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Biomedical subjects

H Hsu

Publications and source records attributed to H Hsu.

At least 55 records · Page 3Linked to original sources
PubMed1995

Gender and haplotype effects upon hematological manifestations of adult sickle cell anemia.

In Africa, the beta-globin gene cluster haplotype may be associated with variation of Hb F levels in subjects with sickle cell anemia (SS). These observations have not yet been conclusively confirmed in SS out of Africa, perhaps because of small sample sizes, the predominance of haplotype heterozygotes, and diverse influences, including gender, upon Hb F levels. We studied 384 adult African-American SS patients (mean age, 31 years) and explored the relationship of gender, beta-globin gene cluster haplotype, and alpha thalassemia to hematological values and Hb F levels. Both haplotype and gender influenced Hb F concentration. In the total sample, Hb F was higher in females than in males (8.2 vs. 6.5%). In 35 males who were either homozygous for the Senegal chromosome or had the Senegal/Benin haplotype, the mean percent Hb F (8.0%) was equivalent to the Hb F level in females with Benin and Bantu haplotypes (approximately 7.5%). Both females and males homozygous for the Senegal haplotype chromosome or with the Senegal/Benin combination had a significant increase in Hb F compared to other groups. In 44 Senegal/Senegal or Senegal/Benin females the Hb F was 10.9%, or 1.0 g/dl, the highest value observed in all primary analysis groups. Preliminary analyses suggested that the presence of a Bantu chromosome blunted the gender-associated difference in Hb F, but Hb F differences between females with the Senegal/Benin haplotype (11.2%) and the Senegal/Bantu haplotype (8.8%) were not statistically significant. Hemoglobin concentrations were higher in males than in females except in subjects with at least one Senegal haplotype chromosome, where hemoglobin levels were equal. As expected, alpha thalassemia reduced the MCV, increased hemoglobin concentration, and lowered reticulocyte counts, regardless of haplotype. Hb F levels were not affected by the presence of alpha thalassemia in any group. We conclude that gender and beta-globin gene cluster haplotype interact significantly in the modulation of Hb F and anemia in adults with SS.

Adult↗
PubMed1995

Comparison of amlodipine and benazepril monotherapy to amlodipine plus benazepril in patients with systemic hypertension: a randomized, double-blind, placebo-controlled, parallel-group study. The Benazepril/Amlodipine Study Group.

A single-blind, run-in, randomized, double-blind, parallel-group, placebo-controlled comparison trial was conducted to assess the safety and efficacy of low-dose amlodipine 2.5 mg daily, low-dose benazepril 10 mg daily, and the combination of the two drugs at the same doses used once daily in patients (n = 401) with mild to moderate (stages I and II) systemic hypertension. Both monotherapy regimens were shown to significantly reduce both systolic and diastolic blood pressure compared with baseline placebo values, and the combination regimen was shown to be superior in lowering systolic and diastolic blood pressure when compared with either of the monotherapy regimens. The combination therapy also resulted in a greater percentage of patients having successful clinical response in mean sitting diastolic blood pressure. The amlodipine and benazepril regimen was also shown to be associated with a similar incidence of adverse experiences as the active monotherapy or placebo regimens, although the group given combination therapy appeared to have a lower incidence of edema than the group given amlodipine alone. Low-dose amlodipine (2.5 mg) plus benazepril (10 mg) provides greater blood-pressure-lowering efficacy than either monotherapy, and has an excellent safety profile.

Adult↗
PubMed1995

Effectiveness of a specialized asthma clinic in reducing asthma morbidity in an inner-city minority population.

Asthma is the most common chronic disease of childhood and a leading cause of morbidity in adults. Despite significant advances in medical therapy, asthma morbidity and mortality rates have risen dramatically over the past two decades, especially in minority and socioeconomically disadvantaged populations. Numerous intervention programs have been designed in an attempt to reduce asthma morbidity but few have targeted poor or minority populations. The purpose of this study was to assess whether an outpatient intervention program specifically targeted at a high-minority population in East Harlem, in New York City, was successful in reducing asthma morbidity. A retrospective chart review of 84 patient records was conducted. The patients were divided into two groups, an intervention group (n = 45), who were followed by an asthma specialist (allergist/immunologist), and a nonintervention group, followed by a general internist or pediatrician. Outcome variables including clinic walk-in visits, emergency room visits, and hospitalizations were determined and compared in the pre- and postintervention period in both groups. Patients in the intervention group had reduced total walk-in visits (73 vs. 27, p < 0.001), emergency room visits (30 vs. 5, p < 0.001), and hospitalizations (16 vs. 2, p < 0.001). In contrast, patients in the nonintervention group had no change in total walk-in visits (88 vs. 72), increased emergency visits (7 vs. 22, p < 0.05), and no change in hospitalizations (5 vs. 2), respectively. The outpatient intervention program has been successful in reducing asthma morbidity in the high-risk minority community of East Harlem. Future larger studies are warranted to extend this pilot program to other high-risk minority populations.

Adolescent↗
PubMed1994

Screening and confirmatory testing of cadaver organ donors for hepatitis C virus infection: a U.S. National Collaborative Study.

Hepatitis C virus (HCV) can be transmitted by organ transplantation. Cadaver organ donors are screened for HCV infection by testing for antibodies to HCV (anti-HCV). The prevalence of HCV infection and performance of anti-HCV tests in detecting HCV infection in organ donors are unknown. Sera from 3078 cadaver organ donors were tested for anti-HCV by a first generation enzyme-linked immunosorbent assay (ELISA1). Sera from all 137 ELISA1 positive donors and a random sample of 92 ELISA1 negative donors were tested for anti-HCV by a second generation ELISA (ELISA2) and for HCV RNA by the polymerase chain reaction. Organ bank records were reviewed for risk factors associated with HCV infection. Follow-up was available on 70 recipients of organs from 42 ELISA2 positive donors. The prevalence of HCV RNA, extrapolated to all 3078 donors, was 2.4%. Liver disease, anti-HCV and HCV RNA were detected more frequently among recipients of organs from ELISA2 positive donors with HCV RNA than from ELISA2 positive donors without HCV RNA. Among donors, the sensitivity and negative predictive value of the ELISA2 for HCV RNA were 100%. However, despite a specificity of 98.1%, the positive predictive value was only 55.1%. Clinical and laboratory characteristics did not distinguish ELISA2 positive donors with and without HCV RNA. The presence of serum HCV RNA in organ donors predicts the risk of transmission of HCV infection. Discarding organs from ELISA2 positive donors would eliminate transmission, but organs from 1.88 percent of donors would be wasted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Colonoscopic screening for first degree relatives of patients with colorectal cancer.

BACKGROUND: In addition to identifying and eradicating premalignant lesions, and detecting early cancer before the development of life-threatening consequences, new concepts and technological advances have stimulated a hightened interest in the secondary prevention of colorectal cancer. METHODS: People whose first degree relatives have had colorectal cancer are considered to run a higher risk of developing colorectal carcinoma. A screening program was carried out for 358 first degree relatives of colorectal cancer patients using colonoscopic screening. RESULTS: The mean age of these first degree relatives was 44 years, ranging from 13 to 78 years. Two hundred and eleven (58.9%) of them were asymptomatic. Totally 73 polyps were detected in 53 subjects (14.9%). Two cancer lesions were identified. Thirty polyps (41.1%) measured between 0.5 cm and 2.0 cm. The polyps were mostly located in the rectum and sigmoid colon (63%). One polyp was found in a subject below 30 years of age. Over the age of 30, the incidence of polyp increased dramatically. CONCLUSIONS: Our results confirmed that the screening program for the first degree relatives of patients with colorectal cancer is worthwhile. The program would have a more significant impact if the screening could start from subjects around the age of 30.

Adult↗
PubMed1994

The application of laparoscopy in colorectal surgery: a preliminary report of twelve cases.

BACKGROUND: With the development of video camera imaging system and the improvement of laparoscopic manipulation instruments, laparoscopic surgery has become applicable to many abdominal surgeries. Having completed the feasibility studies of animal model over 10 dogs, we began to apply this new technique in the field of colorectal surgery. METHODS: From March to July 1993, 12 cases of large bowel resection were performed with laparoscopy. Operations performed included seven cases of laparoscopy-assisted right colectomy (LARC), three cases of laparoscopic abdominal-perineal resection (LAPR), one case of laparoscopic low anterior resection (LLAR) and one case of laparoscopy-assisted subtotal colectomy. Five cases received operation due to diverticular disease, three due to rectal carcinoma, three due to broad villous adenoma and one due to lipoma over ileocecal region. RESULTS: The average operation time for LARC was 4 hours and 50 minutes, and for LAPR was 6 hours and 35 minutes. Operation time required decreased substantially as the number of laparoscopic surgery performed increased. The average post-operative length of stay was 5.5 days for LARC and 11.5 days for LAPR. Most of the patient started diet intake on the third day after surgery. There was no major complication. Only two cases developed minor complications of subcutaneous hematoma over trocar insertion site and minor wound infection. CONCLUSIONS: Laparoscopic technique can feasibly be employed in certain cases of colorectal surgery, although it is rather complicated and requires longer learning curve than other laparoscopic procedures. Therefore, surgeons should take it most caution while carrying out this procedure. Experimental trials over animal model is also highly recommended before clinical practice.

Adult↗
PubMed1993

Slow and incomplete inactivations of voltage-gated channels dominate encoding in synthetic neurons.

Electrically excitable channels were expressed in Chinese hamster ovary cells using a vaccinia virus vector system. In cells expressing rat brain IIA Na+ channels only, brief pulses (< 1 ms) of depolarizing current resulted in action potentials with a prolonged (0.5-3 s) depolarizing plateau; this plateau was caused by slow and incomplete Na+ channel inactivation. In cells expressing both Na+ and Drosophila Shaker H4 transient K+ channels, there were neuron-like action potentials. In cells with appropriate Na+/K+ current ratios, maintaining stimulation produced repetitive firing over a 10-fold range of frequencies but eventually led to "lock-up" of the potential at a positive value after several seconds of stimulation. The latter effect was due primarily to slow inactivation of the K+ currents. Numerical simulations of modified Hodgkin-Huxley equations describing these currents, using parameters from voltage-clamp kinetics studied in the same cells, accounted for most features of the voltage trajectories. The present study shows that insights into the mechanisms for generating action potentials and trains of action potentials in real excitable cells can be obtained from the analysis of synthetic excitable cells that express a controlled repertoire of ion channels.

Action Potentials↗
PubMed1992

Development of a monoclonal antibody to the conserved region of p34cdc2 protein kinase.

Mice and rabbits were injected with various forms of a 16 amino acid synthetic peptide representing PSTAIR, the evolutionarily conserved region of the protein kinase p34cdc2, for polyclonal antisera and hybridoma-monoclonal antibody production. Antisera from mice injected with an unconjugated monomeric form of the peptide showed no reaction to the peptide. Of four animals injected with the monomeric form of the peptide conjugated to keyhole limpet hemocyanin via m-maleimidobenzoyl-N-hydroxysulfosuccinimide (MBS), antisera from only one mouse had a very low titer to the peptide, and all four animals produced antibody to the MBS bridge. Both mice injected with an octameric multiple antigen peptide (MAP) of PSTAIR produced antisera reactive to the octameric MAP form of the peptide in ELISA and also to the cdc2 protein expressed in bacteria in an immunoblotting assay. Splenocytes from one mouse injected with the octameric MAP form of the peptide were successfully used for hybridoma-monoclonal antibody production. A monoclonal antibody was produced that reacted with octamer, monomer and cdc2-expressed protein and specifically with the carboxyl terminus of the 16 amino acid peptide.

Amino Acid Sequence↗
PubMed1992

Trend of large bowel tuberculosis and the relation with pulmonary tuberculosis.

From 1965 to 1989, 60 cases of large bowel tuberculosis among 116 cases of abdominal tuberculosis are reviewed and analyzed. Lesions located in the cecum or ileocecal region were found in 49 of the 60 cases. Most of the patients (50/60) received surgical intervention, but the definite diagnoses had never been proved until surgery. The diagnoses were proved by histopathologic examination in these 50 cases. Antituberculosis medications were given for at least nine months in all patients. Twenty-nine of the 50 patients who received operations had primary anastomosis during the operations, and no leakage occurred. Evidence of pulmonary tuberculous lesions could be found in 40 of the 60 cases. Positive findings of tubercle bacilli in sputum smear or culture were noted in 13 cases. The positive rate of sputum examinations decreased during 1980 to 1989; 25.6 percent (10/39) were positive from 1965 to 1979 and 14 percent (3/21) were positive from 1980 to 1989. In the meantime, there was a steady decline in the cases of large bowel tuberculosis in the most recent few years. An antituberculosis program has been carried out in the past 40 years with remarkable effect in the Taiwan area, but the possibility of intestinal tuberculosis still exists. The authors suggest that surgeons keep tuberculosis in mind when they are dealing with patients who suffer from intestinal obstruction of unknown origin with the suspected findings of pulmonary tuberculosis in chest x-ray films.

Adolescent↗
PubMed1991

Effect of beta-globin gene cluster haplotype on the hematological and clinical features of sickle cell anemia.

In 113 black American adults with sickle cell anemia (HbSS), we examined nine polymorphic restriction sites, including the Xmnl site 5' to the G gamma gene, to see whether haplotype is related to the level of HbF and the proportion of G gamma chains or if it influences the hematological and clinical features of the disease. Seventy-five percent of the patients were homozygous or heterozygous for the Benin (no. 19) or Central African Republic (Bantu, no. 20) haplotypes; 13.3% were homozygous or heterozygous for the Senegal (no. 3) haplotype, while 11.5% had other genotypes. Of the subjects, 14.2% were either homozygous or heterozygous for the Xmnl restriction site 5' to the G gamma gene. We found no effect of haplotype on HbF levels. The level of G gamma chains was 60.5% +/- 17.0% in individuals heterozygous or homozygous for haplotype no. 3 and was 46.9% +/- 11.6% in individuals with other haplotypes. Subjects with the Xmnl site 5' to the G gamma gene had G gamma globin levels of 59.5% +/- 16.7% while those lacking that site had an average of 47.2% +/- 12.1%. There were no significant differences among these groups in hemoglobin concentration, packed cell volume, mean cell volume, or clinical indicators of vaso-occlusive severity, including crises, hospitalizations per year, aseptic bone necrosis, acute chest syndrome, or leg ulcers. While the presence of haplotype 3 and the 5' G gamma Xmnl site were associated with increased G gamma chains, there was no effect on HbF level or other hematological and clinical features that might reflect disease severity. It is likely that determinants unrelated to haplotype, linked or unlinked to the beta-globin gene cluster, are the major effectors of differences in the levels of HbF in American patients with sickle cell anemia.

Adult↗
PubMed1991

Continuous ambulatory peritoneal dialysis: ten years at one facility.

A review of continuous ambulatory peritoneal dialysis (CAPD) performed at one facility over a period of 10 years showed that age and type II diabetes mellitus were associated with the worst technique survival. The median survival of patients entering CAPD was not significantly different when the etiology of renal failure was chronic glomerulonephritis (CGN; 27 months), chronic interstitial nephritis (CIN; 21 months), diabetes mellitus type I (21 months), or hypertension (16 months). Patients with diabetes mellitus type II had significantly (P less than 0.05) worse survival (11 months). A patient remaining on CAPD 6 months had a 55% to 60% chance of remaining on therapy at 2 years and a 47% chance at the end of 3 years, whereas a patient with diabetes mellitus type II had a 34% conditional probability of remaining on dialysis at 2 years and 18% at 3 years. Sex, race, and educational achievement were not important determinants of dialysis technique survival. Studies are indicated to identify predictors of a poor dialysis experience.

Aged↗
PubMed1991

Chronic effect of KCl on black-white differences in plasma renin activity, aldosterone, and urinary electrolytes.

In a 10-week trial of the effect of 80 mEq KCl/day on blood pressure, the following biochemical changes were noted: plasma renin activity (PRA), originally significantly lower in blacks than whites, increased to the same level as whites after K supplementation. A similar trend was noted with aldosterone. KCl increased creatinine excretion in blacks and whites, and lowered Ca excretion in blacks. These results suggest that the low PRA found in blacks is due, at least in part, to low K intake, and not to genetic causes.

Adolescent↗
PubMed1991

[Post-operative evaluation of 1000 consecutive hemorrhoid cases].

From September 1983 to October 1988, one thousand consecutive hemorrhoid patients were hospitalized and treated at T.C.V.G.H.A retrospective evaluation based on their admission charts was conducted. Two surgical procedures, wedge hemorrhoidectomy and anoplasty, were compared. We collected and analyzed the following data: sex, age, surgical procedure, post-operative pain, complications and number of days of hospitalization. This study discovered that the larger the major operative area and the greater the number of suture knots, the severer the post-operative pain. For instance, anoplasties resulted in a higher incidence of urine retention (78.1%) and stool impaction (79.4%) than hemorrhoidectomies did. Early complications were found primarily in cases receiving anoplasty, but in later complications, there were no significant differences found between procedures. Anoplasty also resulted in a longer hospital stay, so when dealing with the same degree of hemorrhoid, the simpler the operation, the better the result, because the patients' discomfort can be reduced and hospitalization can be shortened.

Adult↗
PubMed1991

Abdominal tuberculosis--a retrospective analysis of 121 cases.

From 1960 to 1989, a total of 121 patients with abdominal tuberculosis were treated at this hospital. Ages, at the time of diagnosis, ranged from 14 years to 81 years with a mean of 44 years. There were 86 males and 35 females. No clinical feature was diagnostic, but the leading presenting complaints were abdominal pain (79%) and fever (53%). Chest x-ray showed that 80 patients (69%) had coexisting evidence of pulmonary tuberculosis. Lesions were most commonly located at the ileocecal region (40%). The diagnosis was bacteriologically established in only 39 patients (32%). It was difficult to obtain the definitive diagnosis, most of our patients (91 cases) were diagnosed while undergoing laparotomy with tissue biopsy. Although the principal treatment of abdominal tuberculosis was chemotherapy and operation should be reserved until complications occurred, there were still 96 patients (79%) who underwent surgical procedures. The reasons of high operative rate were the difficulty of early diagnosis and the delay of proper treatment. The common complications of abdominal tuberculosis and the related managements were discussed and the findings in our cases which were helpful in diagnosing abdominal tuberculosis were also presented. Sixteen severely ill patients who died tended to be older, poor nutrition and associated with underlying medical diseases. Abdominal tuberculosis is still persistent in Taiwan, and it must be included in the differential diagnosis of obscure abdominal conditions to avoid diagnostic delay and unnecessary illness and death.

Abdomen↗
PubMed1990

Cost-effective use of microcomputers for quality assurance and resource utilization in the surgical intensive care unit.

Need for organ system support, severity of illness, and the risk of life-threatening complications are major factors in determining the need for ICU care and directly affect ICU costs. Using a microcomputer and a relational database program, an ICU database was developed to study ICU utilization. The following information was collected for each ICU patient on admission, then daily, and on ICU discharge: demographic data, procedures, monitors used, laboratory tests, complications, outcome, and Acute Physiology and Chronic Health Evaluation (APACHE II) score as a measure of acuity. In our study, this information was used as a first step in an attempt to define categories of patients who might benefit most from intensive care and those who would not. From September 1, 1987 to March 1, 1989, 1,062 patients were admitted to the surgical ICU (SICU). Otorhinolaryngology (ENT) patients with major head and neck resections, routinely admitted to the SICU, were compared with those from other surgical services. The ENT patients had the lowest mean admission APACHE II (6.8 +/- 0.4 vs. 11.4 +/- 0.3), lowest mean daily APACHE II (7.8 +/- 0.4 vs. 13.2 +/- 0.1), lowest percent of ventilated patients (7.6% vs. 39.4%) and ventilator days (18.9% vs. 64.6%), and had the least monitoring by central venous catheters (20.9% vs. 57.1%) or pulmonary artery catheters (0.9% vs. 29.8%) (p less than .0001 for all of above). They also had the shortest mean ICU stay (1.2 +/- 0.1 vs. 3.3 +/- 0.2 days, p less than .05). The only complication in 105 ENT patients was one uncomplicated myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Patients with localized pancreatic adenocarcinoma in central Mississippi: a retrospective analysis of survival.

Factors influencing the survival of central Mississippi patients with adenocarcinoma of the pancreas were analyzed by a retrospective analysis of the two largest tumor registries in the state. The authors report that this Mississippi data agree with very recent reports describing significant benefit from chemoradiotherapy in localized disease, and suggests a less fatalistic attitude of the medical community towards localized pancreatic carcinoma is appropriate.

Adenocarcinoma↗