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N H Chow

Publications and source records attributed to N H Chow.

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

Adenoma-carcinoma sequence: a reappraisal with immunohistochemical expression of ferritin.

To examine the biological significance of ferritin (FRN) expression, a retrospective immunohistochemical study was performed in normal colonic mucosae (n = 8), adenomas (n = 88), and colorectal carcinomas (n = 104). FRN was present in some epithelia in the crypt base of normal colonic mucosae. Significant cytoplasmic staining for FRN was revealed in 26 (29.5%) cases of adenoma and 54 cases (51.9%) of adenocarcinoma. The cancer cells had a higher proportion of FRN expression than those of adenomas or non-neoplastic mucosae (P < 0.001). Expression of FRN showed a positive association with the degree of dysplasia (P = 0.039) and the distal location of adenoma (P = 0.013). FRN expression tended to be associated with the tumor size (P = 0.083), but no substantial difference was observed among the histologic types of adenoma (P = 0.754). The results suggest that cytoplasmic FRN expression is associated with cellular proliferation. The proliferative index shows a significant difference through the adenoma-carcinoma sequence. Further investigation is necessary to clarify the clinical implication of FRN expression in tumor cells and normal-appearing mucosae.

Adenocarcinoma↗
PubMed1995

Suprahepatic gallbladder and right lobe anomaly of the liver in patients with biliary cancers.

The suprahepatic region is a rare ectopic location of the gallbladder. It usually combines with right lobe anomaly of the liver. Here we report two unusual cases of suprahepatic gallbladder with agenesis or hypogenesis of the right lobe of the liver and biliary cancer. A patient with a gallbladder tumor was admitted to our emergency room with acute cholecystitis and liver abscess. Imagining examinations and operation confirmed the suprahepatic position of gallbladder, agenesis of the right lobe, and dissemination of gallbladder cancer. In the patient with cholangiocarcinoma, CT scans and percutaneous transhepatic cholangiography documented the presence of a hilar tumor and hypogenesis of the right lobe. Both of these patients died from biliary tract cancer soon after operation.

Adult↗
PubMed1995

Toxic effects of cholelitholytic solvents on gallbladder and liver. A piglet model study.

We evaluated the toxic effects of four currently used chemolytic solvents--dimethyl sulfoxide (DMSO, 99%), ethyl propionate (EP, 99%), tetrasodium ethyl-dimethyl tetraacetate (4Na-EDTA, 2%, pH 11), and methyl tert-butyl ether (MTBE, purity = 99.5%) in an animal model. Each solvent was tested in nine farm piglets (Landrace), weighing between 20 and 25 kg. A solvent-resistant catheter was inserted transhepatically into the gallbladder (GB) using sonographic guidance 24 hr prior to each experiment. Seventy-five milliliters of each solvent was infused over 3 hr into the gallbladder. The following day, a laparotomy was performed in order to assess for possible damage to the liver, GB, bile ducts (BD), or intestines. The GB and liver were resected and their histology examined. The following pathologic grades were assigned to GB, BD, and liver specimens to describe the tissue damage: normal (0), mild (1), moderate (2), and severe (3). We found that DMSO had the highest score on gallbladder and bile duct injury (49, 3), followed by EP (36, 2), EDTA (14, 1) and MTBE (16, 0), respectively; the difference in gallbladder damage was statistically significant. Very mild hepatocyte damage was present in the DMSO (2) and MTBE (2) groups. The administration of EP and EDTA resulted in no liver injury at all. Piglets within each treatment group suffered from varying degrees of tissue injury. No deaths were attributed to the administered solvents. We concluded that DMSO, EP, EDTA, and MTBE do not have serious local toxic effect on the GB, BD, and intestine; nor do they lead to severe hepatotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Clinical significance of urinary ferritin excretion in patients with transitional cell carcinoma.

1. The serum ferritin level provides a valuable index of the body iron store. An increase in serum ferritin has often been observed in patients with neoplastic disease and correlates well with the stage of cancer. A few studies have suggested the potential of urinary ferritin as a marker for transitional cell carcinoma. The rationale of the measurement, however, has not been investigated in detail. 2. Urinary ferritin levels were evaluated in patients with diverse urological diseases to investigate their potential clinical implications. 3. Analysis of logarithmic transformed values (ng/mg creatinine) showed that patients with both neoplastic and non-neoplastic urological diseases had significantly higher ferritin levels than normal control subjects (P = 0.02). There was no apparent difference between subgroups of patients with urological disease (P > 0.5). For patients with urothelial carcinoma, univariate analysis revealed a strong positive relationship between urinary ferritin levels and the density of lymphoid cells in tumour stroma (P = 0.0001), while no important association was observed with tumour grade (P = 0.32), stage (P = 0.29) or urinary cytology detection (P = 0.33). Patients with muscle-invasive tumour had significantly higher ferritin levels than those with papillary, superficial cancer (P < 0.05). For patients with non-neoplastic urological disease (n = 19), urinary ferritin levels tend to correlate with the severity of tissue inflammation (P = 0.03). 4. The results suggest that urinary ferritin may reflect the degree of local inflammatory reaction in the urinary tract.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

The role of transrectal ultrasonography on the palpable and impalpable abnormal prostate.

Two hundred and three male patients underwent transrectal ultrasonography (TRUS) examination because of palpable nodule or hard consistency of the prostate. Of these, 56 of 65 (86.2%) digital rectal examination (DRE)-abnormal and 34 of 138 (24.6%) DRE-normal patients received transrectal sonoguided core needle biopsy. Among the DRE-abnormal patients, 18 (32.1%) had prostatic adenocarcinoma by biopsy with 2 additional patients who had initial negative biopsies eventually found to have cancer by transurethral resection of the prostate. In contrast, only 2 (5.9%) of 34 DRE-normal patients had cancers that were both hypoechoic and peripheral zone located. In 13 patients with transitional zone located lesions (hypoechoic 9, isoechoic 4), none had cancer. Of 27 patients who had normal DRE and unsuspected TRUS and received transurethral prostatectomy because of bladder outlet obstruction, 4 (14.8%) had cancer. In this study, hypoechoic lesions were found in 68 patients, among them 60 (88.2%) underwent biopsy but only 14 (23.3%) had cancer. From the results of this study, we concluded that TRUS can be a useful adjunct of DRE in detecting prostatic malignancy, especially when there has been an abnormal DRE, but its role on a digitally normal prostate requires further evaluation. Serum prostate-specific antigen can be an additional indicator to increase the prostate cancer detection rate.

Adenocarcinoma↗
PubMed1994

An assessment of immunoreactive epidermal growth factor in urine of patients with urological diseases.

To examine the excretion of urinary epidermal growth factor (EGF) in urological diseases and the relationship of EGF urine levels with transitional cell carcinoma (TCC), we measured the concentration of EGF by radioimmunoassay. The series comprised patients with active TCC (n = 52), others in tumor-free status (n = 29) and with non-neoplastic inflammatory diseases (n = 43), and normal controls (n = 50). Urinary EGF values were lower in patients with urological diseases of different etiologies than in normal controls (P < 0.005). Mean EGF levels of patients who had previous bladder tumor resection (n = 21) were not statistically different from normal controls (P = 0.2). For patients with active TCC, EGF urine levels showed a significant inverse relationship to increasing tumor grade (P = 0.02). In addition, subjects who had received nephrectomy for pelvic carcinoma (n = 8) showed significantly lower mean EGF values than those with intact kidneys (n = 21), irrespective of sex (P < 0.05). Immunostaining of EGF on non-neoplastic kidney (n = 9) revealed reactivity in the distal convoluted tubules and thick ascending limbs of Henle. Our results suggest that the kidney is the major source of urinary EGF. Its excretion in urine is decreased in both inflammatory and neoplastic diseases of the urinary tract. EGF may play an important part in the biological activity of TCC. Further study is indicated to investigate the monitoring of EGF urine levels as a marker of recurrence for EGF receptor-positive TCC.

Adult↗
PubMed1994

Near-diploid transitional cell carcinoma: a preliminary report.

DNA ploidy analysis has been accepted as an important prognostic factor for patients with transitional cell carcinoma (TCC). However, there was few information dealing with the clinical relevance of slightly aberrant DNA content by flow cytometry (FCM). Here we present five cases of near-diploid (ND) tumours, with DNA index (DI) varying from 0.92 to 1.14, obtained from a prospective study of fifty-one cases (9.8%). The frequency of ND tumours showed a tendency to decrease with increasing tumour stage. Higher fraction of tumour proliferation, defined by Ki-67 index, showed a steady increment from 3.4 to 23.5% with occurrence of gross chromosomal changes. In contrast, the expression of epidermal growth factor receptor (EGFR) decreased from 48.3 to 35.3% for diploid (n = 29) through aneuploid (n = 17) tumours. All three ND bladder cancers had recurrence of one to three times with median follow-up of 36 months. The incidences of tumour recurrence (60%) and cancer death (20%) in ND tumours were intermediate between the aneuploid and diploid TCCs. But, flow DNA analysis of paraffin-embedded ND tumours revealed wide and symmetrical G0/G1 peak with DI varying from 5.6 to 13.0. Our limited experience suggests the necessity of special treatment for G0/G1 peaks having CV values greater than 5.5% from paraffin-embedded urothelial carcinomas.

Aneuploidy↗
PubMed1994

Effects of chemoimmunotherapy with and without surgery in murine MBT-2 bladder tumor.

Using C3H/He JCr mice bearing the syngeneic MBT-2 bladder tumor, it was found that cyclophosphamide (CYC 100 mg/kg i.p.) treatment, 1 day before and 2 weeks after surgery, followed by postoperative autologous tumor vaccine immunization can be an effective adjuvant anticancer therapy. The short-term exogeneous addition of low dose Il-2 administration to the protocol provided no further benefit. Suppression of tumor growth was observed in a classical Winn assay when splenocytes were obtained on day 23 from mice receiving this effective adjuvant therapy with surgery on day 8. Splenocytes from tumor-bearing mice (TBM) treated with CYC were augmented in terms of their proliferative response to concanavalin A during the first 2 weeks after CYC treatment. Studies using 3-day TBM established that significant suppression of tumor growth and prolonged survivals were dependent upon CYC treatment being combined with tumor vaccine and/or interleukin-2; single agent treatments were ineffective.

Animals↗
PubMed1994

Urinary cytodiagnosis: can it have a different prognostic implication than a diagnostic test?

In order to assess the clinical implications of the cytology of voided urine we analyzed 65 patients among 147 cases of transitional cell carcinoma (TCC) in relation to the cytohistologic correlation and prognostic significance. Urinary cytology detected 42.6% of bladder tumors, 59% of renal pelvic tumors, and 35.3% of ureteral carcinomas. None of the 3 cases of grade-1 upper urinary tract tumors was detected by preoperative urinary cytology. Tumors with positive cytology were associated with epidermal growth factor receptor expression (p = 0.0009) and a higher fraction of tumor proliferation as defined by Ki-67 immunohistochemistry (p = 0.0038). Anaplastic tumor cells in urine correlated fairly well with muscular invasion (p = 0.018) and the DNA aneuploidy of the tumor (p = 0.0038). Tumors with muscular invasion were more likely to be detected by cytologic examination (p = 0.013). In urinary bladder carcinoma (n = 107), patients with positive cytology had a higher incidence of tumor recurrence (p = 0.004), and had an unfavorable prognosis (p = 0.0001) with a median follow-up of 46 months. In Ta-T1 tumors (n = 87), urinary cytology had prognostic value in terms of risk of recurrence (p = 0.0001), and poor patient outcome (p = 0.0001). Our data suggest that urinary cytology can offer important biological information on TCC and may be used as a simple and effective short-term prognostic indicator.

Adult↗
PubMed1994

Hepatitis B and hepatitis C virus infection among chronic alcoholic patients with liver disease in Taiwan.

The prevalence of the anti-hepatitis C virus (anti-HCV) antibody and hepatitis B surface antigen (HBsAg) among 123 alcoholic patients with liver disease from our hospital and 44 alcoholic subjects from the local community was evaluated. By radio-immunoassay HBsAg was detected in 30.1% of alcoholic patients with liver disease, compared with 11.4% of alcoholic subjects from the local community (p < 0.05). The prevalence of HBsAg was 40.7% (11/27) in patients with cirrhosis and hepatocellular carcinoma (HCC), 31.5% (17/54) in patients with cirrhosis only, and 29.4% (5/17) in patients with other liver diseases. By enzyme-linked immunosorbent assay, anti-HCV antibody was detected in 30.9% of alcoholic patients with liver disease, compared with 2.3% of alcoholic subjects from the local community (p < 0.0005). The prevalence of anti-HCV antibody was 44.4% in alcoholic patients with cirrhosis and HCC, 29.6% in alcoholic patients with cirrhosis only, and 17.6% in alcoholic patients with other liver diseases. As the degree of liver damage advanced, the prevalence of either HBsAg or anti-HCV antibody, or both, being detected in these alcoholic patients increased significantly (p < 0.05). The serum ALT level was higher among alcoholic patients who had either HBsAg or anti-HCV antibody than those having neither (151 +/- 204 vs 62 +/- 47 IU/L; p < 0.005). All three alcoholic patients with chronic hepatitis had positive HBsAg or anti-HCV antibody. Histologic findings, except cells within sinusoids, were comparable between the alcoholic patients with or without superimposed hepatitis viruses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Papillary cystic tumor of the pancreas: a case indistinguishable from oncocytic carcinoma.

A case of papillary cystic tumor (PCT) of the pancreas in a 55-year-old woman is described. She presented with a gradually enlarging and painless abdominal mass for > 26 years. The tumor was encapsulated and measured 16 x 12 x 10 cm. The gross features and conventional light microscopic appearance of this tumor were consistent with the previously reported cases of PCT. Perineural and capsular invasions were found. In addition to the densely packed blue granules in the cytoplasm demonstrated by phosphotungstic acid-hematoxylin stain, ultrastructural study revealed the tumor cells to be packed with numerous mitochondria. These oncocytes comprised almost all the non-necrotic tumor areas. Therefore, this case was indistinguishable pathologically from oncocytic carcinoma of the pancreas. DNA flow cytometry showed a diploid pattern and low S phase fraction, indicating that the tumor has a low proliferative activity and a favorable prognosis.

Cell Cycle↗
PubMed1993

Reappraisal of the biological role of epidermal growth factor receptor in transitional cell carcinoma.

Retrospective immunohistochemical and flow cytometric DNA analyses were performed on 56 cases of transitional cell carcinoma (TCC) to examine the biologic implications of epidermal growth factor receptor (EGFR) expression. A total of 28 (50%) cases were reactive for EGFR immunostaining. The receptor expression increased from 41.7 to 56.3% with tumor stage. There was a significant association between EGFR expression and tumor stage (p < 0.0005), but not tumor grade. The flow DNA content and the Ki-67 proliferating index had no relation to the status of EGFR (p = 1, respectively). For those receptor-positive tumors (n = 28), there was a significant association (p < 0.0001) between receptor expression and tumor proliferation. Interestingly, the DNA content was not correlated with EGFR expression (p = 0.69). We support the possible role of EGFR in cell proliferation and the potential significance for tumor growth in TCCs. However, the biology of TCC in half the cases could not be explained by this mechanism. The interaction between EGFR and DNA ploidy status necessitates further evaluation.

Adult↗
PubMed1992

[Parathyroid storm: report of two cases].

Parathyroid storm in patients with primary hyperparathyroidism has previously been described as hyperparathyroid crisis, parathyroid intoxication or acute hyperparathyroidism. Whatever the nomenclature, all emphasize the severity and urgency of this disease entity. Although fewer than 200 cases have been described since the first report by Dawson in 1932, it is generally agreed that parathyroid storm is more prevalent than commonly appreciated. The symptoms and signs of the syndrome are not only due to the hypercalcemia, but also to the toxic effects of the parathyroid hormone (PTH). Its wide, but nonspecific clinical presentations make it easily confused with other cardiovascular or renal diseases. The mortality rate in untreated cases of parathyroid storm is essentially 100%. With combined medical-surgical treatment, it is still reported to be as high as 40%. Two patients with parathyroid storm were encountered at our institute recently, they both presented with severe hypercalcemia, consciousness disturbance and acute renal failure. The serum level of the intact form of PTH (iPTH) in both patients was greater than 1,000 pg/mL. Case 1, a 63-year-old female, presented with hypercalcemic crisis. Initially, good responsiveness to a saline infusion, steroids and furosemide administration was noted. Unfortunately, she became comatous after fine-needle aspiration of the parathyroid tumor. The recurrent storm was refractory to medical therapy, but was treated successfully by surgical removal of the single adenoma. This is a rare reported case regarding a hyperparathyroid storm after fine-needle aspiration of a parathyroid adenoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1992

Caroli's disease and congenital hepatic fibrosis associated with polycystic kidney disease. A case presenting with acute focal bacterial nephritis.

Congenital cystic dilatation of the intrahepatic biliary ducts (Caroli's disease), until recently, has been infrequently recognized. It is often associated with autosomal recessive polycystic kidney disease (ARPKD) and congenital hepatic fibrosis (CHF). We hereby report a case with Caroli's disease, polycystic kidney disease (PKD), and CHF: This 24-year-old female patient initially presented with acute bacterial nephritis (ABN). Renal ultrasonography revealed bilateral enlarged kidneys with multiple cysts. Because her parents showed no renal cyst on ultrasonographic examination, she received further studies. Abdominal ultrasonography showed cystic dilatation of the biliary tree. Computed tomography (CT) with meglumine lotroxinate (biliscopin) infusion study and hepatobiliary scintigraphy confirmed the diagnosis of Caroli's disease. Liver biopsy revealed CHF: The radiographic and scintigraphic pictures are hereby illustrated and CT with biliscopin infusion study is emphasized. We conclude that if radiologic evidence of renal cystic lesions is absent in the parents of patients with PKD, the coexistence of Caroli's disease and CHF should be considered. The clinical pictures of ABN in this patient are also discussed. As far as we know, this is the first reported case of ABN in a patient with PKD and Caroli's disease, and it showed good response to antibiotic therapy.

Adult↗
PubMed1991

Tissue culture, DNA flow cytometric and cytogenetic studies of a giant cell tumor of bone.

An in vitro tissue culture was established using a giant cell bone tumor derived from a 66-year-old female. The tumor was clinically classified as stage 2, and grade 1 histologically. Morphological observations including, in vitro growth character, histochemical and immunohistochemical staining, and ultrastructural studies, support that the giant cell originated from the mononucleated stromal cell. They do not belong to the monocyte-macrophage system. In this aggressive case, we also tried to evaluate the significance of using DNA ploidy flow cytometry, and chromosomal study in predicting its clinical outcome. The DNA ploidies of both the primary and cultured tumor cells were diploid. The chromosomal analyses revealed its chromosome number ranging from 43 to 46 with three clonal structural changes; dic (19;20) (p13;q13), dic (19;22) (q13;q13) and dic (12;?) (p13;?). As previously compared and reported, cases with marker chromosomes usually had a more aggressive clinical course than those without marker chromosomes. Instability of the terminal portion of the F- and G- chromosome groups were reported in other studies and were also detected in our case. Possible association of clinical aggressiveness with the clonal structural changes, especially dic (19;20) (p;q) and dic (19;22) (q;q), needed further investigation.

Aged↗
PubMedDate not supplied

A clinical study of 130 patients with biliary tract cancers and periampullary tumors.

A retrospective review of 130 patients with peripheral-type cholangiocarcinomas (PTCC), hilar-type cholangiocarcinomas (HTCC), extrahepatic cholangiocarcinomas (EHCC), gallbladder cancers (GBCA), and periampullary cancers (PACA), seen at National Cheng Kung University Hospital and Tainan Municipal Hospital from June 1987 to July 1993 was performed. There were 47 (36%) HTCC, 32 (25%) PACA, 24 (19%) PTCC, 17 (13%) GBCA, and 10 (8%) EHCC patients. The distribution is completely different from that reported in western countries. These cancers mainly occur in elderly patients. HTCC and GBCA were predominantly noted in female patients. Biliary cancers in Taiwan were not related to liver fluke infestation, inflammatory bowel disease or hepatitis B virus infection. However, a close association with biliary lithiasis was found. The incidence of gallstones was 67, 39, 20, 29 and 19% for PTCC, HTCC, EHCC, GBCA and PACA, respectively. The most common presentation for PTCC and GBCA was abdominal pain, or jaundice for HTCC, EHCC and PACA. These symptoms correlate well with the location of the tumors. Among serum tumor markers, the elevation of CA19-9 was most frequent, occurring in 86% of the patients while CA125 and CEA occurred in 47% and 30% of the patients, respectively. During the course of disease, infection developed in 61% of the patients and was the main cause of death in 25%. Biliary tract infection and sepsis were the two leading manifestations and occurred in 49% and 32% of the patients, respectively. Overall survival was poor except in patients whose tumor could be completely resected.

Adult↗
PubMedDate not supplied

The role of bcl-2 in the progression of the colorectal adenoma-carcinoma sequence.

BACKGROUND: The bcl-2 proto-oncogene is a known inhibitor of apoptosis that may allow the accumulation and propagation of cells containing genetic alterations. METHODS: An immunohistochemical study was performed to examine the role of BCL-2 protein expression in normal colonic mucosa, adenoma, and adenocarcinoma. RESULTS: BCL-2 was present in the crypt base of normal mucosal glands, while diffuse expression of protein product was observed in 69 cases (65.1%) of adenoma and 29 cases (60%) of adenocarcinoma (p > 0.5). A diffuse expression pattern was often noted in adenomas of the tubular type, solitary lesions, small lesions (< 1 cm), and those with mild glandular dysplasia (p < 0.05, respectively). There was, however, no apparent difference as to location, Yamada type of gross appearance, and gender of patients (p > 0.05, respectively). Patterns of BCL-2 expression did not correlate with the biologic indicators of adenocarcinoma (p > 0.1, respectively). CONCLUSIONS: Our results support that bcl-2 may play an important role in the early stage of the adenoma-carcinoma sequence. Down-regulation of bcl-2 is associated with the risk of malignant transformation for colorectal adenoma.

Adenocarcinoma↗