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Biomedical subjects

W L Ho

Publications and source records attributed to W L Ho.

68 records · Page 4Linked to original sources

[Malignant fibrous histiocytoma of spleen. A case report and literature review].

A 11 year old girl who presented with malaise, poor appetite and flank mass was admitted in Sept. 1988. Abdominal x-ray, sonogram, Gallium scan and CT scan revealed a tumor mass in the spleen. Laparotomy confirmed a hugh mass measuring 15x15x10 cm in the spleen. The histologic study proved the tumor to be malignant fibrous histiocytoma, inflammatory type. Malignant fibrous histiocytoma occur mainly in late adult life, we report this case because the patient is young and the involvement of the spleen is rare.

Child↗

Concomitant splenectomy for hypersplenic thrombocytopenia in hepatic resection for hepatocellular carcinoma.

BACKGROUND/AIMS: Resection of hepatocellular carcinoma (HCC) in patients with liver cirrhosis and hypersplenic thrombocytopenia (HSTC) is risky. Controversy exists concerning the role of concomitant splenectomy for HSTC in cirrhotic patients undergoing hepatectomy for HCC. METHODOLOGY: During the past 10 years, 294 patients have undergone hepatic resection for HCC in our department. Among them, 11 cirrhotic patients with severe HSTC (platelet count < or = 80000/mm3) underwent splenectomy simultaneously. The clinical outcomes were retrospectively reviewed. RESULTS: The resected spleen weighed 479 +/- 242 g. The post-operative mortality and morbidity were 9.1% and 27.3%, respectively. In all patients, the platelet count was elevated to above 100000/mm3, and serum total bilirubin was significantly lowered within 1 week of operation. The overall 5-year actuarial and disease-free survival rates were 66.7%. None of the patients developed severe infectious complications during the follow-up period. CONCLUSIONS: Concomitant splenectomy for severe HSTC in cirrhotic patients undergoing hepatectomy for HCC is justified as the benefits of concomitant splenectomy by far surpass the adverse effects.

Aged↗

Is hepatic resection absolutely contraindicated for hepatocellular carcinoma in Child-Pugh class C cirrhotic patients?

BACKGROUND/AIMS: Liver resection for hepatocellular carcinoma (HCC) in Child-Pugh class C cirrhotic patients is considered to be high risk and even contraindicated. This study examined our results of hepatectomy for HCC in such cirrhotic patients. METHODOLOGY: A retrospective review of the clinicopathological features, as well as early and late resection results of Child-Pugh class A (n = 181) and class C patients (n = 13) were compared. The extent of hepatectomy was based on the pre-operative liver function test and indocyanine-green (ICG) clearance rate. RESULTS: The tumor size in class C patients was smaller than that in class A patients. There were no significant differences with regard to operative blood loss, amount of blood transfusion, operative morbidity or mortality. The surgical margins of class C patients were narrower (p = 0.003). The tumors of class C patients had higher incidences of well-formed capsules and absence of satellite nodules. The 5-year disease-free and actuarial survival rates of class A and C patients were 35.4% and 40.7% (p = 0.28), and 48% and 50% (p = 0.13), respectively. CONCLUSIONS: Not all HCCs in Child-Pugh class C cirrhotic patients are contraindicated for liver resection. In the absence of uncontrollable ascites, marked jaundice and encephalopathy, surgical resection is still justified in some selected cases, in spite of a narrow surgical margin.

Actuarial Analysis↗

Detection of p53 mutations in sputum smears precedes diagnosis of non-small cell lung carcinoma.

Little progress has been made in reducing lung cancer mortality by applying conventional methods to early diagnosis and screening. Recent advances in molecular oncology, however, have provided tools which may be of use in this area. p53 gene mutation is the most common gene alteration in the development of lung cancer. Conventional cytologic analysis of sputum is an insensitive test for the diagnosis of lung cancer. In this study, we attempted to establish a polymerase chain reaction (PCR)-based assay for assessing the possibility of early detection of p53 mutation in archival Papanicolaou-stained cytologic sputum smears. Ten sputum smear slides were collected prior to clinical diagnosis from 10 lung cancer patients who had been confirmed to have p53 mutations in surgically resected lung tumors. We successfully obtained sufficient amounts of RNA from each sputum smear specimen for amplification of PCR and direct sequencing. Only one patient was found to have p53 mutation at codon 286; the other nine patients had wild type p53 genes. This result supports the possibility that detection of p53 mutations in cytologic sputum smears is an available strategy for the early diagnosis of lung cancer.

Aged↗

Precocious puberty associated with growth hormone deficiency in a patient with craniopharyngioma: report of one case.

Isosexual precocious puberty in girls is not uncommon, but its association with craniopharyngioma and growth hormone deficiency is rarely reported. We present a patient with this combination. An 8-year-old girl developed breasts and then had menarche at 7 9/12 years old. Growth hormone deficiency was suspected due to inappropriate height and growth velocity in association with idiopathic precocity and a poor predicted adult height of 138.8 cm. Growth hormone deficiency was confirmed by clonidine and insulin stimulation tests. Intracranial lesion was suspected due to precocity associated with GH deficiency. MRI of the sella's region revealed a 1 cm mass in the hypothalamus. After surgical resection, pathology of the tumor disclosed a craniopharyngioma which has rarely been reported to cause precocious puberty. The precocious puberty regressed after surgery. Growth hormone deficiency persisted and GH therapy was given to improve growth. The growth rate of patients with both growth hormone deficiency and precocious puberty may be maintained within the normal prepubertal range by the effect of sex steroid. We suggest that in patients with central type precocity in association with an inappropriate growth status, physicians should investigate the underlying intracranial lesion, and the possibility of growth hormone deficiency.

Biopsy, Needle↗

Cystic fibrosis in two Chinese infants in Taiwan.

Cystic fibrosis was diagnosed in two female infants, respectively nine months old (Case 1) and six months old (Case 2). Clinical presentation of these two infants showed frequent episodes of pneumonia, dehydration and poor weight gain, despite fair intake of food since birth. Hyponatremic, hypochloremic metabolic alkalosis had been found during their previous hospitalizations. In Case 1, stool fat was positive with negative trypsin test. Both cases had abnormal findings on chest X-ray films, but the pancreas showed no remarkable cystic changes from sonography. Plastic-bag method of sweat test showed Na/Cl: 155/185 nmol/L in Case 1, Na/Cl: 127/135 nmol/L in Case 2. A family history was suggested, since each one had an elder brother who had died in early infancy with similar clinical presentations. Both patients were put on special diet therapy as well as chest physical therapy. Case 1 died suddenly at 16 months of age. Autopsy revealed mucusplugged dilated ducts with atrophy of the exocrine portion of the pancreas. DNA analysis in Case 2 showed abnormal mutation point at 1898+5 G-->T on chromosome 7.

Cystic Fibrosis↗

Neonatal Staphylococcus aureus pancarditis: report of one case.

Due to poor feeding, decreased activity and severe abdominal distension, a 20-day old female infant was admitted to our hospital. The patient was diagnosed as having necrotizing enterocolitis and received a multiple segmental resection. During the hospitalization, recurrent sepsis and candidiasis occurred. On the 56th day of admission, tachycardia, thrombocytopenia and cardiomegaly were noted. Sudden onset of cardiac arrest occurred and a post-mortem examination revealed staphylococcal pancarditis. Pancarditis is a rare and fatal disease in newborns. When a patient with a catheter insertion shows unknown cause of thrombocytopenia and acute onset of cardiomegaly, an echocardiogram is highly suggested. Early diagnosis and proper parenteral antibiotics may be life-saving.

Acute Disease↗

Neurilemmoma of the oculomotor nerve presenting as an orbital mass: MR findings.

Neurilemmoma of the oculomotor nerve is rare and infrequently presents as an orbital mass. We report a neurilemmoma arising from the cavernous sinus with its major part extending into the orbit. The Antoni A part of the neurilemmoma showed intermediate signal intensity in both T1- and T2-weighted MR images and exhibited postcontrast enhancement. The Antoni B part revealed hypointensity on T1-weighted images, hyperintensity in T2-weighted images, and showed no contrast enhancement.

Adult↗