needle aspiration (FNA) cytologic features in four histopathologically verified thymic carcinoid tumors are described here in detail. The FNA cytology of thymic carcinoids is characterized by predominantly single and some loose clusters of small, round to oval cells with scanty cytoplasm, interspersed with some larger cells with moderate to abundant, granular cytoplasm. The differential diagnosis of the cytologic features between carcinoid tumor and other mediastinal tumors is also discussed.

Adenocarcinoma↗

Total parenteral nutrition-associated cholestasis in infants: clinical and liver histologic studies.

To evaluate total parenteral nutrition-associated cholestasis (TPN-C) in infants, a retrospective clinicopathologic study was conducted of 15 infants who had received TPN. The mean gestational age and birth weight were 32.1 weeks (26-40 weeks) and 1807 g (840-5840 g) respectively. Two-thirds of the patients were kept on TPN for more than 60 days. The onset of rising direct bilirubin ranged 2-9 weeks (mean 4.5 +/- 2.4) after TPN therapy. Preterm babies less than 32 weeks of age had an earlier rise of direct bilirubin and AST. Bile sludge of the gallbladder was observed in only one case, and none had gallstone. The main histologic findings of liver biopsy or autopsy were cholestasis (intracellular and canalicular), periportal inflammation, fibrosis and bile ductular proliferation. Sixty percent of these survived, the remaining 40% died of complications unrelated to TPN-C. The liver function profile became normalized within a mean of 14.0 +/- 9.4 (8-34) weeks after discontinuation of TPN in the survival cases. It was concluded that infant TPN-associated cholestasis was mostly reversible, but that the younger preterm babies were susceptible to a prolonged TPN course with more marked clinical and pathological changes.

Cholestasis↗

Juvenile nephronophthisis-medullary cystic disease complex: a family study.

Two sisters, eight and six years old, respectively, were admitted to Mackay Memorial Hospital in 1993 with the chief complaints of growth retardation, polyuria and nocturnal enuresis. Poor urinary concentration, sodium wasting, anemia and renal insufficiency were noted during hospitalization. Ultrasonography revealed increased renal echogenicity, loss of corticomedullary differentiation and multiple tiny corticomedullary cysts in both kidneys. Renal histopathology showed mild increase in glomerular mesangial cellularity and matrix, mild focal tubular atrophy with thickening of the tubular basement membrane. Other family members were screened by ultrasonography and found another six patients in two generations of the paternal side. Renal cysts were found in five cases. Three of them had progressively deteriorating renal failure. Five had stable renal function after three years of supportive treatment. Thus, it was concluded that the age of onset does not differentiate medullary cystic disease (MCD) from juvenile nephonophthisis (JN), and that JN and MCD could be considered a clinical complex. The absence of corticomedullary cysts on ultrasonography does not preclude the diagnosis. It is also suggested that any children with clinical symptoms of polyuria, polydipsia, anemia and growth retardation from their early years should be carefully examined, and the family history should be investigated to permit early detection of the disease.

Adult↗

Increased susceptibility to apoptosis induced by anti-Fas antibody in a Rothmund-Thomson syndrome lymphoblastoid cell line.

Dysregulation of apoptosis leading to reduced DNA repair capacity, increased DNA mutation, and chromosomal instability is one of the pathological mechanisms associated with aging. Rothmund-Thomson syndrome (RTS) is a human genetic disease characterized by several features of premature aging. Although the genetic defect has not been identified, defects in DNA repair capacity have been implicated in the pathogenesis of this disease. To determine whether dysregulation of apoptosis is associated with the pathogenesis of RTS symptoms, we investigated the sensitivity of a lymphoblastoid cell line--derived from a young (10-year-old) individual with RTS--to cell death induced by anti-Fas antibody (clone: CH-11). Cell lines derived from a normal young (14-year-old) individual and a normal aged (79-year-old) individual were used as controls. Treatment with CH-11 (500 ng/ml) resulted in significantly decreased cell viability in the RTS cell line (42.4% +/- 4.2%) and that derived from the aged individual (47.3% +/- 9.2%) as compared to the normal young cell line (66.9% +/- 7.0%). The concentrations of CH-11 required to induce 50% cell death in the RTS (IC50, 890 ng/ml) and that derived from the aged individual (IC50, 3640 ng/ml) were lower than that of the control young cell line (IC50 > 10(5) ng/ml). The lower viability was due to increased susceptibility to apoptosis to CH-11 in the RTS (59.0% +/- 2.0%) compared to that in the normal young cell line (40.9% +/- 0.9%) as shown by 7-amino-actinomycin D (7-AAD) staining (p < .005). Treatment of the RTS cell line with acetyl-Asp-Glu-Val-Asp-aldehyde (Ac-DEVD-CHO), a specific inhibitor of caspase-3, significantly increased the cell viability after CH-11 treatment (75.9% +/- 2.2%). Taken together, these results provide the first evidence to show that RTS lymphoblastoid has an increased sensitivity to cell death mediated by Fas and that inhibition of caspase-3 activity may be a potential target in reversing the sensitivity of RTS cells to Fas-mediated apoptosis in vitro.

Adolescent↗

Neurophysiological basis of sympathetic nerve-preserving surgery for lower rectal cancer--a canine model.

BACKGROUND/AIMS: The relative contribution and interrelated compensation of sympathetic signals among sympathetic components in pelvic plexus remain undefined. This study was designed to investigate the genitourinary function in response to autonomic nerve preservation and severance using a canine model. METHODOLOGY: Eighteen mongrel dogs were randomly divided into 3 groups which received severance of the hypogastric nerves on either the right side, left side, or on both sides. The hypogastric nerves and sacral sympathetic trunks were electrically stimulated and the contraction pressure of the internal urethral orifice was measured immediately, at 1- and 3-month intervals. The ejaculation function and the length of time required to reach sexual orgasm were evaluated by manual penis-stimulation. RESULTS: The difference between the left and right sides of the normal hypogastric nerve in contribution to sympathetic signals was insignificant. Compared with the hypogastric nerve, the bilateral sacral sympathetic trunks were functionally trivial in controlling the closure of the internal urethral orifice. The preserved side of the hypogastric nerve compensated for the loss of sympathetic signals of the severed side within 1 month and, thereafter, remained stationary. In contrast, the functional compensation of bilateral sacral sympathetic trunks for the severed bilateral hypogastric nerves was insignificant. When the hypogastric nerve was preserved in one or both sides, all dogs maintained normal antegrade ejaculation. If bilateral hypogastric nerves were severed, 50.0% (3/6) of the dogs lost both emission and ejaculation function; 33.3% (2/6) presented with retrograde ejaculation; and, 16.7% (1/6) presented with combined retrograde ejaculation and reduced antegrade ejaculation. The time required to reach sexual orgasm was not affected by the severance of the hypogastric nerve. CONCLUSIONS: The normal genitourinary function could be maintained only when at least one side of the hypogastric nerve was preserved.

Animals↗