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Biomedical subjects

H C Kuo

Publications and source records attributed to H C Kuo.

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

Primary malignant lymphoma of the uterine cervix shows favorable response to neoadjuvant chemotherapy.

Primary malignant lymphoma localized in the uterine cervix is a rare condition for which radiation therapy, surgery, or chemotherapy either alone or in combination have been the mainstay of treatment. The effectiveness of neoadjuvant chemotherapy for this condition, however, has not been evaluated. We experienced one case of primary malignant lymphoma of the uterine cervix, stage IIa according to FIGO, and IEA according to the Ann Arbor staging system for extranodal lymphomas, which was treated with neoadjuvant chemotherapy and surgery. The patient first underwent neoadjuvant chemotherapy consisting of cyclophosphamide, vinblastine, epirubicin, bleomycin, procarbazin, and oncovin (COP-BLAM) to reduce the size of the tumor. This was followed by an extended total hysterectomy, left salpingo-oophorectomy, and bilateral pelvic lymph node dissection. Neoadjuvant chemotherapy given before surgery resulted in a remarkable reduction in the tumor size which made the subsequent surgery technically easy. In addition, it is possible that intraoperative micrometastasis of the tumor cells could be better prevented. The patient received additional chemotherapy with COP-BLAM schedules postoperatively. No evidence of recurrent lymphoma has been observed in 2 years after the treatment. Neoadjuvant chemotherapy may be an effective treatment modality for primary malignant lymphoma of the uterine cervix.

Adult↗
PubMed1994

A new gene involved in stationary-phase survival located at 59 minutes on the Escherichia coli chromosome.

We determined the DNA sequence of a 2,232-bp region immediately upstream of the pcm gene at 59 min on the Escherichia coli chromosome that encodes an L-isoaspartyl protein methyltransferase with an important role in stationary-phase survival. Two open reading frames of 477 and 1,524 bp were found oriented in the same direction as that of the pcm gene. The latter open reading frame overlapped the 5' end of the pcm gene by 4 bp. Coupled in vitro transcription-translation analysis of DNA containing the 1,524-bp open reading frame directly demonstrated the production of a 37,000-Da polypeptide corresponding to a RNA species generated from a promoter within the open reading frame. The deduced amino acid sequence showed no similarity to known protein sequences. To test the function of this gene product, we constructed a mutant strain in which a kanamycin resistance element was inserted at a BstEII site in the middle of its coding region in an orientation that does not result in reduction of Pcm methyltransferase activity. These cells were found to survive poorly in stationary phase, at elevated temperatures, and in high-salt media compared with parent cells containing the intact gene, and we thus designate this gene surE (survival). surE appears to be the first gene of a bicistronic operon also containing the pcm gene. The phenotypes of mutations in either gene are very similar and indicate that both gene products are important for the viability of E. coli cells under stressful conditions.

Acid Phosphatase↗
PubMed1994

Application of transrectal sonography in the diagnosis and treatment of female stress urinary incontinence.

One hundred and two women with genuine stress urinary incontinence (SUI) were examined by transrectal sonography and urodynamics. The patients were classified into five types according to their intrinsic and extrinsic continence mechanism defects. Twenty-five patients had a hypermobile bladder neck and urethra (type 1); 31 patients had an incompetent bladder neck and a hypermobile urethra (type 2); 31 patients showed an incompetent urethral sphincter in addition to urethral hypermobility (type 3); 12 patients had a cystocele accompanying incompetent urethral sphincter and hypermobile urethra (type 4); the remaining 3 showed an incompetent urethral sphincter without hypermobility of the urethra (type 5). Whereas the distance from the lower margin of symphysis pubis to the bladder neck (pubovesical ligament; PVL) showed a significant increase in straining state of types 3 and 4, this was not the case in types 1, 2 and 5. There is a significant increase in the posteroinferior rotational of PVL angle on straining compared with resting in types 1, 2, 3, and 4, but not in type 5. The angle on straining also showed an increased tendency from type 1 to 4. The functional degree of SUI showed a significant increase from type 1 to 5. With this classification, the functional class of SUI is thus well correlated with the anatomical defects. The PVL length and the angle of external rotation of this axis are significantly implicated in the severity of SUI.

Female↗
PubMed1993

Ureteroscopic treatment of lower ureteral calculi in the era of extracorporeal shock wave lithotripsy: from a developing country point of view.

In a series of 229 lower ureteral calculi manipulated with either extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy the stone clearance rate 7 days after treatment was 40.6% and 90%, respectively. Only 17 of 32 patients (53.1%) treated with ESWL were rendered stone-free at 4-week followup. In addition to concern about stone clearance, other medical and social factors, and the availability of health insurance coverage must be considered. Since the differences of living standards between highly developed and developing countries are great, the selection of ESWL or ureteroscopy as primary treatment of lower ureteral calculi must be based on the socioeconomical status of a specific country. Because ESWL devices are not readily available in most developing countries and ureteroscopy is cost-effective, highly efficacious (greater than 92%) and involves minimal morbidity (less than 10%) for calculi removal in experienced hands, we recommend ureteroscopy as the treatment of choice for lower ureteral stones, with ESWL as the alternative, in developing countries.

Adult↗
PubMed1993

Predictive factors for successful surgical outcome of benign prostatic hypertrophy.

Four hundred patients with benign prostatic hypertrophy (BPH) undergoing prostatic surgery were enrolled in this study in order to search for factors predictive of a successful outcome. 139 patients had acute urinary retention and the others had irritative and obstructive voiding symptoms. Preoperative examinations included intravenous urography (IVU), transrectal sonography of the prostate (TRSP), cystometry, uroflowmetry, and urethral pressure profilometry (UPP). Retropubic prostatectomy was undertaken in 16 cases, transurethral resection of the prostate in 335, and transurethral incision of the prostate in 49. In the follow-up period of 3 months to 3 years, a strictly successful result was achieved in 324 patients (81%). 26 patients (6.5%) had a fair result, 30 (7.5%) were stationary, in 18 (4.5%) the symptoms became worse, and 2 (0.5%) died postoperatively. On analysis of the success rate, 9 favorable factors and 9 unfavorable factors were noted. A symptomatic large prostatic adenoma proven by IVU, TRSP, or UPP will imply a higher success rate. Urodynamically obstructive BPH proven by a high voiding pressure and constrictive flow pattern can also predict a satisfactory outcome. The unfavorable factors always come from a small adenoma, uncertain irritative symptoms and detrusor underactivity. Patients with more than 2 unfavorable factors should be investigated carefully before surgery. The presence of 2 favorable factors without an unfavorable factor will usually predict the best surgical outcome.

Aged↗
PubMed1993

Extracorporeal shock wave lithotripsy for obstructed proximal ureteral stones. A prospective randomized study comparing in situ, stent bypass and below stone catheter with irrigation strategies.

In an attempt to assess the usefulness of a ureteral stent in facilitating disintegration of obstructed proximal ureteral stone with extracorporeal shock wave lithotripsy (ESWL), a prospective randomized study on 120 patients with ultrasonic evidence of hydronephrosis whose stone sizes were greater than 1.0 x 0.6 cm on KUB film and located above the level of L5 were allocated into three distinct treatment strategies: group 1: in situ without stone manipulation; group 2: bypass stones with stent, and group 3: placement of a catheter below stone with continuous saline irrigation. Of 77 patients, 26, 27 and 24 in each group, followed up for a period of 6 months with sufficient data for analysis, the stone-free rates were 76.9, 59.3 and 62.5%, respectively. The average number of shock waves delivered to accomplish a stone-free state were 3,245, 3,250 and 3,880 for individual groups and the comparisons among them were statistically insignificant (p's > 0.1). ESWL retreatment was common, being 33.3, 29.4 and 43.8%, respectively. Hydronephrosis has a major impact on the outcome of ESWL treatment, as more stone-free cases were found in the mildly hydronephrotic category than in the severer counterparts. About 90% of cases who finally were stone-free, passed all their stone fragments within 28 days. Ancillary procedures were needed in 13 (16.9%), 7 received ureterolithotomy, whilst 6 were removed of their stones by ureteroscopy.

Adult↗
PubMed1992

The primary application of three-dimensional ultrasonography in obstetrics.

To date, no report of three-dimensional ultrasonography in obstetrics has been available in the literature. In this study we describe the primary experience with three-dimensional ultrasonography for the prenatal evaluation of nine fetuses between 21 and 33 weeks of gestation. We found that it provides more information for clinical diagnosis than the traditional two-dimensional ultrasonography. The following advantages are notable: (1) the anatomic area of interest can be located first with the conventional real-time two-dimensional mode, then switched to reveal three-dimensional images, instantly; (2) three images are exhibited concurrently; (3) each of the three images can be arrayed separately and scrolled to search for the area of interest within the scanned volume; (4) the three-dimensional ultrasonography can be equipped with Doppler color flow mapping for the study of the fetal cardiovascular system. In conclusion, we believe that three-dimensional ultrasonography can greatly strengthen diagnostic potential, which deserves obstetricians' attention.

Cardiovascular System↗
PubMed1992

Antithrombin III activity in normal and toxemic pregnancies.

From August 1989 to October 1990, 83 pregnant Chinese women were the subjects for measuring the levels of plasma functional antithrombin III (AT III) activity. The correlations of AT III activity with perinatal outcome and the changes in maternal hepatorenal function were analyzed. The population was divided into four groups: Group I (n = 30), normal pregnancies; Group II (n = 23), mild pre-eclampsia; Group III (n = 26), severe pre-eclampsia; and Group IV (n = 4), eclampsia. The results demonstrated that: 1) AT III activity decreased with the severity of toxemia (p < 0.001), 2) AT III activity correlated with the degree of perinatal outcome and maternal morbidity, and 3) reduction of AT III activity correlated with impairment of maternal hepatorenal function. In conclusion, plasma AT III activity is a valuable parameter in the evaluation of toxemia.

Adult↗
PubMed1992

Urodynamic findings in interstitial cystitis.

Fifty patients with irritative voiding symptoms and a painful bladder when full were engaged in this study to clarify the role of urodynamics in the diagnosis of interstitial cystitis (IC). Patients underwent urodynamic study, cystoscopic hydrodilatation of the bladder under general anesthesia and bladder biopsy. Twenty-eight women and two men who presented with signs of glomerulations or petechial hemorrhage of the bladder mucosa were classified as having IC, while 20 women without this characteristic were classified as having non-IC. A hypersensitive urge sensation, a small bladder capacity, a lower maximal flow rate and an abnormal flow pattern were observed in both groups of patients, but no significant difference was noted. More IC patients had a lower bladder compliance than non-IC patients (p < 0.025), and the maximal bladder capacity under anesthesia was smaller in IC patients (p < 0.05). However, there does not seem to be any definite correlation to the pathologic findings, except in patients with marked bladder inflammation, in whom a small capacity and severe clinical symptomatology were found.

Adult↗
PubMed1991

Control of alternative splicing by the differential binding of U1 small nuclear ribonucleoprotein particle.

Cellular factors controlling alternative splicing of precursor messenger RNA are largely unknown, even though this process plays a central role in specifying the diversity of proteins in the eukaryotic cell. For the identification of such factors, a segment of the rat preprotachykinin gene was used in which differential expression of neuropeptides gamma and K is dependent on alternative splicing of the fourth exon (E4). Sequence variants of the three-exon segment, (E3-E4-E5) were created, resulting in a sensitive assay for factors mediating the splicing switch between E4-skipping and E4-inclusion. A dinucleotide mutation in the 5' splice site of E4 that increase base-pairing of this site to U1 small nuclear RNA resulted in uniform selection of E4, whereas a control mutation that destroyed base-pairing resulted in uniform E4-skipping. Affinity selection of spliceosomes formed on these functionally distinct substrates revealed that the extreme difference in splicing was mediated by differential binding of the U1 small nuclear ribonucleoprotein particle (snRNP) to the 5' splice site of E4. These data show that, apart from its established role in selecting 5' splice sites, U1 snRNP plays a fundamental role in 3' exon selection and provides insight into possible mechanisms of alternative splicing.

Animals↗
PubMed1991

Combinatorial splicing of exon pairs by two-site binding of U1 small nuclear ribonucleoprotein particle.

A two-site model for the binding of U1 small nuclear ribonucleoprotein particle (U1 snRNP) was tested in order to understand how exon partners are selected in complex pre-mRNAs containing alternative exons. In this model, it is proposed that two U1 snRNPs define a functional unit of splicing by base pairing to the 3' boundary of the downstream exon as well as the 5' boundary of the intron to be spliced. Three-exon substrates contained the alternatively spliced exon 4 (E4) region of the preprotachykinin gene. Combined 5' splice site mutations at neighboring exons demonstrate that weakened binding of U1 snRNP at the downstream site and improved U1 snRNP binding at the upstream site result in the failure to rescue splicing of the intron between the mutations. These results indicate the stringency of the requirement for binding a second U1 snRNP to the downstream 5' splice site for these substrates as opposed to an alternative model in which a certain threshold level of U1 snRNP can be provided at either site. Further support for the two-site model is provided by single-site mutations in the 5' splice site of the third exon, E5, that weaken base complementarity to U1 RNA. These mutations block E5 branchpoint formation and, surprisingly, generate novel branchpoints that are specified chiefly by their proximity to a cryptic 5' splice site located at the 3' terminus of the pre-mRNA. The experiments shown here demonstrate a true stimulation of 3' splice site activity by the downstream binding of U1 snRNP and suggest a possible mechanism by which combinatorial patterns of exon selection are achieved for alternatively spliced pre-mRNAs.

Base Sequence↗
PubMed1991

A new classification of female stress urinary incontinence--based on transrectal sonographic cystourethrography.

A new classification of female stress urinary incontinence was made according to the results of transrectal ultrasonography of the urinary bladder and urethra (cystourethrography) studied in 67 women with genuine stress urinary incontinence (SUI). This classification is based on the following changes of the bladder and urethra on abdominal straining: hypermobility of the urethra, bladder neck incompetence, urethral sphincter incompetence and presence of a cystocele. Five types of SUI has been classified. We believe that this new classification can provide a better understanding of the anatomical changes as well as the pathophysiology of SUI. In addition, it can serve as a guideline of proper surgical management for SUI.

Adult↗
PubMed1990

Transrectal sonographic cystourethrography: studies in stress urinary incontinence.

Transrectal ultrasonic sagittal transducer is an excellent modality to image the bladder and urethra in dynamic change. In female patients, we found it is also helpful for the diagnosis of urinary stress incontinence. The posterior urethrovesical (PUV) angle is measured with the transrectal sonoprobe under strain and non-strain conditions. We compared the results of sonographic cystourethrogram with the radiographic chain cystourethrogram. The sonographic cystourethrography is superior to the radiography. The former may estimate the PUV angle accurately and differentiate between the patients with and without stress urinary incontinence. Furthermore, we also use the transrectal sagittal probe intraoperatively to adjust the suspension force as well as PUV angle in patients who underwent vesical neck suspension for stress urinary incontinence (SUI).

Adult↗
PubMed1990

A Sequential splicing mechanism promotes selection of an optimal exon by repositioning a downstream 5' splice site in preprotachykinin pre-mRNA.

To explore the structural basis of alternative splicing, we have analyzed the splicing of pre-mRNAs containing an optional exon, E4, from the preprotachykinin gene. This gene encodes substance P and related tachykinin peptides by alternative splicing of a common pre-mRNA. We have shown that alternative splicing of preprotachykinin pre-mRNA occurs by preferential skipping of optional E4. The competing mechanism that incorporates E4 into the final spliced RNA is constrained by an initial block to splicing of the immediate upstream intervening sequence (IVS), IVS3. This block is relieved by sequential splicing, in which the immediate downstream IVS4 is removed first. The structural change resulting from the first splicing event is directly responsible for activation of IVS3 splicing. This structural rearrangement replaces IVS4 sequences with E5 and its adjacent IVS5 sequences. To determine how this structural change promoted IVS3 splicing, we asked what structural change(s) would restore activity of IVS3 splicing-defective mutants. The most significant effect was observed by a 2-nucleotide substitution that converted the 5' splice site of E4 to an exact consensus match, GUAAGU. Exon 5 sequences alone were found not to promote splicing when present in one or multiple copies. However, when a 15-nucleotide segment of IVS5 containing GUAAGU was inserted into a splicing-defective mutant just downstream of the hybrid exon segment E4E5, splicing activity was recovered. Curiously, the 72-nucleotide L2 exon of adenovirus, without its associated 5' splice site, activates splicing when juxtaposed to E4. Models for the activation of splicing by an RNA structural change are discussed.

Base Sequence↗
PubMed1990

Antenatal ultrasonographic diagnosis of hypotelorism.

Hypotelorism is one of the most important fetal anomalies, which deserves early antenatal detection and management. To date, only a few cases of antenatally diagnosed hypotelorism have been reported. In this series, we report a case of hypotelorism and microphthalmia diagnosed prenatally. A 30-year-old female, G1P0, was admitted to our hospital due to chronic bronchitis and a breech presentation of the fetus at 38 weeks of gestation. Routine ultrasound screening revealed hypotelorism. Associated anomalies detected by ultrasound were alobar holoprosencephaly, microcephaly, microphthalmia and oligohydramnios. After delivery, hypotelorism with holoprosencephaly was confirmed, which corresponded with the antenatal ultrasound findings. In conclusion, systemic routine ultrasound screening of fetal orbits is the best way to prenatally detect hypotelorism and microphthalmia.

Face↗