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Biomedical subjects

L Y Shih

Publications and source records attributed to L Y Shih.

At least 91 records · Page 5Linked to original sources

Alpha-chain disease. Report of a case from Taiwan.

The occurrence of alpha-chain disease (alpha-CD) in a Chinese patient, a resident of Taiwan, is reported. The patient's clinical features were characterized by severe malabsorption and ran a rapidly deteriorated course. Duodenal biopsy showed total villous atrophy with a heavy infiltration of the lamina propria by lymphoplasmacytic cells. Colonic biopsy revealed immunoblastic lymphoma. alpha-CD protein was demonstrated in the patient's serum and concentrated urine by the immunoselection method, and also detected in the cellular infiltrate by immunoperoxidase technique. Postmortem examination disclosed that the lymphoma involved not only the entire gastrointestinal tract and mesenteric nodes, but also the retroperitoneal and peripheral lymph nodes. Immunoperoxidase studies support the concept of a common clonal origin of the lymphoplasmacytic proliferation and immunoblastic lymphoma in alpha-CD.

Adult↗

Chronic myeloid leukemia: manifesting as spontaneous splenic rupture and terminating in megakaryoblastic transformation.

We report a case of chronic myeloid leukemia with spontaneous splenic rupture as the initial presenting feature; there was a successful surgical outcome, but this case terminated in megakaryoblastic transformation. Results are reported based on morphological, immunological, cytochemical, ultrastructural, immunocytochemical studies, and in vitro liquid culture studies. The megakaryocytic nature of the blast cells was identified through the demonstration of platelet peroxidase activity by ultrastructural cytochemistry and the presence of platelet and megakaryocyte-specific antigen using monoclonal antibody, as well as the anti-factor VIII antibody by immunocytochemical technique.

Adult↗

In-vitro granulopoiesis in adult acute lymphoblastic leukemia at various phases of the disease.

We used the in-vitro agar culture technique to monitor the granulopoiesis in 68 adult patients with ALL during the course of their disease. Bone marrow cells were cultured from 42 patients at diagnosis, 26 patients in relapse, 36 patients in early remission and 31 patients in full remission. The results of culture growth were characterized by sparse or no growth at diagnosis. No inhibition of normal CFU-C by leukemic cells was demonstrated by co-culture experiments. In relapsed marrows with blasts exceeding 60%, the culture results were identical to those at first presentation. The colonies grown in ALL cultures showed normal morphology with a normal granulocytic and monocytic differentiation. The colony-forming potential gradually increased following induction therapy, but there was no relationship between the CFU-C number and the percentage of blasts. The impaired granulopoiesis usually recovered once a remission was obtained and remained normal throughout the remission period. In some instances, cultures were performed within a short period prior to relapse or carried out more than one occasion during stable remission, wide fluctuations in CFU-C incidences were observed. Our study indicates that the CFU-C assay in ALL is useful for monitoring the in-vitro granulopoietic activity at various phases of the disease, but is of limited value in predicting the response to treatment as well as in determining the remission-relapse status.

Adolescent↗

Presence of hepatitis B virus DNA in serum of surface-antigen-seronegative immunocompromised patients.

We compared the prevalence of serum hepatitis B virus (HBV) DNA in cancer patients who were immunocompromised with that in healthy subjects. Testing positive for serum HBV DNA were 27 of the 232 (11.6%) surface-antigen-negative cancer patients and 7 of the 382 (1.8%) surface-antigen-negative healthy subjects. These data suggest that the negative serology, at least in immunocompromised individuals, is probably not sufficient to exclude HBV infection.

DNA, Viral↗

Erythrocyte sedimentation rate and C-reactive protein values in patients with total hip arthroplasty.

Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured serially in 50 osteoarthritic patients treated with uncomplicated primary total hip arthroplasties (THAs) and also in 28 patients with painful hip for different periods after THA. The follow-up period was one year. In uncomplicated primary THA, the ESR was slightly elevated before surgery and was variable after surgery; some patients continued to have abnormally high ESRs one year after surgery. However, CRP was normal before surgery and after surgery showed a distinctive pattern that rapidly normalized within three weeks. In patients with a painful hip after THA, ESR was elevated in those with septic loosening and variable in those with mechanical loosening; however, the difference was not significant. ESR after successful revision THA was also variable. CRP was high in patients with septic loosening and normal in those with mechanical loosening. Normalization of CRP was rapid after control of infection or within three weeks of successful revision THA. Uneventful recovery after THA is indicated by normalization of CRP within three weeks, regardless of ESR. Measurement of both ESR and CRP is helpful in differentiating septic and mechanical loosening, detecting complications, and monitoring the effects of treatment, but CRP is more informative and sensitive than ESR for these purposes.

Adult↗

Identification of monocytic nature in acute undifferentiated leukemia by in vitro marrow culture study.

We report a case with acute undifferentiated leukemia whose leukemic blasts lacked morphological, cytochemical and immunological features of lymphoid or myeloid differentiation. The in vitro culture study defined her leukemia as of monocytic origin. Her marrow blasts underwent monocytic differentiation with strong nonspecific esterase activity when cultured in a liquid system with human placental conditioned medium. The semisolid agar culture showed an AML-type growth pattern. The present study indicates that in vitro culture study can be used as a supplement to improve the classification of certain unclassifiable leukemias.

Adult↗

Prognostic significance of in vitro marrow culture growth pattern in untreated acute nonlymphocytic leukemia.

The growth pattern of marrow cells in agar culture was studied in 90 adult patients with acute nonlymphocytic leukemia (ANLL) at diagnosis. We classified the abnormal growth patterns into 4 groups, A: no growth, B: decreased growth, C: excessive microcluster formation and D: excessive cluster growth with more than 20 colonies. There was a good correlation between growth pattern and FAB subtype. A predominance of group A growth was observed in M1, while group B growth was found in 50% of patients with M2 and M5. No relationships between the growth patterns and other clinical parameters were detected. Sixty-six patients were evaluable for treatment outcome. The growth pattern significantly correlated with complete remission rate. The remission rates were 52, 87, 80, and 25% for patients with group A, B, C and D growth, respectively. Analyses of remission duration and survival curves showed significant differences among the different growth patterns. Patients with D growth experienced a shorter remission duration and a lower survival rate than other groups. These results indicate that the in vitro culture growth pattern in untreated ANLL is of prognostic significance in predicting the response to therapy.

Acute Disease↗

Detection of antibodies to HTLV-III by ELISA in AIDS risk groups in Taiwan: a preliminary report.

A total of 2321 serum samples were collected from a variety of AIDS risk groups. The samples were tested for anti-HTLV-III using ELISA. Low prevalences of seropositivity were detected in the high-risk groups. Among 120 homosexuals/bisexuals, one seropositive suffering from full-blown AIDS was an American traveler. Another native homosexual who yielded a high ELISA reading was a "possible" AIDS. Three hemophiliacs with strongly positive reactions received injections of a U.S.-produced factor VIII; all are asymptomatic currently. A patient with hairy cell leukemia had a markedly elevated ELISA reading. Another patient with syphilis also had a markedly high reading, despite having no other known risk factor. Among the low-risk groups a patient who had suffered from oral candidiasis for eight years had no risk factor, yet he yielded repeatedly high ELISA readings. Another patient with a weak positive reaction was a symptomless blood donor. This preliminary study concludes that Taiwan is several years behind the U.S. and is at present not an endemic area for AIDS. To achieve successful AIDS control in the future, however, the homosexuals in Taiwan should change their sexual behavior now. Since many initially weakly-reactive samples became negative on repeated testing it appears that non-specific or false positive ELISA reactions occur frequently. Accordingly when ELISA is used for diagnostic purposes, additional confirming tests are mandatory.

Acquired Immunodeficiency Syndrome↗

Adult T-cell leukemia/lymphoma in Taiwan. A clinicopathologic observation.

The retrovirus-associated adult T-cell leukemia/lymphoma (ATL) has not been previously documented in Taiwan. Five cases identified recently by the authors are reported. Three of the patients were women, and their ages ranged from 36 to 60 years. The most important diagnostic clue was the observation of polylobated lymphoid cells in the peripheral blood. Other variably observed significant features included hypercalcemia, cutaneous eruptions, osteolytic bone lesion, hepatomegaly, and lymphadenopathy. Surface marker studies revealed that the leukemic or lymphoma cells were T-helper cells. Histopathologic examination revealed one case of pleomorphic type and three cases of medium-sized cell type. No tissue was available for study in one case. The diagnosis of ATL was confirmed by the indirect immunofluorescence test on MT-1 cell for antibodies to adult T-cell leukemia virus-associated antigen (ATLA). Three patients were dead within 6 months, and two patients had been in clinical remission for 7 and 10 months, respectively. These two latter cases were similar to the so-called smoldering type of ATL. Two descendents among nine relatives of the patients were also positive for anti-ATLA (22%). Two husbands were negative. Four of the five patients lived in the same county in northeastern coastal Taiwan, which suggested a possible clustering of ATL in that region.

Adult↗

Marrow culture studies in adult acute myeloid leukemia at diagnosis and during complete remission.

We used the human placental conditioned medium stimulated single layer agar culture technique to study the in vitro growth of marrow cells from 62 adult patients with acute myeloid leukemia (AML). Bone marrow cells were cultured from 50 patients at the time of initial diagnosis, 19 patients in early remission and 20 patients during their full complete remission. Marrow cultures from untreated patients exhibited heterogeneous growth patterns ranging from complete growth failure to excessive microcluster formation. We classified the growth patterns into 4 groups: (1) Gr I: normal growth, (2) Gr II: no growth, (3) Gr III: decreased growth, (4) Gr IV: excessive growth of microclusters. At presentation, none had Gr I growth; Gr II growth was observed in 23; Gr III in 14 and Gr IV in 13. A predominance of no growth were seen in M1 and M3 subtypes, while Gr IV growth was more commonly observed in M2 or M4 subtype. We were unable to correlate the culture findings with age or white cell count. The present results not only indicated that AML at diagnosis was characterized by abnormal granulopoiesis but also demonstrated that leukemic progenitor cells were heterogeneous with different capacities to express their proliferating potential in vitro. Except few with decreased growth, the growth characteristics generally returned to normal with successful remission induction. Both Gr II and Gr IV growth patterns were not observed either in early remission or during full complete remission.

Adolescent↗

Cutaneous manifestations of adult T cell leukemia/lymphoma. Report of three different forms.

The clinical and pathologic features of cutaneous lesions observed in three adult T cell leukemia/lymphoma (ATL) patients identified in Taiwan are described. They represent one classical case of ATL and two "smoldering" variants. The classical ATL patient when first seen had numerous erythematous or purpuric papules, nodules, and plaques with or without ulceration. The two "smoldering" cases developed encrusted purpuric plaques with subcutaneous erythematous nodules in one patient and pompholyx-like vesicular eruptions with tumor masses in another patient. The pompholyx-like eruptions have not been described before. Pruritus was the major complaint in two patients. Histopathologic studies revealed pleomorphic infiltration in the classical case and monomorphic infiltration with medium-sized cells in the two "smoldering" variants. Therefore, the cutaneous lesions of ATL are diverse and not pathognomonic. The diagnosis requires a high index of suspicion, detection of circulating characteristic multilobated lymphoid cells with T helper/inducer cell marker, and demonstration of serum antibody against the adult T cell leukemia virus-associated antigen.

Adult↗

Pathologic and immunologic characterization of malignant lymphoma in Taiwan. With special reference to retrovirus-associated adult T-cell lymphoma/leukemia.

One hundred four cases of malignant lymphomas, including 90 cases of non-Hodgkin's lymphoma, 5 cases of histiocytic malignancy, and 9 cases of Hodgkin's disease were analyzed pathologically and immunologically using a panel of monoclonal and conventional antibodies for T-, B-, histiocyte, and Hodgkin's neoplastic cells. Our results revealed a high frequency of T-cell lymphoma (42.3%), a low percentage of follicular lymphoma (10.5%), and Hodgkin's disease (8.7%) in Taiwan. More than half of the malignant lymphomas belonged to the high-risk unfavorable group. Peripheral T-cell lymphomas (33 cases) showed characteristic clinical and histologic features, which can sometimes be confused with Hodgkin's disease. Monoclonal antibodies Leu-M1 and 2H9 were an important aid for their differential diagnosis. Five of the 33 peripheral T-cell lymphomas were positive for antibody to adult T-cell lymphoma/leukemia (ATL) virus associated antigen (ATLA). Four patients were from the northeast coast of Taiwan, I-Lan county. Five (4.8%) were diagnosed as true histiocytic malignancies, including two true histiocytic lymphoma and three malignant histiocytosis. Two cases each of large cell lymphoma and immunoblastic lymphoma showed no identifiable marker expression. The distribution of lymphoproliferative disorders in Taiwan is similar to that in Japan but much different from western countries.

Adolescent↗

Gene dosage studies supporting localization of the structural gene for galactose-1-phosphate uridyl transferase (GALT) to band p13 of chromosome 9.

A newborn male was diagnosed as having a duplication of distal 9p material by GTG banding analysis. Gene dose studies for galactose-1-phosphate uridyl transferase (GALT) were performed on the patient, his mother (the balanced translocation carrier), a 3-year-old 47,XY + 9p male control, a 30-year-old woman with mosaic trisomy 9p, a newborn female control infant with complete trisomy 9, and age-matched chromosomally normal control individuals. The findings support previous evidence that the GALT locus is at band p13 of chromosome 9.

Chromosome Aberrations↗

Disseminated petriellidiosis (allescheriasis) in a patient with refractory acute lymphoblastic leukaemia.

A case of disseminated petriellidiosis is presented. This complication occurred in a patient with refractory acute lymphoblastic leukaemia, who was receiving repeated courses of cytotoxic drugs, antibiotics and prolonged corticosteroid therapy. The diagnosis of infection by Petriellidium boydii was established by pathological and microbiological studies of a specimen obtained at open lung biopsy. The portal of entry was probably through the lung spreading later via the blood stream to the brain, thyroid and kidneys. The present case once again emphasises the importance of specific microbiological identification in definitive diagnosis. To our knowledge, only three cases of disseminated petriellidiosis have been reported and this case appears to be the first case with renal involvement.

Adult↗