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Biomedical subjects

R H Hu

Publications and source records attributed to R H Hu.

50 records · Page 3Linked to original sources
PubMed1992

Calorimetric study of thermal denaturation of type I human placenta collagen.

The thermal denaturations of type I human placenta collagen were studied in different aqueous solutions in the temperature range from 274 to 345 K by differential scanning calorimetry. The thermodynamic parameters of denaturational process were accurately. The average temperature of denaturation of the collagen Td is 47.1 degrees C, and the denaturational enthalpy delta Hd is 8.43 kJ per mole of residue in salt-free aqueous solution at pH 3.7. The linear relationship of delta Hd with Td has been obtained for the various collagens studied. The various factors concerning the stabilization of collagen structure of the Sigma collagen have been demonstrated. The dominant factors are hydrogen bonding and the participation of water molecules in the collagen structure. It is concluded from the thermodynamic evidence obtained that the water-carbonyl model is preferable to other models. By means of calculating the van't Hoff enthalpy of the collagen denaturation, the number and the size of cooperative blocks of the Sigma collagen have been evaluated. Its molecule contains five cooperative blocks, each having 600 residues or so. The type I human placenta collagen is a multi-domain protein.

Calorimetry, Differential Scanning↗
PubMed1992

Lymphokinetic monitoring of a liver transplant recipient treated with OKT3.

Orthotopic liver transplantation was performed on a 48-year-old female patient with end-stage liver disease due to primary biliary cirrhosis. A course of OKT3 (5 mg/kg intravenously for 14 days) was given as immunosuppressive therapy. Lymphocyte population, T lymphocyte subsets and the lymphokine level in the peripheral blood were serially measured. Total T cells disappeared in the peripheral circulation within 10 minutes after an injection of OKT3. Helper T cells and suppressor T cells were also suppressed during the course of treatment. The ratio of T4/T8 declined from 2.5 to around 1.3. The serum interleukin-2 and the interleukin-2 receptor did not change markedly during treatment. The serum neopterin level increased after discontinuation of OKT3. The anti-mouse OKT3 antibody increased after the ninth day of OKT3 treatment. OKT3 showed potent T cell suppressive activity.

Female↗
PubMed1992

Serum interleukin-2 and soluble interleukin-2 receptor in renal transplant recipients.

Interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R), released during T-lymphocyte activation, were measured in serial samples of serum from 32 patients with renal allografts and other uremic patients. Patients undergoing chronic hemodialysis had elevated sIL-2R levels (1,801.93 +/- 753.23 U/mL) which dropped after stable renal transplantation (822 +/- 438 u/mL). However, these values were higher than those of a normal control group (397.3 +/- 84.5 u/mL, p < 0.01). Marked elevation of sIL-2R (1,503.78 +/- 640 u/mL) was noted in patients with acute rejection episodes compared to those in a stable allograft condition (p < 0.02) and those with cyclosporine nephrotoxicity (793.2 +/- 245.2 u/mL, p < 0.01), but returned to a stable level after successful anti-rejection treatment (745.91 +/- 345.8 u/mL, p < 0.01). Acute tubular necrosis and infection also showed a comparable rise in the sIL-2R level. The increase in sIL-2R with rejection was found one to four days earlier than the clinical diagnosis of acute rejection. There was a marked rise in the serum IL-2 level of uremic and post-transplant patients when compared to normal subjects (34.76 +/- 32.16 u/mL and 9.3 +/- 12.7 u/mL vs 4.38 +/- 3.38 u/mL, p < 0.001), but no significant differences were found between the IL-2 level of patients with acute rejection and cyclosporine nephrotoxicity or acute tubular necrosis (3.74 +/- 4.51 u/mL, 1.57 +/- 1.25 u/mL and 6.73 +/- 6.3 u/mL, p > 0.05). The diagnostic value of sIL-2R assay was more meaningful than that of IL-2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Monitoring of serum neopterin in renal transplant recipients.

Postoperative management of kidney allograft recipients requires a reliable and rapid diagnostic method so that proper therapy can be initiated. In this study, we tried to correlate serum neopterin levels with different conditions after transplantation. Serial serum neopterin levels were assessed after operation. Serum neopterin levels of uremic patients were significantly higher than those of healthy persons (239.9 +/- 177.7 nmole/L, n = 33 vs 6.14 +/- 2.78 nmole/L, n = 10, p < 0.001). In recipients with a stable post-transplant course, the serum neopterin level was low. On the contrary, acute rejection episodes were associated with a high level of serum neopterin which declined after successful treatment, although the difference was not significant (96.2 +/- 57.7 nmole/L vs 56 +/- 38.1 nmole/L, p > 0.05). The serum neopterin level was also high in post-transplant acute tubular necrosis (ATN, 256.6 nmole/L), which gradually declined parallel to the resolution of ATN. The neopterin level was low in patients with cyclosporine nephrotoxicity (17.8 +/- 7.6 nmole/L). In summary, the serum neopterin levels were persistently high in uremic and post-transplant ATN patients. Acute rejection episodes were correlated with an increased level of neopterin. It appears that daily measurement of the serum neopterin level may be useful for biochemical detection of immunologic complications in allograft recipients.

Adult↗
PubMed1991

Clinical manifestations of acute rejection in renal allograft recipients receiving cyclosporin-A therapy.

Cyclosporin-A-treated renal allograft recipients have demonstrated an improved graft survival rate, when compared to that of patients treated with conventional azathioprine and steroid therapy. Cyclosporin-A has been used for immunosuppressive therapy after renal transplantation at the National Taiwan University Hospital since November 1985. Since then, the one-year graft survival rate has been 78%, and the patient survival rate is 91%. At our service, acute rejection is confirmed mainly by an increase in the serum creatinine level of 0.5 mg% per day and a subsequent return of kidney function to normal after pulse steroid therapy. Twenty patients receiving cyclosporin-A and suffering from acute rejection episodes were chosen for comparison with 18 patients receiving conventional azathioprine and steroid therapy. Compared to conventional therapy, the classical systemic manifestations of rejection, such as malaise, lethargy, apathy, general weakness, vague discomfort, increase in body weight, swelling of graft with tenderness, were all more mild and less frequent in the cyclosporin-A-treated group. Episodes of rejection appeared earlier and the duration of rejection was shorter than in those of the conventional group. The urinary sodium concentration and the ratio of urine urea nitrogen to blood urea nitrogen were reliable references during the acute rejection episode in the conventional group, but it cannot be used as indices in the cyclosporine group. These findings can help us understand the changes which occurred in acute rejection in patients who receive renal transplantation during the cyclosporine era.

Adult↗
PubMed1991

The outcome of delayed graft function in cadaveric renal transplants treated with low dose cyclosporine.

Thirty-three consecutive cadaveric renal transplantations performed at the National Taiwan University Hospital from November 1985 to December 1989 were reviewed to determine the effect of early function on the 1-year patient and graft survival rates. Immediate function was present in 17 transplants; delayed graft function with acute tubular necrosis occurred in 16 cases. The 16 transplants with acute tubular necrosis (ATN) were treated with low dose cyclosporine. Among them, 13 patients had delayed function which resolved after 2 to 60 days of hemodialysis, but 3 grafts did not regain function. The allograft survival rate at 1-year was 68.7% for the delayed function group and 88.2% for the immediate function group. This difference was not statistically significant (p greater than 0.05). The 1-year patient survival rate was also not significantly different (87.5% vs 88.2%). There was no relationship between graft loss and duration of ATN. However, the graft survival rate in patients with a serum creatinine level below 2 mg/dL, after recovery either from ATN or non-ATN, was better than that for patients with a serum creatinine level of more than 2 mg/dL. The difference was statistically significant (95.8% vs 50.0%, p less than 0.02). It is concluded that delayed allograft function with acute tubular necrosis does not significantly alter the 1-year survival rates of patients and grafts in low-dose cyclosporine therapy. However, it is deleterious to the 1-year survival rate of an allograft when poor functional recovery occurs in an ATN or non-ATN condition.

Adult↗
PubMed1991

Lymphocele after renal transplantation: a case report.

A case of lymphocele after an allograft renal transplant at the National Taiwan University Hospital is reported. A 32-year-old female patient received a kidney transplant from a cadaver donor on 23 November 1990 after a 10-year course of hemodialysis. Acute tubular necrosis of 31 days duration developed on the 6th postoperative day after a severe episode of acute rejection. On the 44th POD, sonographic examination showed an echo-free space between the graft and the urinary bladder. Emergent marsupialization through an intraperitoneal window of the lymphocele was performed on the 45th POD due to a sudden decrease in urine output. After releasing the compression of the lymphocele, the urine output returned to over 2,500 mL on the following day. The patient was discharged on the 63rd POD with normal renal function. Repeated sonographic examination showed no reaccumulation of lymphocele. The literature concerning lymphocele is reviewed.

Adult↗
PubMedDate not supplied

Serum hepatocyte growth factor before and after resection for hepatocellular carcinoma.

BACKGROUND/AIMS: Hepatocyte growth factor (HGF) is the most potent hepatocyte proliferation stimulator. Serum HGF levels are high in various liver disease states such as cirrhosis, hepatocellular carcinoma (HCC) and hepatitis. But the role HGF plays in HCC is not clear at present. The purposes of this study are: 1) to reveal the HGF profile pre- and post-HCC resection, which has not been well-described before; and, 2) to analyze the relationships between the pre- and post-operative HGF levels and various clinical parameters. METHODOLOGY: We performed a retrospective cohort study to check the HGF profiles before and after curative resections for HCC and to analyze the relationships between them by using clinical parameters from 35 consecutive patients at the Department of Surgery, National Taiwan University Hospital. Blood samples collected from another 23 healthy individuals admitted for health check-ups were used as normal controls. Serum HGF was determined with an ELISA kit. RESULTS: The baseline HGF concentration in HCC patients was significantly higher than that in normal controls (1743+/-73 vs. 948+/-54 pg/ml, p<0.0001). The HGF concentrations on post-operative days (POD) 1, 3, 5, 7, and 14 were all significantly higher than those seen in normal controls (all p less than 0.0001). The first and third POD HGF values were significantly higher than the pre-operative level (p=0.00135 and 0.00187 respectively). The HGF concentrations would return to the pre-operative level on the fifth POD, but they never returned to normal level at the end of the two-week study. The pre-operative HGF level was affected by patient age (p=0.0236), and the post-operative peak HGF level was positively correlated with the pre-operative indocyanin green retention rate (ICGR15) and GOT level (p=0.0320 and 0.0234 respectively). CONCLUSIONS: In this study, we proved, indirectly, that HGF was not secreted by the HCC tumor cells per se. The peak post-operative HGF level reflected the relative stress of the operation on the diseased liver, but did not reflect the absolute physical extent of liver resection. The relationships between HGF and the prognosis of the patients after HCC resection demands further investigation.

Adult↗
PubMedDate not supplied

Salvaging procedures for dysfunctional peritoneovenous shunt.

BACKGROUND/AIMS: Peritoneovenous shunt is one of the treatments for refractory ascites. However, the dysfunction of the shunt is frequently seen and needs further management. We in this manuscript reported our experience in the salvaging procedures of dysfunctional peritoneovenous shunt. METHODOLOGY: A total of 29 Denver shunts were constructed for the management of refractory ascites at the Department of Surgery, National Taiwan University Hospital since January 1992 to February 1999. A cross-sectional case study was performed. RESULTS: There was a total of 20 cases of mechanical dysfunction for these 29 patients. In the management of 6 peritoneal catheter occlusions which occurred in the early phase of this series, revision was performed by lengthening of the peritoneal catheter with a peritoneal dialysis catheter so that the catheter tip could rest in the Douglas pouch. The same procedure was adopted in the last 14 consecutive Denver shunts and this significantly decreased the incidence of peritoneal catheter occlusion (6/15 vs. 0/14, P = 0.011 by Fisher's exact test). In the 6 episodes of valve occlusion, the reservoir of the Denver shunt was replaced with a new one but the peritoneal and venous catheters were not changed. In the 8 episodes of venous catheter dysfunction, two venous catheters slipping out were managed by lengthening the catheter with a large-bore Hickmann catheter. In the other 6 episodes, a new venous catheter was inserted to the other side of the internal jugular vein or saphenous vein through a subcutaneous tunnel and the catheter was connected to the reservoir with a connector. CONCLUSIONS: Although peritoneovenous shunt did not prolong the life expectancy of the patients with decompensated liver cirrhosis, it did relieve tense ascites rapidly and improve the quality of life remarkably. The modifications and salvaging procedures we used in our series could restore a dysfunctional Denver shunt easier, safer and with a higher cost-saving than a total revision of the shunt.

Adolescent↗