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Biomedical subjects

S H Kuo

Publications and source records attributed to S H Kuo.

At least 37 records · Page 2Linked to original sources
PubMed1999

Tuberculous pleurisy with effusion.

To assess the clinical features of Taiwanese patients with tuberculous pleurisy and their response to treatment, we analyzed the records of patients treated for this condition from December 1990 through November 1995, at a regional 100-bed referral center for tuberculosis care. Diagnosis of tuberculous pleurisy was based on histologic evidence of caseating granulomatous inflammation in the pleural biopsy specimen, or evidence of mycobacteria in pleural fluid. Patients were also stratified on the basis of parenchymal involvement. Ninety-seven patients (79 men, 18 women) with a mean age of 47.5 (range, 15-90) years were included in the analysis. The two major symptoms were cough (69%) and shortness of breath (57%). Chest roentgenographs showed that the pleural effusion was unilateral in 88 (91%) patients, and small to moderate in amount in 74 (76%). Laboratory analysis of the pleural fluid showed moderate levels of glucose (4.6 mmol/L), with no significant difference between patients with and without parenchymal involvement. The levels of lactate dehydrogenase and triglycerides were significantly higher in patients with parenchymal involvement (172 vs 240.5 IU and 0.36 vs 0.45 mmol/L, respectively). In 85 of 93 patients (91%) with available data, lymphocytes were predominant in the differential count. All patients had received short-course chemotherapy for at least 6 months. After excluding the defaulters and patients receiving subsequent management in other hospitals, the overall rate of successful treatment was 97% (72/74). There was no significant difference in the treatment outcome between patients with parenchymal involvement and those without. None of the successfully treated patients had a relapse within a mean follow-up period of 31.7 +/- 18.4 months. We conclude that current patients with tuberculous pleurisy in Taiwan are not young, and short-course chemotherapy with isoniazid, ethambutol, rifampicin, and pyrazinamide is an effective treatment. The presence of parenchymal tuberculous lesions does not appear to influence the treatment outcome.

Adolescent↗
PubMed1998

Interferon treatment for corneolimbal squamous dysplasia.

PURPOSE: To report a patient with corneolimbal squamous dysplasia successfully treated with interferon therapy. METHODS: A 78-year-old man had a gelatinous and vascularized lesion involving the left cornea and adjacent limbus. Impression cytology studied with periodic acid--Schiff-hematoxylin stain disclosed severe squamous dysplasia. Topical instillation and subconjunctival injection of interferon alpha-2b was instituted. RESULTS: The gelatinous tumor mass involving the cornea and adjacent limbus completely resolved 2 months after interferon treatment. He showed no sign of recurrence during the 10-month follow-up. CONCLUSION: Interferon therapy may be a therapeutic alternative for treating corneolimbal squamous dysplasia.

Aged↗
PubMed1998

Tumour-infiltrating lymphocytes in non-small cell lung cancer are activated T lymphocytes.

This study was carried out in order to investigate the local immune reaction of tumour-infiltrating lymphocytes (TILs) in the primary tumours of non-small cell lung carcinomas. Thirty non-small cell lung cancer (NSCLC) patients were included. The tumour tissue was taken at thoracotomy and monocellular suspension of the tumour was obtained by mechanical disaggregation. Dual-coloured flow cytometric analysis of TILs and their corresponding peripheral blood lymphocytes (PBLs) was performed. Tumour-infiltrating lymphocytes contained significantly higher proportions of CD3(+) T lymphocytes and CD8(+) T lymphocytes than the corresponding PBLs (82.0%+/-13.9% vs 66.3%+/-10.6% for CD3, P<0.001; 39.0%+/-18.4% vs 26.4%+/-5.2% for CD8, P<0.001). Tumour-infiltrating lymphocytes contained significantly higher proportions of activated memory lymphocytes than PBLs did (9.8%+/-8.6% vs 1.3%+/-1.5% for CD25, P<0.001; 40.5%+/-30.2% vs 10.2%+/-14.8% for CD71, P<0.001; 75.5%+/-11.9% vs 28.6%+/-9.8% for HLA-DR, P<0.001). These findings were also found in both CD4(+) TILs and CD8(+) TILs. The TILs of NSCLC contained higher proportions of T lymphocytes and CD8(+) lymphocytes than their corresponding peripheral bloods. The proportions of activated memory lymphocytes were also significantly higher in the TILs, both in CD4(+) TILs and CD8(+) TILs, than the corresponding PBLs.

Adult↗
PubMed1998

Diagnosis of pulmonary arteriovenous malformations by colour Doppler ultrasound and amplitude ultrasound angiography.

BACKGROUND: The clinical value of colour Doppler ultrasound and amplitude ultrasound angiography in the diagnosis and follow up of pulmonary arteriovenous malformations (PAVM) was investigated. METHODS: Six consecutive patients suspected by clinical appearance and abnormal chest radiographic findings of having PAVM were included in the study. Ultrasonography was performed first by real time grey scale imaging then by colour Doppler imaging and amplitude ultrasound angiography in a random order. All were later proved by angiography to have PAVM. RESULTS: The ultrasound study was successfully performed in all six patients. A total of eight lesions was detected. The real time grey scale image of PAVM revealed well defined hypoechoic subpleural nodules with strong posterior acoustic enhancement. Colour Doppler ultrasound of PAVM showed turbulent flow, manifest as an area of intense colour with high and mixed velocities (reticulated or mosaiclike pattern). Anatomical continuity was demonstrated in some PAVM. Amplitude ultrasound angiography can delineate a tangled vascular structure with a clear vessel wall and anatomical continuity as well as conventional angiography. Spectral wave analysis showed a relatively low impedance flow presenting with high peak systolic velocity (mean 44.4 cm/s) and relatively high diastolic velocity (mean 19.3 cm/s). The mean pulsatility index (PI) and resistive index (RI) were 1.80 and 0.49, respectively. In two patients who received embolotherapy the colour Doppler ultrasound scan obtained after the procedure showed that the previous focal areas of colour flow signals disappeared or diminished in size. This was compatible with the decrease in, or absence of, blood flow demonstrated by angiography after embolotherapy. CONCLUSIONS: Combined colour Doppler ultrasound and amplitude ultrasound angiography are useful non-invasive techniques for diagnosis PAVM and provide an alternative approach to angiography in evaluating the efficacy of embolotherapy.

Adolescent↗
PubMed1998

PKC activation is required by EGF-stimulated Na(+)-H+ exchanger in human pleural mesothelial cells.

Epidermal growth factor (EGF) stimulates the Na(+)-H+ exchanger, leading to enhanced cell proliferation. In human pleural mesothelial cells (PMCs), the intracellular signaling mechanism mediating the EGF-induced stimulation of the Na(+)-H+ exchanger has not yet been identified. Using a pH-sensitive fluorescent probe, 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein, to measure changes in intracellular pH (pHi), we found that 1) EGF and 12-O-tetradecanoylphorbol 13-acetate (TPA; a phorbol ester) both stimulate the ethylisopropyl amiloride-sensitive Na(+)-H+ exchanger; 2) TPA-induced alkalosis can be blocked by protein kinase C (PKC) inhibitors (chelerythrine and staurosporine) or by PKC down-regulation, indicating that PKC activation is involved in the stimulation of the Na(+)-H+ exchanger. However, TPA-induced alkalosis is not blocked by tyrosine kinase inhibitors; and 3) the stimulatory effect of EGF on the Na(+)-H+ exchanger acts via stimulation of tyrosine kinase-receptor activity because it is inhibited by tyrosine kinase inhibitors (genistein, lavendustin A, and herbimycin A). It also involves PKC activation because EGF-induced alkalosis was blocked by PKC inhibitors. These results suggest that PKC activation is one of the downstream signals for EGF-induced activation of the Na(+)-H+ exchanger in primary cultures of human pleural mesothelial cells.

Cells, Cultured↗
PubMed1998

Quantitative analysis of mRNA encoding MUC1, MUC2, and MUC5AC genes: a correlation between specific mucin gene expression and sialomucin expression in non-small cell lung cancer.

The expression of mucins is important for tumor invasiveness and metastasis. In our previous report (Am. J. Respir. Crit. Care Med. 1997; 155:1419-1427), non-small cell lung cancers bearing sialomucin expression tended to relapse earlier than those without sialomucin. However, it remained unclear whether the expression of sialomucin in lung cancer is caused by an abnormal glycosylation process or by the expression of a specific mucin gene product. To address this problem, we established a modified quantitative competitive polymerase chain reaction (QC-PCR) analysis. RNA internal standards of MUC1, MUC2, and MUC5AC non-tandem repeat sequences were constructed, and known copy numbers of mucin RNA internal standards were introduced into reverse transcription-polymerase chain reactions (RT-PCR) for each mucin gene in order to compete with native mucin gene RNA during the reaction. The RNA of Gbeta-like gene (a housekeeping gene) was used as internal control for the RNA analysis. Twenty-five lung cancer tissues (13 adenocarcinomas and 12 squamous cell carcinomas) were used for analysis. Mann-Whitney rank sum test was applied to compare the expression amounts of different mucin genes in tissues. The results revealed that adenocarcinoma expressed higher amounts of MUC5AC gene than did squamous cell carcinoma (P = 0.03). The expression amount of MUC5AC correlated positively with the expression status of sialomucin (P = 0.012). Further studies are anticipated to elucidate the underlying mechanism contributing to this phenomenon.

Adenocarcinoma↗
PubMed1998

Pulmonary arteriovenous malformation: analysis of 10 cases.

Pulmonary arteriovenous malformation (PAVM) is an uncommon but not rare disease. It is very often associated with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease, OWRD). Both conditions may be readily diagnosed at the bedside when careful attention is given to clues from history taking and physical examination. Sometimes the clinical features may be neglected, delaying the diagnosis. The natural history of this disease is still incompletely understood because of the paucity of cases. This retrospective study was undertaken to evaluate the clinical manifestations and treatment options in patients with documented PAVM at the National Taiwan University Hospital between 1985 and 1997. Ten patients (4 men, 6 women) of documented PAVM were evaluated. Mean age at diagnosis was 37.8 years (range 22-63). Presenting symptoms included dyspnea on exertion, characteristics of OWRD, and major neurologic events. Six episodes of brain abscess occurred in three patients. The predominant location of PAVMs was the lower lobe. Solitary PAVM was more frequent in our patients (5/6) with OWRD than in other reports. The therapeutic options were: surgical resection (3 patients), embolotherapy (4), and no treatment (4). One patient, who refused treatment at first, developed a brain abscess later. There was no documented recurrence or growth of new PAVMs in patients who underwent surgical resection. Embolotherapy failed in one patient; no recanalization was found in the remaining patients. In conclusion, the diagnosis of PAVM may be subtle, but careful attention to historic clues and physical findings may lead to early diagnosis. Appropriate treatment is mandatory and may prevent the severe complications of PAVM. The debate about the preferred treatment seems likely to continue until more is known about the natural history of this disease.

Adult↗
PubMed1997

A new flavone C-glycoside and antiplatelet and vasorelaxing flavones from Gentiana arisanensis.

A new flavone C-glycoside, isovitexin 6"-O-glucoside (1), and three known flavonoids, quercetin, isovitexin, and luteolin-7-O-beta-D-glucoside, have been further isolated from the whole plant of Gentiana arisanensis Hayata. The new compound was characterized by spectral methods and chemical reactions. The antiplatelet effects of isovitexin 6"-O-glucoside (1), isoorientin (2), 2 peracetate (3), isovitexin (4), luteolin 7-O-beta-D-glucoside (5), luteolin (6), isoorientin 6"-O-glucoside (7), and 7 peracetate (8) were studied using washed rabbit platelets. Of the compounds tested, 6 showed potent antiplatelet effects on arachidonic acid (AA)-induced platelet aggregation (IC50 = 43.5 microM). The effect of 2, 5, and 6 on the contraction of rat thoracic aorta was also studied. Compound 6 depressed markedly the contraction induced by Ca2+ (1.9 mM) in high-K+ (80 mM) medium, with an IC50 of about 156 microM and also inhibited noradrenaline (3 microM)-induced phasic and tonic contractions, with an IC50 of about 68 and 72 microM, respectively.

Animals↗
PubMed1997

Intracellular pH regulation in cultured human pleural mesothelial cells.

The human pleural space is lined by a single layer of mesothelial cells, the intracellular pH (pH(i)) of which has never been investigated. In the present study, the intrinsic buffering power of H+ ions (beta(i)) and the pH(i) regulatory systems were investigated in primary cultures of human pleural mesothelial cells (PMCs) with microspectrofluorimetry. We found: (1) that at the resting pH(i), the beta(i) was low and increased as the pH(i) decreased; (2) that the pH(i) recovery was largely inhibited either with Na+-free medium or nominally HCO3 free medium containing ethyl-isopropyl amiloride (EIPA); (3) a 4-4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DIDS)-sensitive, Na+/HCO3-dependent, but Cl(-)-independent acid extrusion mechanism in CO2/HCO3 buffer; and (4) that in the same buffer, a DIDS- sensitive but Na+-independent alkalosis was induced by intracellular Cl- depletion. We therefore conclude that at least three membrane pH(i) regulators are involved in regulating the pH(i) in PMCs, these being the EIPA-sensitive Na+-H+ exchanger; a novel electroneutral, DIDS-sensitive Na+-HCO3 cotransporter; and the DIDS-sensitive Cl(-)-HCO3 exchanger. Furthermore, under physiologic conditions, the Na+-HCO3 cotransporter plays a more important role in extrusion of excess intracellular H+ ions than does the Na+-H+ exchanger.

Amiloride↗
PubMed1997

Sialomucin expression is associated with erbB-2 oncoprotein overexpression, early recurrence, and cancer death in non-small-cell lung cancer.

Mucin production, when heavily sialylated, can promote cancer cell invasion and metastasis, and modulate the immune recognition system of the host. To explore the prognostic implication of sialomucin expression in lung cancer, we studied 116 patients with non-small-cell lung cancer (NSCLC). Tumor specimens were stained immunohistochemically with monoclonal antibodies (mAbs) against mucin glycoprotein (17Q2, HMFG2, SM3), and histochemically with periodic acid-Schiff/alcian blue to differentiate neutral mucin from acid mucin, and with high-iron diamine/alcian blue to differentiate sialomucin from sulfomucin. The expression status of two established molecular prognostic factors, the p53 and erbB-2 oncoproteins, were evaluated immunohistochemically. The staining was performed on two separately archived, paraffin-embedded tumor blocks for each patient, with normal lung as a control. Correlations were subsequently made among stains and various clinicopathologic factors. All analyses were blinded, and included Kaplan-Meier survival estimates with Cox proportional hazards regression modeling. Associations were established among adenocarcinoma histotype and erbB-2 overexpression, sialomucin expression, and 17Q2 and HMFG2 immunohistochemical positivity (p < 0.05). Sialomucin expression was closely linked to erbB-2 overexpression (p = 0.01). Significant univariate predictors (p < 0.05) of recurrence and cancer death were surgical stage, p53 expression, erbB-2 overexpression, and sialomucin expression. These four factors remained as independent predictors of early recurrence (p < 0.05) after multivariate analysis. For cancer death prediction, p53 and sialomucin expression had a marginal effect. We concluded that sialomucin expression is also a poor indicator of prognosis, which is associated with erbB-2 oncoprotein overexpression, early postoperative recurrence, and cancer death in NSCLC.

Actuarial Analysis↗
PubMed1997

Nontuberculous mycobacteria isolates: clinical significance and disease spectrum.

The incidence of diseases caused by nontuberculous mycobacteria (NTM) is increasing worldwide. There has been no previous report regarding the clinical significance and disease spectrum of these bacteria in Taiwan. From January 1992 to June 1996, 201 isolates of NTM were recovered from clinical specimens from 143 patients at National Taiwan University Hospital. We retrospectively studied the clinical records and radiographs of these patients. A total of 86 isolates of NTM were considered clinically significant; they were cultured from 39 patients with soft-tissue infections and/or osteomyelitis (16 patients), isolated pulmonary infections (10), keratitis (6), disseminated infections (4), peritonitis, enteritis, and conjunctivitis. The most common organisms involved in these patients were Mycobacterium fortuitum complex, followed by Mycobacterium avium-intracellulare. Positive cultures of NTM were derived from respiratory sources (sputum, bronchial washing, and pleural effusion) from 111 patients; in 11 the isolates were associated with clinically significant disease, in two they were persistent colonizers, in 79 the isolates were considered to be contaminants, and for the remainder there were insufficient cultures to classify. The organisms involved in pulmonary diseases were M. avium-intracellular (4 patients), Mycobacterium chelonae (1), Mycobacterium abscessus (1), M. fortuitum (2), Mycobacterium gordonae (1), and unidentified scotochromogens (2), M. fortuitum complex (55%) was the most common pathogen of keratitis and soft-tissue infection. Three of the four cases of disseminated disease were caused by M. avium-intracellulare. The only isolate of Mycobacterium kansasii found in this study was a contaminant. The strains of clinically significant NTM isolates found in our hospital and their disease spectrum differ from those reported in other regions of the world.

Adult↗
PubMed1996

Overexpression of MUC5 genes is associated with early post-operative metastasis in non-small-cell lung cancer.

Mucin glycoprotein can promote tumor-cell invasion metastasis and modulate the immune recognition of cancer. This study aimed to elucidate the clinical significance of mucin gene overexpression in lung cancer. We collected 60 lung cancer samples and paired non-tumorous lung portions of varying types and stages. Slot-blot analysis with specific anti-sense oligonucleotide probes derived from tandem repeat sequence of MUC1, -2, -3, -4, 5B and 5AC were utilized to compare the amount of mucin gene mRNA in tumor samples with that of the non-tumorous counterparts. A ratio higher than 1.5 for each specific mucin mRNA amount was considered to indicate mucin gene overexpression in tumors. Immunohistochemical staining of monoclonal antibodies against mature airway mucin (17Q2) and MUC1 mucin protein (HMFG2) were also used to analyze mucin protein. The study showed that overexpression of mucin genes frequently occurred in lung cancer (25 out of 60, 41.7%), but that there was no preferential expression of a particular mucin gene or a combination of mucin genes in these tumors. The overexpression of mucin genes and mucin protein had no correlation with tumor stage, nodal stage, histology or pathological differentiation grade. Tumors of smokers had higher MUC5B and MUC5AC mRNA expression ratios than those of non-smokers. Tumors with increased expression of mucin genes tended to be associated with post-operative relapse, especially when MUC5B and MUC5AC genes were overexpressed (p = 0.015 and 0.025, respectively). The study suggests that overexpression of novel tracheobronchial mucin genes may result in an increased likelihood of post-operative lung-cancer recurrence or metastases.

Adult↗
PubMed1996

Nucleolar organizer regions as a prognostic factor in surgically treated lung cancer patients.

The prognostic value of the number of nucleolar organizer regions (NORs) (DNA loops in the nucleus) in tumor cells from various kinds of malignancies has been widely studied in recent years. During the period 1989 to 1992, a total of 73 primary lung tumors was examined for the number of NORs by silver staining AgNOR proteins on the stump smear of resected specimens in this hospital. The relations of the mean number of AgNOR per cell with other factors such as sex, age, habit of smoking, performance status, tumor location, tumor size, pathological stage, histological type, degree of differentiation, and whether histologically vascular or lymphatic invasion were analysed. It was found that the mean number of AgNOR was significantly different between positives and negatives of histologically vascular or lymphatic invasion (6.4 +/- 0.4 vs 5.5 +/- 0.2) (p < 0.05). Both single and multiple-variate analysis of patient survival revealed that the mean number of AgNOR was a significant prognostic factor, as were pathological stage, histological type, and performance status of the patient. Patients with a higher mean number of AgNOR (> 7) had a significantly worse prognosis compared with those with less AgNOR (< or = 7) (median survival 28 versus 43 months) (p < 0.05). It was concluded that the mean number of AgNOR of tumor cells is a significant prognostic factor in surgically treated lung cancer patients.

Adult↗
PubMed1996

Case report: reversible systolic heart failure and deep jaundice in hyperthyroidism.

Systolic heart failure because of hyperthyroidism in patients without preexisting heart disease is not common. Thyrotoxic systolic heart failure is rarely diagnosed during life. Reports about thyrotoxicosis-related systolic heart failure have been diagnosed postmortem. However, antemortem diagnosis of this fatal disease has important clinical implications because if detected early, thyrotoxicosis-related systolic heart failure is reversible. Here is a report a patient with Graves' disease, systolic heart failure, and deep jaundice, which resolved after the treatment of antithyroid drugs.

Female↗
PubMed1996

Bronchoscopic and angiographic findings in tracheobronchial endometriosis.

The case is described of a 31 year old woman who presented with complaints of recurrent haemoptysis coinciding with menstruation. Bronchoscopic examination revealed multiple purplish-red submucosal lesions on the right side of the trachea and bilateral bronchial trees which appeared during her menses and regressed in the intermenstrual periods. Brush cytology revealed cell clusters consistent with endometrial origin. Bronchial angiography demonstrated prominent vasculature at the right paratracheal area and bilateral bronchial trees corresponding to the lesions seen on bronchoscopic examination. Her haemoptysis was satisfactorily controlled by danazol therapy and follow up bronchoscopy showed disappearance of the tracheobronchial lesions. To our knowledge this is the first case of thoracic endometriosis with tracheal involvement.

Adult↗
PubMed1995

Urinary beta-glucuronidase activity as an initial screening test for urinary tract malignancy in high risk patients. Comparison with conventional urine cytologic evaluation.

BACKGROUND: Routine urine cytology is not particularly useful as a screening test for urinary tract malignancy in the general population, due to its low detection rate. Bladder, ureteral, and pelvic lavage and flow cytometry increased the test sensitivity but could be applied only to a limited number of patients. A simple, sensitive screening test is needed. METHODS: Two hundred eighty-two urine samples from 146 patients from the Urology Tumor Clinic patients during their initial visits were subject to cytologic evaluation and measurement of the activity of endogenous beta-glucuronidase, followed by confirmation procedures, including cystoscopy with biopsy, ultrasonography, radiography and/or computed tomography. RESULTS: Among 146 patients, 32 had confirmed transitional cell carcinoma and 14 renal cell carcinoma. The urinary beta-glucuronidase activity was higher in patients with cancer than in those without cancer in the Urology Service and in 80 normal healthy control subjects. The accuracy of the urine enzyme diagnostic system measured by the receiver-operating characteristic (ROC) plot was 98% or higher based on the number of patients. The upper threshold value determined by ROC analysis was 1.7 nmol/min/mumol creatinine. At this threshold value, the sensitivities of the enzyme assay for transitional cell carcinoma, renal cell carcinoma, and all cancers were, respectively, 94%, 98%, and 95%. These values were much higher than the corresponding sensitivities of urine cytology: 41%, 0%, and 22%. CONCLUSION: Urinary beta-glucuronidase is a much more sensitive test to screen for urinary tract malignancy than routine urine cytology in high risk patients, provided that a positive test is followed by diagnostic procedures for confirmation.

Adult↗