Search PubMed⌕ Search

Biomedical subjects

W C Hsu

Publications and source records attributed to W C Hsu.

47 records · Page 3Linked to original sources

[A study of referral pattern of group practice centers in Taiwan].

To investigate the referral patterns of group practice centers in Taiwan, 18 group practice centers were studied. These study sites were sampled in a stratified random method over four districts (eastern, northern, central, and southern) in Taiwan. The study period took place between July 1989 and June 1990. Prospective referral forms were applied in every study site during the 12-month period. A computer-assisted data base for referral contents was established to follow up referral cases. During the study period, 1,647 referrals were generated from 735,534 patient visits, for an overall referral rate of 0.22 percent of all office visits. According to the International Classification of Health Problems in Primary Care, 2nd edition, most of the problems that needed referral were signs, symptoms, ill-defined conditions, digestive system diseases, genitourinary system diseases, circulatory system diseases, neoplasms and musculoskeletal, connective tissue diseases. The top 6 consulting specialties were internal medicine, surgery, obstetrics & gynecology, orthopedics, urology and pediatrics. Periodic evaluation of the dynamic referral contents is a useful method to improve the quality of primary medical care.

Adolescent↗

Growth factor binding and bioactivity in human kidney epithelial cell cultures.

Insulinlike growth factors (IGF) and epidermal growth factor (EGF) are produced in renal tissue, as are specific receptors for these hormones. To evaluate the significance of these observations to regulation of renal tubular cell proliferation, we have examined the interaction of IGF and EGF with cultured human proximal tubular epithelial cells (HPT). HPT cells showed specific binding of IGF-1, insulin, and EGF. IGF-1 binding was inhibited by antibody to the type 1 IGF receptor (alpha-IR3). Insulin receptors and type 1 IGF receptors were identified by bifunctional cross-linking. IGF-1, insulin, and EGF stimulated [3H]thymidine incorporation by 77, 73, and 87%, respectively. Half maximal stimulation by IGF-1, insulin, and EGF were produced with 4 X 10(-9) M, 2.5 X 10(-8) M, and 8 X 10(-10) M concentrations of these hormones. Alpha-IR3 inhibited stimulation of thymidine incorporation by IGF-1 and insulin but had no effect in EGF-stimulated thymidine incorporation. EGF and high concentrations of insulin both stimulated cell proliferation by 83 and 79%, respectively. These data are consistent with regulation of tubular epithelial proliferation by IGF-1, insulin, and EGF and suggest that the mitogenic activity of both insulin and IGF-1 is mediated by the type 1 IGF receptor.

Cells, Cultured↗

[Propionic acidemia: report of a case that is successfully managed by peritoneal dialysis and sodium benzoate therapy].

Propionic acidemia is a rare hereditary disease which is an autosomal recessive disorder. Defect of propionyl CoA carboxylase results in abnormal accumulation of propionate and its metabolites which interfere the pathway of glycine cleavage and the urea cycle. This organic acidemia is characterized by a wide spectrum of clinical and biochemical findings, including recurrent vomiting, difficult feeding, lethargy, hypotonia, metabolic ketoacidosis, hyperglycinemia and hyperammonemia during the acute episodes. We present a male newborn infant who sustained this disorder and was managed successfully with blood exchange transfusion, peritoneal dialysis, supplemented with sodium benzoate and sodium bicarbonate therapy. Urine gas chromatography disclosed significant elevation of propionate and its metabolites which subsided 2 days after peritoneal dialysis. Special designed formula was then given with restriction of protein intake and supplement with sodium benzoate and sodium carbonate. Prenatal genetic counseling is necessary in further pregnancy. Diagnosis can be obtained when propionyl CoA carboxylase activity is low in cultured amniotic fluid cells or chorion villi sample or when there is abnormally high methylcitrate level in amniotic fluid.

Benzoates↗

Prolonged bleeding time in cirrhotic patients: relationship to peripheral vasodilation and severity of cirrhosis.

A prolonged bleeding time (> 540 s), measured with a Simplate single template device, was found in 0% of 50 patients with chronic hepatitis and 38% of 154 cirrhotic patients. Cirrhotic patients with a prolonged bleeding time (n = 59) had lower platelet counts (P < 0.001) and a longer prothrombin time (P < 0.001) and activated partial thromboplastin time (P < 0.001) compared with cirrhotic patients with a normal bleeding time (n = 95). A weak but significant negative correlation existed between the bleeding time and platelet count in cirrhotic patients (n = 154, r = -0.3668, P < 0.001). Patients with decompensated cirrhosis had a longer bleeding time in comparison to patients with compensated cirrhosis (621 +/- 39 vs 478 +/- 27 s, respectively, P < 0.01). The prolonged bleeding time was also discovered in 25% of 83 cirrhotic patients with a platelet count > 80 x 10(9)/L and a prothrombin time < 17 s (usually taken as safe limits for invasive procedures). Twenty-seven of the 83 cirrhotic patients received a haemodynamic study by Swan-Ganz catheterization. A lower systemic vascular resistance was found in cirrhotic patients with an abnormal bleeding time than in cirrhotic patients with a normal bleeding time (844 +/- 57 vs 1171 +/- 60 dyne.s.cm-5, respectively, P < 0.001), whereas both groups had similar hepatic venous pressure gradient (16.2 +/- 1.2 vs 18.1 +/- 1.4 mmHg, respectively, P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Bleeding Time↗

[Microcolon in newborns: clinical significance and differential diagnosis].

Microcolon is a radiological finding of a colon of tiny caliber on barium enema examination. There are no absolute standards for measurement of this condition which is probably caused in utero by lack of appropriate distention of the colon with intramural content. A review was undertaken of 228 barium enema examinations of newborns admitted to Mackay Memorial hospital from January 1987 to December 1988. Twenty cases (8.7%) were regarded by the same radiologist as microcolon. Among them, ileal atresia was found in nine cases (45%); colonic atresia in two cases (10%); total colon agangliosis in three cases (15%); prenatal volvulus in two cases (10%); meconium ileus in two cases (10%); duplication of ileum in one case (5%): and megacystis-microcolon-intestinal hypoperistasis (MMIHS) in one case (5%). The characteristic features of plain abdomen and barium enema study were discussed. The finding of a microcolon on contrast enema study in newborn with lower gastrointestinal obstruction signifies that it may rise from lower gastrointestinal obstruction above colon, external compression, or motility disorder of the intestine itself. The outcome of microcolon seems to depend on its underlying causes. In those caused by obstruction, only the caliber may return to normal within days after removal of the obstruction.

Barium Sulfate↗

Pulmonary hypoplasia associated with oligohydramnios: report of five cases.

From January 1986 to December 1988, 5 cases of oligohydramnios with pulmonary hypoplasia were experienced. Clinically, all of the newborn infants had unique faces and evidence of respiratory distress with tachypnea, cyanosis, intercostal retractions, nasal flaring and grunting respiration presented within minutes after birth. Usually, they had no response to respiratory therapy. Most of them showed small lung volume by chest roentgenogram and were prone to develop pneumothorax. All 5 cases did not survive more than a few hours. Autopsy findings disclosed pulmonary hypoplasia. Four of them had urinary tract malformation, and the other one had the history of prolonged leakage of amniotic fluid.

Female↗