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Biomedical subjects

T J Liu

Publications and source records attributed to T J Liu.

At least 109 records · Page 6Linked to original sources

Spontaneous rupture of splenic hemangioma: a case report.

Splenic hemangioma is rare. The major problem concerning splenic hemangioma is the difficulty of preoperative diagnosis. No characteristic signs allow the specific diagnosis of this tumor. Spontaneous rupture is the main complication, occurring in up to 25% of cases reported. In cases of rupture of the tumor, splenectomy is a life-saving and mandatory procedure. A case of spontaneous rupture of splenic cavernous hemangioma is presented and the literature is reviewed.

Adult↗

Reconstitution of enzymatic activity in hepatocytes of phenylalanine hydroxylase-deficient mice.

Phenylketonuria (PKU) is a metabolic disorder secondary to a deficiency of the hepatic enzyme phenylalanine hydroxylase (PAH). The recent creation of a mouse strain for PAH deficiency has provided an excellent model system to explore the possibility of its phenotypic correction by hepatic gene therapy. A recombinant retrovirus containing the mouse PAH cDNA under the transcriptional control of the human CMV promoter was constructed and used to transduce hepatocytes isolated from PAH-deficient mice. Viral-transduced hepatocytes produced dramatically higher levels of mouse PAH mRNA as compared to control mock-infected hepatocytes. The PAH mRNA was translated efficiently into PAH protein that is capable of converting phenylalanine to tyrosine in vitro. These results demonstrate that the PAH-deficient mouse hepatocytes can be readily reconstituted by retroviral-mediated gene transduction, which is a crucial step towards somatic gene therapy for PKU.

Animals↗

Hepatic gene therapy: persistent expression of human alpha 1-antitrypsin in mice after direct gene delivery in vivo.

The liver represents an excellent target organ for gene therapy. The current strategy for hepatic gene therapy involves the isolation of primary hepatocytes from a resected liver lobe, transduction of therapeutic genes in vitro followed by autologous hepatocellular transplantation. This ex vivo approach is a rather complex procedure in its entirety; thus, a simple method for direct gene delivery into hepatocytes in vivo has been developed. The procedure involves partial hepatectomy followed by the portal vein infusion of recombinant retroviral vectors. Histological analysis of hepatocytes after in vivo delivery of a recombinant retrovirus bearing the E. coli beta-galactosidase gene showed that 1-2% of the parenchymal cells were transduced. Direct hepatic transfer of human alpha 1-antitrypsin cDNA under the transcriptional direction of the albumin promoter-enhancer led to constitutive expression of the human protein in the sera of recipients at concentrations of 30-1,400 ng/ml for at least 6 months. The experimental animals showed no signs of illness and histologic analysis of the liver revealed no evidence of pathologic abnormalities. The results suggest that the in vivo approach is an attractive alternative for hepatic gene therapy.

Albumins↗

[Binding of Actinomyces viscosus to collagen].

The ability of collagen adsorbed on apatitic surfaces to promote adhesion of A. viscosus was studied. Treatment of hydroxyapatite (HA) with human type I or type III collagen strongly promoted adhesion of A. viscosus LY7. TEM observations revealed that A. viscosus also attached to fibrils prepared from human type I collagen. The alpha(2) polypeptide derived from type I collagen exhibited moderate activity in promoting binding. Mutans of A. viscosus which possess type I fimbriae, but not type 2 fimbriae or no fimbriae, also bound to collagen-treated HA. This suggests that the adhesin responsible was associated with type I fimbriae, strains of A. israelii and A. odontolyticus also exhibited strong binding to collagen-treated HA. The avidity of Actinomyces species for collagen would seem to be partially responsible for the high proportions of these organisms found on root surfaces.

Actinomyces viscosus↗

Improvements in hepatocellular carcinoma resection by intraoperative ultrasonography and intermittent hepatic inflow blood occlusion.

From September, 1989, to December, 1990 (late period), intraoperative ultrasonography (IOU) and intermittent hepatic inflow blood occlusion were introduced in hepatectomy. Compared with the early period from January, 1983, to August, 1989, the resectability of hepatocellular carcinoma (HCC) increased from 12.1 to 62.1% (P less than 0.0001). More resections on cirrhotic patients (P less than 0.05) and more combined resections with other organs (P less than 0.005) were carried out. Although the operation time was longer (P less than 0.01), less blood loss during surgery and fewer perioperative blood transfusions (P less than 0.001) were found during the late period. Since the rate at which classical resections were performed has reduced (P less than 0.001), postoperative morbidity has also decreased (P less than 0.05). Although the surgical mortality did not differ between the two periods, most deaths in the early period were caused by postoperative hepatic failure which was not found in the late period. Since IOU can clarify the intrahepatic vasculature and identify impalpable and invisible tumors, more precise resections can now be carried out. Intermittent hepatic inflow occlusion reduces blood loss during surgery without increasing risk. We suggest both techniques should be mandatory in hepatectomy for HCC in order for the safety range of resections to be broadened.

Adolescent↗

[A study of perigastric lymph node metastasis in patients with early gastric cancer].

The prognosis after a gastrectomy for early gastric cancer (EGC) is favorable. Among 115 patients with early gastric cancer since 1983, 96 patients have received a radical gastrecomy (RG) and 19 have received a simple gastrectomy (SG). The cancer was confined to the mucosa in 47 cases and had invaded into the submucosa in 68 cases. Perigastric lymph nodes metastasis was observed in 17 patients (14.8%). The metastatic rate for mucosal cancer was 2.1% and that of submucosal cancer was 23.5% (p less than 0.005). Advanced nodal metastasis was occasionally visible in a few patients with submucosal cancer. The macroscopic pattern, size, primary site and differentiation of the cancer and the age and sex of the patients did not influence the rate of nodal metastasis. A follow-up study of 61 patients with EGC operated on before 1988 was carried out, the 5-year survival rate of RG was 92.9% and that of SG was 84.2% (p = 0.3109). The 5-year survival rate for mucosal cancer for RG was 100% and that for was 90.9% (p = 0.3048). The 5-year survival rate for submucosa] cancer for RG was 89.3% and that for SG was 75.0% (p = 0.0685). We suggest that RG be mandatory for EGC unless the depth of invasion is confined to the mucosa in the preoperative diagnosis, or if gross advanced metastasis is present to obtain more accurate postoperative staging and to achieve a curative resection. However, SG is still an alternative treatment for EGC if a patient's condition is poor or for extremely old patients.

Adult↗

[Bleeding secondary duodenal diverticulum: a rare late complication following nephrolithotomy].

Secondary duodenal diverticula are due primarily to traction upon that section from some other cause such as ulcer, cholecystitis and so forth. It accounts for 1.6 to 20% of all duodenal diverticula. Numerous reports of gastrointestinal hemorrhage from duodenal diverticula have appeared in the literature. But massive UGI bleeding due to secondary duodenal diverticulum, caused by nephrolithotomy, was a rare late complication. Here we present a case of a 63-year-old male patient who underwent a right side nephrolithotomy 10 and 8 years previously, then developed massive UGI bleeding suddenly. Pre-operative UGI series and gastroscopy showed chronic duodenal ulcer and duodenal diverticulum at second section where much blood clot was noted. In time, a successful operation was performed. This complication of secondary duodenal diverticulum was rare, so consideration regarding management and surgical approach was discussed.

Diverticulum↗

[Primary omental torsion--report of two cases].

Primary omental torsion is a rare disease, with only two cases in the past four years reported at our hospital. The patients suffered from pains over the right lower quadrant region of the abdomen for 3 days. Physical examination showed tenderness and rebounding pain over the right lower quadrant region of the abdomen. Laboratory data revealed leucocytosis. Surgical intervention was performed under the initial impression of acute appendicitis. The surgery revealed omental torsion. The twisted omentum was smoothly, resected and the postoperative course was uneventful. We present these two cases and review the literature.

Adult↗

Primary retroperitoneal sarcomas--a report of 16 cases.

From November 1982 to August 1990, 16 patients with primary retroperitoneal sarcoma were treated in our hospital. The most frequent types of tumor were liposarcoma (6), malignant fibrous histiocytoma (3). The commonest clinical findings were palpable abdominal mass (14/16). In management of these patients; nine patients underwent complete resection of the tumor; three patients underwent partial resection of the tumor and four patients underwent biopsy only. The histology of tumor appeared to have prognostic significance. Patients suffering from liposarcoma (3/5) and malignant fibrous histiocytoma (1/2) survived the longest. With a mean follow up of 25.0 months, the three year overall survival rate of complete resection group was 50 per cent. No patients with partial resection and biopsy only group survive three years and the total three-years overall survival rate was 29%. The mean survival for patients after adjuvant chemotherapy and/or radiotherapy was similar to that after a radical operation alone. The prognosis of primary retroperitoneal sarcoma is grave and complete resection of the tumor as initial treatment seems to provide the only chance of cure for these patients.

Adolescent↗

Management of penetrating abdominal injury.

We present the results of immediate exploratory laparotomies for penetrating abdominal injuries that were performed in the past five and half years. Thirty-eight cases (37 males and 1 female) were collected in this study, ranging in age from 17 to 74 years, with a mean of 36 years. Nine suffered from gunshot injuries and 29 from stab injuries. The negative exploratory laparotomy rate was 22.2%, the surgical complication rate was 18.4%, and the mortality rate was 5%. In this retrospective study, we conclude that: 1. Patients with injuries of the abdomen or unstable vital signs should be operated on immediately. 2. Peritonitis signs are not absolute indications of the need for emergent exploration. 3. For the stab injury patients with stable pre-operative vital signs, conservative treatment with simple closure of wounds is adequate. Frequent checks of vital signs and abdominal condition can possibly prevent unnecessary operations.

Abdominal Injuries↗

[Gastrectomy for advanced gastric carcinoma with serosal involvement].

Four hundred and eighty five gastric cancer patients underwent gastrectomy in the past 6 years and of those 332 patients (68.2%) were found to have only serosal involvement (se) or adjacent organ invasion (sei). Simple gastrectomy (SG) was carried out in 144 cases while radical gastrectomy (RG), which included systemic lymphadenectomy, was performed in 188 cases. This type of operation was chosen by the operators arbitrarily except in the presence of non-curative factors such as multiple liver metastasis, peritoneal seeding and distant metastasis, in which case SG was always used to relieve gastrointestinal obstruction or bleeding. The operative mortality of SG was 2.7% and that of RG was 3.2%. On average, 15.8 lymph nodes were taken out per patient in SG and 33.6 lymph nodes in RG. The chance of nodal metastasis was higher in sei than in se. According to the Japanese General Rules of Gastric Cancer Study, we found that for gastric cancer with serosal involvement: (1) the long term result of RG was superior to SG in both stage 3 and 4 patients, (2) when absolute curative resection was achieved, the result was the best in stage 3 patients, (3) no patient in stage 4 who underwent absolute non-curative resection survived for more than 42 months, therefore this result was the worst. RG is recommended for advanced gastric cancer patients with serosal involvement whenever the patient's condition permits and in absence of the unresectable non-curative factors.

Gastrectomy↗

Introns in histone genes alter the distribution of 3' ends.

Chimeric genes were constructed which contained either a histone or globin promoter, a human alpha-globin coding region as a cDNA or containing one or both intervening sequences, and the 3' end of a mouse histone H2a gene. The genes were introduced into mouse L cells or Chinese Hamster Ovary cells. The genes containing at least one intervening sequence produced two mRNAs in about equal amounts, one which ended at a cryptic polyadenylation site 33 nucleotides 3' to the normal histone mRNA 3' end and one which ended at the normal histone 3' end. In contrast, the same construct containing a globin cDNA yielded mRNA ending only at the correct histone 3' end. Similar proportions of polyadenylated and non-polyadenylated mRNA were obtained when the cryptic polyadenylation signal was replaced with the globin polyadenylation signal. More than 90% of the transcripts were accurately spliced. All of the unspliced transcripts had histone 3' ends.

Animals↗

Acute biliary septic shock.

Forty-seven cases of biliary tract infection with septic shock are presented. The sepsis was caused by empyema of the gallbladder in 23 cases and by cholangitis in the remainder. Gallstones were most frequently the cause of the sepsis. An appropriate diagnostic description of the syndrome of biliary tract infection and septic shock should therefore include a description of the underlying biliary disease as well as the term acute biliary shock. In this series, emergency surgical management by removal of gallstones and drainage of suppuration was felt to be the most appropriate treatment. There was a high incidence of gallbladder rupture (10.6%) and intrahepatic stones (53.2%). Of the 13 patients who died, 8 might have survived if early operation had been performed after the diagnosis of acute biliary septic shock was established.

Acute Disease↗

[Retrograde jejuno-jejunal intussusception. A rare complication following total gastric resection].

Jejunogastric intussusception is an infrequent complication following simple gastrojejunostomy or Billroth II anastomosis. Jejunojejunal intussusception through enteroenteric anastomosis following total gastrectomy, however, was reported in 2 cases. Here we present a case of a 59-year-old male patient with gastric ulcer who received a total gastrectomy with loop esophagojejunostomy and Braun's anastomosis 10 years previously, then developed retrograde jejunojejunal intussusception through Braun's anastomosis. The patient presented after a day of acute attacks of left upper quadrant pain with bilious vomiting. In-time, an operation was performed with successful results. This complication of retrograde jejunojejunal intussusception has never been reported. Clinical history, diagnosis, and treatment are discussed.

Anastomosis, Surgical↗

Surgical management of small bowel injury following radiation therapy.

Radiation enteritis is a rare complication of abdominopelvic radiotherapy at the present time. Chronic radiation enteritis with complications, e.g. stricture, perforation and fistula formation, causes significant morbidity and mortality. We present our experience with 4 cases of small bowel radiation injury manifested by intestinal obstruction or perforation. Wide resection of the lesion bowel with non-irradiated bowel for anastomosis will resolve the poor healing capacity of the irradiated bowel and obtain a satisfying results.

Adult↗

Transcatheter arterial chemoembolization for hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) was treated with transcatheter arterial chemoembolization (TACE) in a sample of 129 patients. The cumulative survival rate was 49% at 1 year and 22% at 2 years. The median survival time was 11.9 months. The survival rates at 1 year of 84 patients in Child's group A and 27 in Child's group B were 56% and 40%; out of 52 HCC patients with portal vein patent and 77 with portal vein invasion 75% and 40% survived, and the 1-year survival rates for 33 HCC patients with capsule intact, 14 with capsule broken and 82 with no capsule were 85%, 65% and 40% respectively. From the above results there were statistically significant differences in survival time in those with good clinical performance status by Child's classification, those showing patency of the portal vein and those where the capsule was present. Therefore, we would like to recommend, TACE of HCC in well-selected patients presenting with good clinical status, patency of the portal vein and without broken capsule, in order to achieve better clinical results.

Adult↗

The efficiency of 3'-end formation contributes to the relative levels of different histone mRNAs.

Sequences at both the 5' and 3' ends of mouse histone genes contribute to the expression of individual genes. The 3' sequences required for high expression of the mouse H2a-614 gene are the same as the sequences required for 3'-end formation. When these sequences were substituted for the 3' end of the poorly expressed H2a-291 gene, expression of the H2a-291 gene was increased fivefold. A 65-nucleotide fragment containing the H2a-614 3' processing signal increased expression of the H2a-291 gene when it was placed in the proper orientation downstream of the H2a-291 3' end. The only mRNAs that accumulated from this gene ended at the H2a-291 3' end, which suggests that the transcript is sequentially processed. In an in vitro processing system, the different histone 3' ends showed different processing efficiencies, which correlated with their expression in cells. These results suggest that the efficiency of processing is important in determining the steady-state levels of individual mouse histone mRNAs.

Animals↗

Unconscious processing of dichoptically masked words.

In three experiments, the subjects' task was to decide whether each of a series of words connoted something good (e.g., fame, comedy, rescue) or bad (stress, detest, malaria). One-half second before the presentation of each such target word, an evaluatively polarized priming word was presented briefly to the nondominant eye and was masked dichoptically by either the rapidly following (Experiment 1) or simultaneous (Experiments 2 and 3) presentation of a random letter-fragment pattern to the dominant eye. (The effectiveness of the masking procedure was demonstrated by the subjects' inability to discriminate the left vs. right position of a test series of words.) In all experiments, significant masked priming effects were obtained; evaluative decisions to congruent masked prime-target combinations (such as a positive masked prime followed by a positive target) were significantly faster than those to incongruent (e.g., negative prime/positive target) or noncongruent (e.g., neutral prime/positive target) combinations. Also, in two of the three experiments, when subjects were at chance accuracy in discriminating word position, their position judgments were nevertheless significantly influenced by the irrelevant semantic content (LEFT vs. RIGHT) of the masked position-varying words. The series of experiments demonstrated that two very different tasks--speeded judgment of evaluative meaning and nonspeeded judgment of word position--yielded statistically significant and replicable influences of the semantic content of apparently undetectable words. Coupled with previous research by others using the lexical decision task, these findings converge in establishing the reliability of the empirical phenomenon of semantic processing of words that are rendered undetectable by dichoptic pattern masking.

Adult↗