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Biomedical subjects

N Y Hsu

Publications and source records attributed to N Y Hsu.

35 records · Page 2Linked to original sources
PubMed1996

Oesophageal squamous cell carcinoma after gastrectomy for benign ulcer disease.

Of 684 patients treated for squamous cell carcinoma of the oesophagus in 1982-1993, 19 (2.8%) had previously undergone partial gastrectomy for benign ulcer disease. The average interval between gastrectomy and diagnosis of oesophageal carcinoma was 14 years. In six of the 19 (31.6%) cases the carcinoma was in the lower thoracic oesophagus, an incidence not significantly higher than the 25% in the total series. The oesophageal resectability rates were 52.6% in the gastrectomized patients and 44.4% in the total series (intergroup difference not significant). Of the ten gastrectomized patients who underwent oesophageal resection, only one had oesophagitis at the oesophagogastric junction, without significant histologic characteristics. The relationship between oesophageal squamous cell carcinoma and previous gastrectomy for benign ulcer disease may be incidental.

Adult↗
PubMed1996

Change of lower esophageal sphincter pressure in rabbits by Teflon injection.

BACKGROUND: The mechanically incompetent lower esophageal sphincter (LES) plays a key role in patients with gastroesophageal reflux disease. The purpose of the study was to assess the pressure changes of LES in rabbits by intraabdominal injection of Teflon paste (Polytetrafluoroethylene) at the gastroesophageal junction. METHODS: New Zealand white breed of rabbits were used in these studies. The anesthetized rabbit was injected with a 21-gauge needle and a syringe loaded with Teflon paste. The injection sites were around the gastroesophageal junction. LES pressure was measured by conventional methods using a water-filled infused system. The pressure gradient was measured immediately before and after the injection as well as by a weekly measurement over four weeks. The histologic characteristics of the injection sites were studied four weeks later. RESULTS: The mean pressure gradient of LES of twelve rabbits of immediate preinjection and post-injection was 29.71 +/- 8.10 mmHg and 37.58 +/- 10.69 mmHg (mean +/- S.D.), respectively (p value, 0.0329) Animals were followed upifor from one to four weeks, and were then sacrificed. The mean pressure gradient of LES of the twelve rabbits in the first week, the second week, the third week and the fourth week was 37.80 +/- 11.36 mmHG, 35.77 +/- 3.54 mmHg, 33.42 +/- 4.95 mmHg and 32.68 +/- 4.62 mmHg (mean +/- S.D.), respectively. Compared to pre-injection data, a significant difference was found in the first week and the second week (p value, 0.0342 and 0.0281, respectively). Gross examination of the gastroesophageal regions showed a welldefined Teflon mass of firm consistency at the site of the injection. Histological examination showed encapsulation of the implant by a thin layer of fibrous tissue and a benign foreign body granulomatous reaction with round cells surrounding the implant. CONCLUSIONS: It is technically feasible to produce experimentally pressure changes of LES in rabbits by intraabdominal injection of Teflon paste. Nevertheless, the clinical validity on patients with gastroesophageal reflux induced by the incompetence of LES remains to be verified.

Animals↗
PubMed1996

Detection of k-ras point mutations in codons 12 and 13 in non-small cell lung cancers.

Point mutations of the K-ras gene have been reported in a wide variety of human tumors. By using polymerase chain reaction followed by direct DNA sequencing, we screened for point mutations at codons 12 and 13 of the K-ras gene in specimens obtained from fresh frozen tumors in 38 patients with non-small cell lung cancers. Point mutations were detected in two of 38 (5.3%) resected non-small cell lung cancers. Both of them were G to T transversions. One patient was found to have a K-ras codon 13 point mutation (GGC to TGC, gly to cys), while the other had a codon 12 point mutation (GGT to GTT, gly to val). Based on the limited numbers in this study, we found that the frequency of K-ras point mutations in codons 12 and 13 among Asian patients with lung adenocarcinomas was lower than that detected among Caucasian patients.

Adult↗
PubMed1995

Overexpression of ribonucleotide reductase in transfected human KB cells increases their resistance to hydroxyurea: M2 but not M1 is sufficient to increase resistance to hydroxyurea in transfected cells.

Ribonucleotide reductase (RR) is a rate-limiting enzyme in DNA synthesis. The enzyme consists of two subunits, M1 and M2. Hydroxyurea (HU) is an M2-specific inhibitor. It has been shown that a HU-resistant clone derived from stepwise exposure to HU overexpresses the M2 mRNA and the RR protein (Y. Yen et al., Cancer Res., 54: 3868-3691, 1994). In this study, we established stable clones by transfecting human KB cells with the cDNA of human wild-type RR in which each subunit was overexpressed by a SV40 promoter. The mammalian cell expression vector ph beta APr-1 was used for constructing M1, M2, and M1/M2 subunit cDNA. The transfected cells were selected with G418. The clones designated M2-D, M1-D, X-D, and KB-V represent transfectant clones which contain M2 cDNA, M1 cDNA, M1/M2 cDNA, and vector alone, respectively. The parental KB cells and clones containing vector plasmid KB-V express equally low amounts of M2 and M1 mRNA from the endogenous genes. The expression of M2 mRNA and M1 mRNA is elevated 2-3 fold in the X-D transfectants. M2-D clone demonstrated a 6-fold higher M2 mRNA level although the M1 mRNA expression remains the same as parental cells. M1-D transfectants have a 3-fold increase in M1 mRNA expression relative to parental cells, but reveal no alteration of M2 mRNA. Southern analysis of genomic DNA suggested the incorporation of the plasmid into the genome. The X-D clone revealed both integration of the M2 and M1 gene while the M2-D clone only showed M2 gene integration. The M1-D clone revealed M1 gene integration relative to the parental cells. The Western blot of M2 protein showed a 3-fold increase in the X-D and M2-D clones whereas the M2 protein level in M1-D was the same as it was in parental cells. The M1 protein was increased 3-fold in X-D and 1.5-fold in M1-D over that of parental cells. However, lower M1 protein levels were identified in the M2-D clone. The specific activity of the RR enzyme from each transfectant showed a 3-fold increase in both the X-D and M2-D clones and slightly increased in M1-D clone over that of parental cells. However, X-D and M2-D both demonstrated a 3-fold increase in resistance to HU as compared to M1-D which showed the same sensitivity as the parental enzyme.(ABSTRACT TRUNCATED AT 400 WORDS)

Blotting, Southern↗
PubMed1995

Bronchioloalveolar carcinoma.

Bronchioloalveolar carcinoma is a subtype of adenocarcinoma of the lung with a relatively better prognosis. We reviewed the cases of 50 consecutive patients with bronchioloalveolar carcinoma treated during a 10-year period and attempted to analyze factors related to prognosis. During the 10-year study period, the prevalence of bronchioloalveolar carcinoma relative to adenocarcinoma of the lung remained steady. The subjects included 32 male and 18 female patients with mean ages of 64.7 years and 55.1 years, respectively (p = 0.0030). The preoperative radiographic findings included 40 cases of localized and 10 cases of diffuse bronchioloalveolar carcinoma. The clinicopathologic TNM staging included 20 patients with stage I cancer, 4 with stage II cancer, 11 with stage IIIa cancer, 3 with stage IIIb cancer, and 12 with stage IV cancer. Forty patients with clinical stage I, II, or III disease underwent operation (operability 80%). The resectability rate was 90% (36 of 40). Thirty-four procedures were considered as curative. The overall cumulative survival at 5 years was 22.2% (46.4% for stage I). Different TNM stages showed significant differences in survival time (p = 0.0001). The median survival times were 64.6 months for stage I, 48.0 months for stage II, 24.7 months for stage IIIa, 9.0 months for stage IIIb, and 4.5 months for stage IV disease. The median survival time for localized bronchioloalveolar carcinoma was 27.5 months, and the median survival time for diffuse bronchioloalveolar carcinoma was 4.3 months (p = 0.0002). The median survival time for the curative resection group was 30.6 months, and the median survival time for the noncurative resection or nonresection group was 5.8 months (p = 0.0001). On the basis of this study we conclude that (1) the prevalence of bronchioloalveolar carcinoma is quite steady, (2) bronchioloalveolar carcinoma presents at an earlier age in women, (3) bronchioloalveolar carcinoma frequently presents with lymphatic spread or systemic metastasis at diagnosis, (4) most localized bronchioloalveolar carcinomas are resectable and the prognosis with this type is better than that of the diffuse type, and (5) long-term survival correlates closely with initial roentgenographic appearance, TNM stage, and completeness of surgical resection.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed1994

Prediction of probability of pneumonectomy for lung cancer using Tc-99m MAA perfusion lung imaging.

Pulmonary perfusion scintigraphy with Tc-99m MAA was performed on 182 patients, on whom either pneumonectomy or lobectomy was performed, because of primary nonsmall-cell lung carcinoma. Among them, 76 underwent pneumonectomy, and 106 underwent lobectomy. The mean value of the perfusion fraction (PF) of the affected lung of the patients undergoing pneumonectomy was 32.3 +/- 13.6% (range, 4%-50%) and was less than that of the patients undergoing lobectomy, 43.5 +/- 4.5% (range, 27%-50%). The difference was statistically significant (t-test, t = 6.82; P < 0.001). Among the 28 patients whose PF of the affected lung was equal to or less than 30%, 26 underwent pneumonectomy and only 2 had a lobectomy. Among the 154 patients whose PF of the affected lung was more than 30%, 50 underwent pneumonectomy and 104 had a lobectomy. These result suggest that "30%" can be a cutoff value (Yates correction X(2) test, X2 = 33.09; P < 0.001).

Adult↗
PubMed1994

Thymic carcinoma. Ten years' experience in twenty patients.

Thymic carcinoma is a rare neoplasm with extremely poor prognosis. To evaluate the outcome of treatment in thymic carcinoma, we reviewed a 10-year (1982 to 1992) experience with 20 consecutive patients in Taichung Veterans General Hospital. There were 9 men and 11 women: ages ranged from 34 to 70 years old (mean 51.4 years). None of these patients had concomitant myasthenia gravis. All of the patients received surgical intervention, and the diagnosis was made by pathologic study. Postoperative staging was made according to the modified Masaoka staging system. None of our patients were in stage I. One patient (5%) had stage II disease, 12 (60%) stage III, and 7 (35%) stage IV. The pathologic subtypes of thymic carcinoma included eight squamous cell carcinomas, seven undifferentiated carcinomas, one lymphoepithelioma-like carcinoma, one clear-cell carcinoma, 1 mucoepidermoid carcinoma, and two carcinoid tumors. Curative resection could be done in seven patients (35%). The overall cumulative survival was 45.9% at 3 years and 34.4% at 5 years. The median survival times for patients with complete and incomplete resection were 39.0 months and 14.3 months, respectively (p = 0.1752). The median survival times of patients with postoperative radiotherapy and without postoperative radiotherapy were 39.3 months and 15.0 months, respectively (p = 0.0738). The median survival times of patients with squamous cell carcinoma and undifferentiated carcinoma were 25.4 months and 11.3 months, respectively (p = 0.1464). Our data show that complete resection, postoperative radiotherapy, and squamous cell carcinoma do not indicate a significantly favorable result, even though they result in longer median survival times. Yet a positive trend of favorable outcome in patients who received postoperative radiotherapy is ambiguously shown.

Adult↗
PubMed1993

Sclerosing hemangioma of the lung: a clinicopathologic study.

The clinical and pathological features of 11 cases with sclerosing hemangiomas of the lung seen between 1982, and 1992 were reviewed. There were 1 male and 10 female patients aged 15 to 74 years (mean age, 53 years) at operation. Among the 11, 4 were asymptomatic, with the tumor discovered only on routine chest roentgenograms. All 11 patients had a solitary tumor showing as a well-defined homogeneous round or oval shadow on chest x-rays. Microscopically, 8 of the 11 tumors consisted of a mixture of the four major patterns: hemorrhagic, sclerotic, papillary and solid. Five patients received enucleation; four, wedge resection; one, segmentectomy and one, lobectomy. Since this tumor is usually clinically benign and surgically curative, thoracotomy and complete removal of the tumor by limited resection is recommended.

Adolescent↗
PubMed1993

[Carcinosarcoma of the esophagus].

Carcinosarcoma of the esophagus is a rare neoplasm of the esophagus, composes both of carcinomatous and sarcomatous elements. From Oct. 1982 to Sept. 1991, there were 516 neoplasms of the esophagus, 2 (0.39%) carcinosarcoma, treated at our hospital. The first patient was a 62-year-old man, pathological stage III (T3N2M0). The second patient was a 68-year-old man, pathological stage I (T1N0M0). The tumors were polypoid and located at the middle portion of the esophagus. They had received subtotal esophagectomy, mediastinal lymph node dissection and cervical esophagogastrostomy, retrosternally. The first patient has still lived disease free for seven years. The second patient died one year after the operation due to intra-abdominal lymphadenopathy, liver metastasis and massive ascites. As epidermoid carcinoma, radical esophagectomy with lymph node dissection is the standard procedure for carcinosarcoma of the esophagus.

Aged↗
PubMed1993

Surgical management of intrathoracic goiter.

Thirty-three consecutive patients of intrathoracic goiters underwent resection at the TCVGH during a nine-year period 1982-1991. The mean age of 21 men and 12 women was 65 years. Six (18 per cent) had undergone prior thyroid surgery. Thirty-one of the 33 patients were euthyroid. Thirty patients underwent transcervical approach for resection; three had cervical incision plus median sternotomy. Pathological examination revealed multinodular goiter in 31 (94 per cent) and follicular carcinoma in two (6 per cent). The mean mass of goiter was 201.25 g and the mean greatest dimension was 10 cm. Thyroidectomy is advisable in all cases of intrathoracic goiter and resection can almost invariably be performed through a transcervical approach.

Adult↗
PubMed1991

Open-lung biopsy in patients with pulmonary infiltrate.

The application of open-lung biopsy to a patient with diffuse pulmonary infiltrate is dependent on whether it affords to a specific information and leads to a change in therapy. To evaluate the impact of open-lung biopsy on diagnosis and treatment of diffuse pulmonary infiltrates, we conducted a retrospective review of 37 patients undergoing this procedure during a 8-year period. There were 26 males and 11 females, at an average age of 53 years (ranging from 3 months to 79 years). Diagnostic yield was 97.2%, and biopsy yielded a specific diagnosis in 25(67.6%) patients and a change in therapy in 19 (51.4%) patients. Complications developed in 4 (11%) patients and the rate was higher under local anesthesia (3/4). Seven patients died, but no one was related to biopsy procedure. A specific diagnosis was obtained in 4 (50%) of the 8 immunocompromised patients, and a change in therapy occurred in 2 (25%) of these patients after biopsy, but these findings could not affect the survival rates. A specific diagnosis was obtained in 21 (72.4%) of the 29 nonimmunocompromised patients and a change in therapy occurred in 17 (58.6%) patients in this group. Five (83%) of 6 patients, who lacked definite tissue diagnosis by transbronchial biopsy, achieved confirmed diagnosis by open-lung biopsy. Open-lung biopsy in patients with a diffuse pulmonary infiltrate is an accurate diagnostic tool and frequently leads to a change in treatment. The procedure can be performed with acceptable morbidity and mortality in nonimmunocompromised patients, but should be used conservatively in immunocompromised patients.

Adult↗
PubMed1991

[Patterns of recurrence in resected non-small-cell lung cancer--emphasis on its relation to cell type and staging].

Pulmonary resection remains the most effective treatment for patients with non-small-cell lung cancer. The purpose of this study is to determine the incidence, pattern, and site of lung cancer recurrence in patients surviving resection for non-small-cell lung cancer. One hundred ninety-eight patients with post-surgical non-small-cell lung cancer were followed up from 6.5 to 0.5 years (median: 2.0 years). Recurrent cancer developed in 103 patients (52.0%). Nineteen cases had local recurrence (9.6%) and 84 (42.4%) were distant metastasis. The incidence of recurrence increased with TN status, but there was no significant difference (P = 0.451) in the overall rate of recurrent lung cancer among the various TN staging. The overall recurrent rate of non-squamous cell lung cancer was 57.4%, which was higher than 47.7% in squamous cell lung cancer. Still, it made no significant difference among the various cell types (P = 0.058). Distant metastasis occurred most commonly to the bone (22.7%), then the contralateral lung (12.6%). Curative resection with accurate staging, appropriate adjuvant therapeutic modality and continued periodic surveillance are necessary in all patients who overcome the initial carcinoma.

Adenocarcinoma↗
PubMed1990

Surgical management of spontaneous pneumothorax.

From 1982 to 1989, 293 patients with spontaneous pneumothorax were treated at VGHTC. There were 251 males and 42 females, aged 1-85 years, mean 49.3 years. The location of pneumothorax included right side 148 cases, left side 129 cases and bilateral 16 cases. The treatment included tube thoracostomy in 282 cases, thoracotomy abrasive pleurodesis in 39 cases, median sternotomy bilateral abrasive pleurodesis in 31 cases and chemical pleurodesis in 18 cases. Indications for pleurodesis included (1) recurrent pneumothorax (2) bilateral pneumothorax (3) persistent air leakage more than 7 days (4) massive air leakage (5) complications of pneumothorax. From our study, we concluded that: (1) The simplest management for spontaneous pneumothorax is tube thoracostomy. (2) In young adults or suspicious bilateral lesions, median sternotomy with bilateral abrasive pleurodesis is first choice of management for some special indications. (3) In aged patients or patients needing concomitant procedure for other pulmonary disease, thoracotomy abrasive pleurodesis is better choice. (4) When poor lung function and contraindicated to have an operation, chemical pleurodesis can also get some advantages.

Adult↗
PubMedDate not supplied

Detection of esophageal carcinoma using single-photon emission computed tomography of thallium-201: a preliminary report.

The aim of this preliminary study was to evaluate the potential usefulness of thallium-201 (Tl-201) in detecting esophageal carcinoma. A total of 15 patients with esophageal carcinoma were arranged for Tl-201 single-photon emission computed tomography (SPECT) of the chest. Thirteen of the patients had epidermoid carcinoma and two had adenocarcinoma. Meanwhile, 7 normal controls without any history of esophageal disease also accepted Tl-201 SPECT of the chest for comparison. From the 15 patients, Tl-201 chest SPECT detected esophageal carcinoma in 13 (86.7%) but not in 2 (13.3%) patients with epidermoid carcinoma. In contrast, all 7 normal controls (100.0%) had negative results of Tl-201 chest SPECT. Our study showed that the Tl-201 chest SPECT scan could be considered as a non-invasive useful imaging method in detection of esophageal carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

[Appendicitis in children: clinical observation in 88 surgical cases].

From February 1983 to December 1987, appendectomy was done in 106 children for the presumptive diagnosis of appendicitis with or without perforation at VGH-Taichung. Subsequent pathological findings confirmed suppurative appendicitis in 53 patients (48.1%), and perforated appendicitis in 37 patients (34.9%). There were 18 (17.0%) normal appendices. The age of patients ranged from 2 to 14 years, with an average of 8.9 years. Only 9.1% of the patients were under 5 years of age. The perforation rate was 62.5% in children under 5 years of age, and 59.4% in children 5 to 8 years old, both of them had a higher incidence than children over 8 years of age (27.1%, P less than 0.05). The mean duration of symptoms was 76.2 hours in children with perforated appendicitis, which was significantly longer than that in children with suppurative appendicitis (28.7 hrs, P less than 0.05). The use of triple combination of antibiotics in the treatment of perforated appendicitis has been proved to significantly decrease the incidence of postoperative wound complications. Early diagnosis, prompt surgical intervention, and recognition and treatment of residual septic foci were proved appropriate means of treatment of appendicitis.

Adolescent↗
PubMedDate not supplied

Benign partial epilepsy with centrotemporal spikes: analysis of 94 Chinese children.

From October 1982 to June 1992, 94 neurologically normal Chinese Children (50 males & 44 females) with benign partial epilepsy of childhood with centrotemporal spikes were studied among 1847 epileptic infants and children. Their ages at onset were between 3.6 and 12 years (a mean of 7.3 years). All of them had normal birth and developmental histories. Seven patients (7.5%) had past history of febrile convulsion and 12 cases (12.8%) had family history of epilepsy. The depicted seizure patterns were protean, but most attacks (83%) occurred during sleep (nocturnal & diurnal). The duration of active period and seizure frequency had no significant difference in terms of sex and treatment, but early-onset patients (< 7.3 years) had statistically significant longer duration of active period than that of late-onset group (p < 0.01). We recommend that antiepileptic drug treatment is not essential for this disease. Even if antiepileptic drug is used, the low-dosed carbamazepine is suggested.

Carbamazepine↗