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T C Chao

Publications and source records attributed to T C Chao.

At least 19 recordsLinked to original sources
PubMed2001

Outcome after treatment for papillary thyroid cancer.

BACKGROUND: To evaluate the results of treatment and the prognostic variables of papillary thyroid carcinoma patients after long-term follow-up. PATIENTS AND METHODS: Retrospective review of 1,373 thyroid cancer patients. Of the 1,016 papillary thyroid cancer patients, 394 patients received follow-up for more than 5 years, including 305 women (mean age, 38.4 +/- 13.7 years) and 89 men (mean age, 44.0 +/- 13.4 years). Of these papillary thyroid carcinoma patients, 227, 76, 68, and 23 patients were categorized in clinical stages I, II, III, and IV, respectively, at the time of diagnosis. RESULTS: After treatment, 36 (9.1%) patients died. Only 23 (5.8%) of them died of papillary thyroid carcinoma. The 1-, 5-, 10-, and 20-year survival rates were 0.980, 0.951, 0.901, and 0.731. Mortality factors of the papillary thyroid carcinoma patients related to age, gender, tumor size, and postoperative serum thyroglobulin (Tg) levels. Twenty-four patients progressed from clinical stages I, II, and III to stage IV during the follow-up period. Of these 24 patients, 12 died during the follow-up period. In this study, age, gender, 131I accumulated dose, postoperative serum Tg levels, and the survival rate were demonstrated to be statistically significant between the patients in early stage and advanced stage groups after treatment. CONCLUSION: Twenty-four of the 47 papillary thyroid cancer patients with distant metastases were diagnosed during the follow-up period. This study suggests that distant metastasis may occur at a serum Tg level of 2.3 ng/mL with thyroxine replacement. Postoperative long-term close follow-up of these patients is recommended.

Adult↗
PubMed2001

Angiomyolipoma of the liver.

BACKGROUND AND OBJECTIVES: Angiomyolipoma is a rare benign tumor that occurs in the liver and other organs. We provide data on eight cases of hepatic angiomyolipoma, regarding clinical presentations, diagnoses, management, and prognosis. METHODS: A retrospective review of medical records of the eight patients with hepatic angiomyolipoma treated at the Chang Gung Memorial Hospital-Taipei between October 1988 and October 1999. RESULTS: Eight female patients with hepatic angiomyolipoma were identified, with ages ranging from 30 to 66 years (mean, 45.3 years). Abdominal pain was the most common symptom, occurring in six of eight patients (75%). Hepatocellular carcinoma was the most common preoperative diagnosis, occurring in three of eight patients (37.5%). Laparotomy was performed in seven of eight patients (87.5%). Among these seven patients, three patients (43%) received hepatic resection with 100% cure rate to date. One of the eight patients (12.5%) was closely follow up after diagnosis made by echo-guided needle biopsy. CONCLUSIONS: Hepatic angiomyolipoma is a rare and benign entity. It has a wide variation and poses a diagnostic challenge clinically, radiologically, and pathologically. Its prognosis is good regardless of management, including hepatic resection or conservative treatment after tissue biopsy by echo-guided needle. To alleviate the mass effect, surgical resection may be needed for hepatic angiomyolipoma in selected cases.

Abdominal Pain↗
PubMed2001

Color Doppler ultrasound in breast carcinomas: relationship with hormone receptors, DNA ploidy, S-phase fraction, and histopathology.

Data on 368 patients with breast carcinomas measuring < or = 5 cm were analyzed to study the relationship between the prognostic factors and the flow indices measured by color Doppler ultrasound (US). Vascularity was detected by color Doppler US in 348 (94.6%) of the 368 breast tumors. Tumors without vascularity were significantly (p = 0.0001) smaller than the tumors with vascularity. There was a correlation between Vmax and tumor size. Postmenopausal women had greater values of RI, PI, and V(max). Tumors larger than 2 cm had significantly greater RI, V(max) and number of vessels as compared with the tumors smaller than 2 cm. RI was significantly greater in the nondiploid tumors than in the diploid tumors. RI > or = 0.7 was significantly associated with nondiploid carcinomas and SPF > or = 7%. Tumor size and Vmax significantly predicted axillary lymph node metastases.

Adult↗
PubMed2001

Specific absorbed fractions from the image-based VIP-Man body model and EGS4-VLSI Monte Carlo code: internal electron emitters.

VIP-Man is a whole-body anatomical model newly developed at Rensselaer from the high-resolution colour images of the National Library of Medicine's Visible Human Project. This paper summarizes the use of VIP-Man and the Monte Carlo method to calculate specific absorbed fractions from internal electron emitters. A specially designed EGS4 user code, named EGS4-VLSI, was developed to use the extremely large number of image data contained in the VIP-Man. Monoenergetic and isotropic electron emitters with energies from 100 keV to 4 MeV are considered to be uniformly distributed in 26 organs. This paper presents, for the first time, results of internal electron exposures based on a realistic whole-body tomographic model. Because VIP-Man has many organs and tissues that were previously not well defined (or not available) in other models, the efforts at Rensselaer and elsewhere bring an unprecedented opportunity to significantly improve the internal dosimetry.

Bone Marrow↗
PubMed2001

Identifying differentially expressed genes associated with metastasis of follicular thyroid cancer by cDNA expression array.

Patients with follicular thyroid carcinoma have a higher incidence of metastasis than papillary thyroid carcinoma when thyroid cancer is diagnosed. The cDNA expression array technology is utilized herein to profile differentially expressed genes from metastatic human follicular thyroid carcinoma and reveal new tumor markers as well as target genes for therapeutic intervention. Tissue samples were obtained during surgical resection of the thyroid follicular carcinoma and metastatic tissue in the brain of the same patient. Two identical Atlas human cDNA expression arrays were hybridized with 32P-labeled cDNA probes derived from RNA of either primary thyroid cancer or metastatic tissue. Parallel analysis of the hybridized signals allowed us to identify the alteration of gene expression in the metastasis process. Eighteen genes significantly overexpressed and 40 genes significantly underexpressed were identified in the metastatic thyroid cancer. Genes that displayed an altered expression were associated with the processes of cell cycle regulation, apoptosis, DNA damage response, angiogenesis, cell adhesion and mobility, invasion, and immune response. An expression profile of genes that are associated with metastasis process of follicular thyroid cancer was also discussed. Further investigation is required to understand the precise relationship between the altered expression of these genes and the metastasis process of follicular thyroid cancer.

Adenocarcinoma, Follicular↗
PubMed2001

Conversion coefficients based on the VIP-Man anatomical model and EGS4.

A new set of conversion coefficients from kerma free-in-air to absorbed dose and kerma free-in-air to "effective VIP-Man dose" has been calculated for external monoenergetic photon beams from 10 keV to 10 MeV using an image-based whole-body anatomical model. This model, called VIP-Man, was recently developed at Rensselaer from the high-resolution color images of the National Library of Medicine's Visible Human Project. An EGS4-based Monte Carlo user code, named EGS4-VLSI, was developed to efficiently process the extremely large image data in VIP-Man. Irradiation conditions include anterior-posterior, posterior-anterior, right lateral, left lateral, rotational, and isotropic geometries. Conversion coefficients from this study are compared with those obtained from two mathematical models, ADAM and EVA. "Effective VIP-Man doses" differ from the previously reported effective dose results by 10%-50% for photons between 100 keV and 10 MeV. Discrepancies are more significant at lower energies and for individual organ doses. Since VIP-Man is a realistic model that contains several tissues that were not previously defined well (or not available) in other models, the reported results offer an opportunity to improve the existing dosimetric data and the mathematical models.

Air Pollutants, Radioactive↗
PubMed2001

Fluence-to-dose conversion coefficients based on the VIP-Man anatomical model and MCNPX code for monoenergetic neutrons above 20 MeV.

A new set of fluence-to-absorbed dose and fluence-to-effective dose conversion coefficients has been calculated for high-energy neutrons using a whole-body anatomical model, VIP-Man, developed from the high-resolution transversal color photographic images of the National Library of Medicine's Visible Human Project. Organ dose calculations were performed using the Monte Carlo code MCNPX for 20 monoenergetic neutron beams between 20 MeV and 10,000 MeV under 6 different irradiation geometries: anterior-posterior, posterior-anterior, left lateral, right lateral, isotropic, and rotational. For neutron Monte Carlo calculations, results based on an image-based whole-body model were not available in the literature. The absorbed dose results for 24 major organs of VIP-Man are presented in the form of tables and selected figures that compare with those based on simplified mathematical phantoms reported in the literature. VIP-Man yields up to 40% larger values of effective dose and many organ doses, thus suggesting that the results reported in the past may not be conservative.

Humans↗
PubMed2001

Organ dose conversion coefficients for 0.1-10 MeV electrons calculated for the VIP-Man tomographic model.

A whole-body tomographic model, called VIP-Man, was recently developed at Rensselaer Polytechnic Institute from the high-resolution color photographic images of the National Library of Medicine's Visible Human Project. An EGS4-based Monte Carlo user code, named EGS4-VLSI, was developed to efficiently transport electrons using the large image data set for VIP-Man. VIP-Man has been used to calculate doses for neutrons and photons. This paper presents a new set of fluence-to-absorbed-dose conversion coefficients for monoenergetic electron beams between 100 keV and 10 MeV for VIP-Man. Irradiation conditions include anterior-posterior, posterior-anterior, right lateral, left lateral, rotational, and isotropic source geometries. Comparisons between organ doses from VIP-Man, which is taller and heavier than the Reference Man, and existing data from mathematical models show significant discrepancies. It appears that even slight differences between body models can cause dramatic dosimetric deviations for low penetrating electron irradiation. This suggests that a single standard body model may poorly represent a large population and may not be acceptable for electron dosimetry.

Electrons↗
PubMed2001

Chronic hepatitis C virus infection associated with primary warm-type autoimmune hemolytic anemia.

Autoimmune hematologic abnormalities are not well recognized in chronic hepatitis C virus infection. We demonstrate an unusual association between primary autoimmune hemolytic anemia and chronic hepatitis C virus infection. A 69-year-old woman who had a history of hepatitis C virus-related liver cirrhosis was found to have deteriorating anemia with reticulocytosis when admitted to the hospital. Laboratory work revealed both positive direct and indirect Coombs' tests, and warm-type immunoglobulin G against surface antigens of red blood cells. After prednisolone therapy, her anemia improved dramatically. To our knowledge, this is the first reported case of chronic hepatitis C virus infection linked with autoimmune hemolytic anemia in its natural course, not related to prior interferon treatment. Our report suggests that isolated autoimmune hemolytic anemia may be one of the unusual hematologic manifestations of chronic hepatitis C virus infection.

Aged↗
PubMed2001

Expression of sodium iodide symporter in benign and malignant human thyroid tissues.

The extent of human sodium iodide symporter (hNIS) expression in different kinds of human thyroid cancer tissues and cell lines remains controversial. In this study, polyclonal antibodies to hNIS were used to analyze the expression of symporter protein in benign and malignant human thyroid tissues. Formalin-fixed, paraffin wax-embedded tissue sections were used. Staining was performed using primary polyclonal antibody of rabbit anti-human hNIS diluted in PBS (1:500). Results showed that 2 of 3 normal tissue, 3 of 6 nodular hyperplasia, one follicular adenoma, 3 of 11 papillary thyroid carcinoma, 1 of 5 follicular carcinoma and none of 3 metastatic thyroid epithelial tissue specimens stained positively for hNIS. A higher percentage of positive staining for symporter protein was found in benign thyroid tissues including normal thyroid tissue, nodular hyperplasia, and adenoma (60%). In contrast, papillary and follicular thyroid carcinomas demonstrated lower symporter protein expression (20%). In conclusion, although the number of tissue samples examined in this study was small, hNIS staining found a higher ratio of symporter protein expression in normal and benign thyroid tissues compared with malignant tissues. Determination of the reason for discrepancies in the expression of hNIS in in vivo and in vitro studies will require further investigation.

Adenoma↗
PubMed2001

Molecular analysis of mucosa-associated lymphoid tissue (MALT) lymphoma of ocular adnexa.

Lymphomas of mucosa-associated lymphoid tissue (MALT) are a distinct subgroup of extranodal B-cell non-Hodgkin's lymphomas. Most studies have failed to demonstrate the clonal rearrangement of BCL-1, BCL-2 or c-MYC genes for MALT lymphomas. Further, alteration of the p53 gene is rarely demonstrated in low-grade MALT lymphomas, but can be detected in high-grade disease. Lymphomas of the ocular adnexa represent approximately eight percent of all extranodal lymphomas, most of which are MALT lymphomas, but few studies had explored the alterations of BCL-1, BCL-2, c-MYC and p53 genes specifically for ocular MALT lymphomas. We investigated the changes to BCL-1, BCL-2, c-MYC and p53 genes in these lymphomas for Taiwanese patients. Clonal rearrangement for immunoglobulin heavy-chain (IgH), BCL-1, BCL-2, c-MYC and p53 genes was examined for 16 cases of ocular MALT lymphoma. Restriction-length polymorphism and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) of the DNA, corresponding to exons 5 through 9, followed by DNA sequencing, were utilized to analyze the possible mutations of the p53 gene for these tumors. Thirteen of the cases revealed rearranged IgH genes using Southern blotting or PCR. No rearrangement of BCL-1, BCL-2, c-MYC or p53 genes was discovered, with point mutation of the p53 gene in one case. As for other types of MALT lymphomas, BCL-1, BCL-2 and c-MYC genes are not implicated in the pathogenesis of the ocular sub-group. Although alteration of the p53 gene is rare for low-grade ocular MALT lymphoma, its role in disease progression merits further research.

Adolescent↗
PubMed2001

Laparoscopic cholecystectomy for polypoid lesions of the gallbladder: a clinicopathologic study.

The size and number of gallbladder polyps are used to differentiate between benign and malignant lesions before surgery and to determine whether surgery is necessary for the lesion. Since 1987, laparoscopic cholecystectomy has been widely used as the management method of choice for gallbladder lesions. The results of a clinicopathologic study of polypoid lesions of the gallbladder, based completely on laparoscopically resected gallbladder tissue, have not yet been evaluated fully. Data from 123 patients with polypoid lesions of the gallbladder treated by laparoscopic cholecystectomy were reviewed retrospectively. The gallbladders were classified into four histologic groups. Clinical features, maximal diameter, and the number of lesions were compared among the groups. The mean age of patients with adenoma and cancer was significantly greater than that of patients with cholesterol polyps and other lesions. More women than men had a neoplasm (adenoma and cancer). Patients in the neoplasm group tended to have a single lesion. The mean maximal diameter of neoplasms was significantly larger than that of lesions in the nonneoplasm group. All seven malignant lesions that were detected measured at least 1.5 cm. Univariate analysis showed that polypoid lesions of the gallbladder with neoplastic lesions correlated significantly with age, sex, size, and number of the lesions. Univariate analysis also showed that malignancy in polypoid lesions of the gallbladder correlated significantly with age, size, and number of the lesions. Multivariate logistic regression analysis showed that the age of the patient and the size of the lesion (> or = 1.0 cm) are two independent factors in predicting neoplastic lesions in polypoid lesions of the gallbladder. The size of the lesion (> or = 1.5 cm) is the only independent factor in predicting malignancy in the polypoid lesions of the gallbladder as shown by multivariate logistic regression analysis. Laparoscopic cholecystectomy is a safe and feasible method for gallbladder polypoid lesions. Neoplastic change in polypoid lesions of the gallbladder should be considered when a patient older than 50 years of age has a polypoid lesion larger than 1.0 cm. Cancer should be suspected when a polypoid lesion of the gallbladder is larger than 1.5 cm, and an aggressive surgical approach is warranted so that early gallbladder cancer can be detected and patients can have an increased chance of cure.

Adenocarcinoma↗
PubMed2000

Detection of mRNA of sodium iodide symporter in benign and malignant human thyroid tissues.

Human sodium iodide symporter (hNIS) is an intrinsic membrane protein with 12 transmembrane regions, which shows homology to other sodium-dependent transporters. There is controversy as to the amount of hNIS expression in different kinds of human thyroid cancer tissues and cell lines. In this study, reverse transcription-polymerase chain reaction (RT-PCR) was used to detect mRNA of hNIS in various fresh normal, benign tissues and malignant human thyroid tissues. The forward primer was nested hNIS-5' primer containing the sequences: ACCTGGAAATGCGCTTCAGC. The reverse primer was nested hNIS-3' primer containing the sequences: AAGCATGACACCGCGTGCCA. The results revealed three of three normal tissues, six of eight nodular hyperplasia, two of two hyperthyroidism, one of three follicular adenomas, five of ten papillary thyroid carcinomas, one of one follicular carcinoma and zero of one metastatic follicular tissues demonstrated positive results for hNIS in thyroid epithelial cells. A higher percentage of positive results of the symporter mRNA were found in normal benign thyroid tissues and the thyroid tissues of hyperthyroidism, and nodular hyperplasia (84.6%); however follicular adenoma, papillary and follicular thyroid carcinomas demonstrated a lower percentage of expression in the RT-PCR studies (46.7%). Serum thyrotropin levels and the degree of differentiated components presented in cancer tissues have been mentioned as important factors for hNIS expression in the cancer tissues. The discrepancies of the expression of hNIS in in vivo and in vitro studies need further investigation. In conclusion, hNIS was found in higher ratios in normal and benign thyroid tissues than in the malignant tissues. In addition, the RT-PCR technique hNIS did not detect the transporter in most papillary thyroid cancer tissues.

Adenocarcinoma, Follicular↗
PubMed2000

Expression of sodium iodide symporter in metastatic and follicular human thyroid tissues.

Active iodide uptake across the basal membrane mediated by human sodium iodide symporter (hNIS) has been shown to be a process coupled with the flow of sodium. There is still controversy as to the amount of hNIS expression present in different kinds of human thyroid cancer tissues. In this study, we present a 58-year-old women with follicular thyroid carcinoma with vertebra and skull metastases. 201Tl and 5 mCi 131I scans clearly demonstrated the metastatic lesions in the brain of this patient. Thyroid and metastatic tissues were then obtained for this study, which is aimed at comparing the iodide trapping ability in vivo and in vitro of hNIS, and then comparing their expression in both thyroid tissue and metastatic tissues. Polyclonal antibodies to hNIS and competitive RT PCR were used to analyze the symporter protein and mRNA expressed in follicular human thyroid and metastatic tissues. Positive staining of the symporter protein was performed in the follicular thyroid carcinomas, otherwise, the metastatic tissues could not have demonstrated the protein in the staining. Follicular thyroid carcinoma tissues from thyroid were revealed around 5 pg hNIS expressed in follicular thyroid carcinoma tissues from the thyroid. Otherwise, there was almost an absence of hNIS expression in the metastatic tissue. These discrepancies of the expression in hNIS in vivo and in vitro studies need further investigation.

Adenocarcinoma, Follicular↗
PubMed2000

Characteristics of thyroid carcinomas in aging patients.

BACKGROUND: To investigate the clinical features of thyroid cancer in aging patients and to present the results of treatment. From this we can provide bases for earlier diagnoses and better treatment of thyroid malignancies in older patients. MATERIALS AND METHODS: In this study a retrospective analysis was performed with 204 thyroid cancer patients aged 60 years or older (132 women, with a mean age of 68.3 +/- 6.6 years; 72 men, with a mean age of 67.0 +/- 5.3 years). RESULTS: Of the 204 patients, 142 had well-differentiated thyroid carcinomas (96 papillary thyroid carcinomas, 43 follicular carcinomas, three Hürthle cell carcinomas) and three medullary carcinomas. Sixty-nine (33.8%) of the 204 patients died after treatment. Of these, three patients died of causes not related to thyroid cancer. For well-differentiated thyroid carcinomas, male gender, follicular carcinoma, and a larger tumour size indicated a poor prognosis. Of the 59 non-well-differentiated thyroid carcinomas, 39 were anaplastic thyroid carcinomas, nine metastatic cancers of the thyroid, seven lymphomas, and four squamous cell carcinomas. After treatment, 40 (67.8%) of the 59 patients died. In multivariant analysis of the differences in clinical parameters between aging and younger thyroid cancer patients, the current status, tumour size, follow-up period, sex, and stage at diagnosis were independent factors. From this data the delayed diagnosis of aging patients with thyroid cancer was of note when compared with younger patients. CONCLUSION: Thyroid cancer in older patients is not a benign clinical disorder. Early diagnosis and urgent aggressive treatment are recommended courses of action for this type of cancer, especially for non-well-differentiated thyroid cancers.

Adenocarcinoma, Follicular↗
PubMed2000

Fluence-to-dose conversion coefficients from monoenergetic neutrons below 20 MeV based on the VIP-man anatomical model.

A new set of fluence-to-absorbed dose and fluence-to-effective dose conversion coefficients have been calculated for neutrons below 20 MeV using a whole-body anatomical model, VIP-Man, developed from the high-resolution transverse colour photographic images of the National Library of Medicine's Visible Human Project. Organ dose calculations were performed using the Monte Carlo code MCNP for 20 monoenergetic neutron beams between 1 x 10(-9) MeV and 20 MeV under six different irradiation geometries: anterior-posterior, posterior-anterior, right lateral, left lateral, rotational and isotropic. The absorbed dose for 24 major organs and effective dose results based on the realistic VIP-Man are presented and compared with those based on the simplified MIRD-based phantoms reported in the literature. Effective doses from VIP-Man are not significantly different from earlier results for neutrons in the energy range studied. There are, however, remarkable deviations in organ doses due to the anatomical differences between the image-based and the earlier mathematical models.

Algorithms↗
PubMed2000

VIP-Man: an image-based whole-body adult male model constructed from color photographs of the Visible Human Project for multi-particle Monte Carlo calculations.

Human anatomical models have been indispensable to radiation protection dosimetry using Monte Carlo calculations. Existing MIRD-based mathematical models are easy to compute and standardize, but they are simplified and crude compared to human anatomy. This article describes the development of an image-based whole-body model, called VIP-Man, using transversal color photographic images obtained from the National Library of Medicine's Visible Human Project for Monte Carlo organ dose calculations involving photons, electron, neutrons, and protons. As the first of a series of papers on dose calculations based on VIP-Man, this article provides detailed information about how to construct an image-based model, as well as how to adopt it into well-tested Monte Carlo codes, EGS4, MCNP4B, and MCNPX.

Adult↗