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Biomedical subjects

W Y Lui

Publications and source records attributed to W Y Lui.

At least 217 records · Page 12Linked to original sources
PubMed1979

Phenothiazine-induced dystonia associated with an increase in serum creatine phosphokinase.

A transient but considerable rise in serum creatine phosphokinase (CPK) levels occurred in six boys aged between 8 and 11 years and suffering from phenothiazine-induced dystonia. In one boy (Case 4), after the CPK level had returned to normal after withdrawal of the drug, its reintroduction orally at lower dosage caused a slight increase in the level of CPK in the absence of any recurrence of the dystonia.

Child↗
PubMed1979

Salmonella gastroenteritis in Hong Kong--a clinical review of 200 patients.

A sudden increase in Salmonella gastroenteritis affecting infants and children in Hong Kong in 1971 prompted a clinical review of 200 such patients seen over a 6 year period. It showed unprecedented prevalence of Salmonella johannesburg infections and unusually protracted diarrhoea. Only 3.5 per cent of patients were breast fed. Factors causing this chronicity are discussed. All 8 fatal cases were under 7 1/2 months old, with protracted diarrhoea starting within 1 month after birth in 7. The invasiveness of Salmonella johannesburg is low although its infectivity high. Bacteraemia occurred in only 1 patient and focal infections other than gastroenteritis in none. Antibiotics did not improve diarrhoea nor eliminate faecal excretion in the majority of those treated. Prolonged and intermittent faecal excretion of Salmonella was common. Nineteen per cent of patients acquired diarrhoea in hospital; some after a course of antibiotics given for other infections. Experience from this series does not recommend administration of antibiotics to patients with uncomplicated Salmonella johannesburg gastroenteritis. As chronicity of diarrhoea seemed to be the major prognostic factor with regard to mortality and morbidity in this series, further search for causes and control measures of this chronicity is required.

Child, Preschool↗
PubMedDate not supplied

Monoclonal antibodies against antigens expressed on human hepatocellular carcinoma cells.

Monoclonal antibodies with selectivity for human hepatoma cell lines were produced by immunizing BALB/c mice with human hepatoma cell lines, HA22T/VGH or Hep 3B, and fusing sensitized mouse spleen cells with mouse myeloma cells. Two monoclonal antibodies recognizing antigens present only on human hepatoma cell lines were investigated. The monoclonal antibody IB1 was found to react with 3 of 9 hepatoma cell lines. Monoclonal antibody 9B2 reacted with all nine hepatoma cell lines. None of the other 20 cell lines tested was bound by IB1 and 9B2. The immunoperoxidase staining of monoclonal antibodies on frozen sections of paired hepatoma and normal liver tissues from the same individuals were studied. Antibody IB1 reacted with 3 of 13 hepatoma tissues, but with none of the normal liver and other tissues, and antibody 9B2 was reactive with antigens appearing on the bile canalicular domain of hepatoma and normal liver tissues. The antibody 9B2 stained no normal tissues with the exception of proximal tubules of kidney. Radioimmunoprecipitation tests identified two antigens reacting with 9B2. The major antigen had an apparent molecular weight of 140,000 and a minor one of 130,000. Therefore, antibody IB1 seems to be specific for antigens present on a group of human hepatoma cells and may be useful for classification and diagnosis of human hepatomas. Antibody 9B2 is quite specific to human liver cells and may be used to provide clues for the characterization of tumor cell lines, identification of metastatic tumors with hepatocytic origin, and study of the structure and function of bile canaliculi.

Animals↗
PubMedDate not supplied

Factors affecting morbidity and mortality in biliary tract surgery.

Thirty-six clinical and laboratory parameters in 770 consecutive patients undergoing biliary tract surgery over a 3 year period were analyzed in an effort to define the patients at greatest risk. Twelve parameters had a significant correlation with hospital mortality, while multivariate analysis revealed that septic shock, malignant obstruction, serum albumin less than 3.0 gm%, history of hypertension, and plasma urea nitrogen greater than 20 mg% had an independent significance in predicting postoperative mortality. The presence of more than 2 of these risk factors identified a group of patients with an 18% mortality rate. It is for this group of patients that adequate pre-operative preparation such as fluid resuscitation, prophylactic antibiotics, and nutritional support are essential. The controversial preoperative biliary drainage might be only indicated in this group of patients.

Adolescent↗
PubMedDate not supplied

Management of pancreatic lesions in von Hippel-Lindau disease.

Twelve patients with von Hippel-Lindau disease were collected in our institute from 1981 to 1995. All had a family history of the disease. Eleven patients underwent abdominal computed tomography, sonography, or angiographic studies. Ten had pancreatic involvement that included cystic lesions in nine and a solid lesion in one. Seven patients were asymptomatic. Another three presented with obstructive jaundice or upper gastrointestinal (UGI) bleeding. Except for case 8, who died of a central nervous system complication soon after diagnosis of the pancreatic lesion, the other patients had been found to have pancreatic involvement for a variable period of time, ranging from 1 to 13 years (median 5 years). Serous cystadenoma was proved pathologically in two with cystic lesions, and pancreatic endocrine tumor was diagnosed in one with a solid mass. One patient (case 1) underwent biliary bypass due to obstructive jaundice and died of cholangitis and pneumonia 6 years later. One patient (case 3) had total pancreatectomy and lived well with good diabetic control for more than 5 years. The patient with a solid lesion was explored because of repeated UGI bleeding. Surgical resection was impossible owing to advanced tumor with vascular involvement, and a pancreatic endocrine tumor was diagnosed pathologically. He was followed for 1 year. The other seven patients remained asymptomatic during the successive follow-up period. From a literature review and our own experience, we suggest that conservative measures are adequate for the cystic lesions; however, aggressive resection is mandatory for a solid pancreatic lesion in von Hippel-Lindau disease.

Adult↗
PubMedDate not supplied

Hypercholesterolaemia in patients with hepatocellular carcinoma.

Ninety-one (11.4%) subjects with hypercholesterolaemia (serum cholesterol level more than 250 mg/dL) of 792 Chinese patients with hepatocellular carcinoma (HCC) were studied in Taiwan. All 91 patients had large tumours greater than 7 cm in diameter and a tumour volume greater than 50%; 56 (61%) of these patients manifested tumour involvement in both lobes of the liver. The HCC patients with hypercholesterolaemia had significantly higher mean serum levels of albumin, triglyceride and alpha-fetoprotein (AFP) compared with age-sex-tumour volume matched HCC patients without hypercholesterolaemia. The associated incidence of hypoglycaemia in hypercholesterolaemic HCC patients was significantly higher than in HCC patients without hypercholesterolaemia (15/90 vs 4/90; P = 0.01). There was no significant difference in the survival analysis between HCC patients with and without hypercholesterolaemia. Eight and 11 of hypercholesterolaemic HCC patients had their tumours surgically resected and received transcatheter hepatic arterial chemoembolization (TAE), respectively. Serum cholesterol levels fell to the normal range after treatment and rose to abnormal levels again when tumours recurred after surgery or progressively enlarged after TAE. The change in pattern of serum cholesterol was parallel to the change in serum AFP. Serum cholesterol levels may serve as another marker in identifying tumour recurrence and the presence of a viable tumour mass in hypercholesterolaemic HCC patients who have received surgical resection or TAE.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Pre-operative serum levels of tissue polypeptide antigen in patients with gastric cancer.

Pre-operative serum tissue polypeptide antigen (TPA) levels were measured in cases of gastric cancer from December 1987 to December 1992. All 351 cases received gastrectomies. The clinicopathological factors were analysed. The significant factors that correlated with the elevation of pre-operative serum TPA levels included tumour size (> 7 cm), Borrmann-type cancers, late stages (III and IV), lymph node metastasis, hepatic metastasis and Ming's expanding type cancers. Multivariate analysis showed that the tumour size (> 7 cm) and the presence of hepatic metastasis are significant factors. To clarify the relationships between gastric cancer per se and the pre-operative serum TPA levels, we selected cases without evidence of metastasis (n = 139). The tumour size was the only significant factor when multivariate analysis was applied. Possibilities of hepatic recurrence were found in cases with high pre-operative serum TPA levels (> 220 U/L), even radical gastrectomies were performed. A high pre-operative serum TPA level did not display a poor survival prognosis, if the radical gastrectomy was possible. We thus concluded that: (i) elevated pre-operative serum levels of TPA are associated with either a large size tumour (> 7 cm) or the presence of hepatic metastasis and the tumour size is the most important factor relating to the serum TPA levels; (ii) high pre-operative serum TPA levels (> 220 U/L) may serve as indicators of later hepatic recurrence; and (iii) elevated serum TPA levels were not indicators of survival prognosis.

Aged↗
PubMedDate not supplied

Helicobacter pylori infection in patients with gastric adenocarcinoma.

We examined the biologic tumor behavior in Helicobacter pylori-seropositive patients with gastric adenocarcinoma. A total of 214 consecutive patients with pathologically confirmed adenocarcinoma of the stomach who underwent gastric resection were studied. The stored serum samples were tested for serum antibody to H. pylori by using a highly sensitive and specific IgG enzyme-linked immunosorbent assay. The difference in H. pylori-seropositive and seronegative patients with gastric adenocarcinoma was evaluated in terms of various clinicopathologic parameters. A multivariate logistic regression analysis was used to adjust for potential confounding variables. Antibodies to H.pylori were detected in 65.9% of patients with gastric adenocarcinoma. H.pylori-seropositive patients were younger than seronegative patients and had infiltrative tumor according to Ming's criteria. When adjusted for age, infiltrative tumor come out stronger. These findings suggest that H.pylori infection may be related to infiltrative type gastric adenocarcinoma; further study is necessary.

Adenocarcinoma↗
PubMedDate not supplied

Hepatocyte growth factor and Met/HGF receptors in patients with gastric adenocarcinoma.

Overexpression and amplification of Met/HGF receptor has been detected in gastric cancer tissues and cell lines. In this study hepatocyte growth factor (HGF) and Met/HGF receptors were localized in 32 gastric cancer and adjacent normal gastric tissues by the avidin-biotin-peroxidase complex technique. HGF (87.5%) and Met/HGF receptors (68.8%) were demonstrated in gastric cancer tissues. A high positive rate of HGF (87.0%) and Met/ HGF receptors (82.6%) presented in intestinal type gastric cancer. HGF immunoreactivity in gastric cancer tissues was a significant and powerful prognostic indicator (relative risk 15.9; p=0.01). These data suggest that HGF and Met/HGF receptors are involved in the morphogenesis of intestinal type gastric cancer. HGF may have other mechanism that favor gastric cancer spread and independently affect survival.

Adenocarcinoma↗
PubMedDate not supplied

Surgical resection of hepatocellular carcinoma in elderly cirrhotic patients.

BACKGROUND/AIMS: Both cirrhosis and old age have been reported to be risk factors for hepatic resection. This study evaluated the clinical results of hepatic resection in elderly hepatocellular carcinoma (HCC) patients with cirrhosis. METHODOLOGY: During a 5-year period, 248 patients with HCC underwent curative hepatic resection. Among them, 24 elderly patients (age: > or = 70 years) with cirrhosis (Group I), 24 patients (age: > or = 70 years) without cirrhosis (Group II), and 98 patients (age: < 70 years) with cirrhosis (Group III) were selected for the study. The clinical and pathologic parameters, including pre-operative demographic features, surgical factors, pathological factors, DNA flow-cytometric analysis of the resected specimen, and post-resection prognosis were compared among the three groups. RESULTS: Group I patients had a significantly higher incidence of small-size tumors, hepatitis C infection, concomitant esophageal varices, and minor resection with a shorter surgical margin in the resected specimen. The surgical morbidity and mortality of Group I was similar to that of Group II and III patients. However, the disease-free survival rate was significantly lower in the Group I patients than in Group II (p = 0.02) and Group III patients (p = 0.04). CONCLUSIONS: Our findings indicate that although hepatic resection can be done safely in elderly cirrhotic HCC patients, the prognosis for these patients was less favorable even when curative resection was performed.

Adult↗
PubMedDate not supplied

Factors affecting morbidity, mortality and survival after pancreaticoduodenectomy for carcinoma of the ampulla of Vater.

BACKGROUND/AIMS: The aim of this paper is to reevaluate the factors responsible for hospital morbidity, mortality and post-operative survival following pancreaticoduodenectomy for ampullary cancer. METHODOLOGY: Peri-operative data on 132 patients undergoing pancreaticoduodenectomy for ampullary cancer were correlated with post-operative morbidity, mortality and long-term survival. RESULTS: Three factors were found to correlate well with post-operative morbidity; however, only intraabdominal or wound sepsis was an independently significant variable. Four parameters correlated well with hospital mortality, while multivariate analysis revealed age > 75 y/o, positive blood culture and albumin < or = 3.0 g% to be independently significant in predicting post-operative mortality. Univariate analysis identified seven significant factors: 1) age < or = 75 y/o, 2) hematocrit > 30%, 3) blood urea nitrogen < 20 mg%, 4) earlier TNM staging, 5) smaller tumor size, 6) negative nodal status and 7) well-differentiated tumors, which were associated with longer survival. However, multivariate analysis disclosed nodal status and hematocrit to be the two most significant independent variables. CONCLUSIONS: Although radical resection for ampullary cancer can be performed with a low mortality in recent years, the justification for performing this major operation in a patient over 75 years of age should be reevaluated for prohibitively high mortality (10x) and shorter survival (median 6.0 months). Pre-operative nutritional support and careful surgical technique to prevent post-operative sepsis are mandatory to reduce operative morbidity and mortality. Correction of anemia and adequate lymph node dissection will clarify the patient's survival benefit following this operation.

Adult↗
PubMedDate not supplied

Preparation and in vitro evaluation of B-lipiodol as a boron delivery agent for neutron capture therapy of hepatoma.

BACKGROUND: We prepared boron containing lipiodol (B-lipiodol), elucidated the retention of B-lipiodol in hepatoma cells and evaluated the in vitro cellular toxicity of B-lipiodol for neutron capture therapy. MATERIALS AND METHODS: Human hepatoma HepG2 cells were used to examine the uptake and retention of B-lipiodol. Light microscopes were used to examine the interaction and retention of B-lipiodol globules in individual hepatoma cells. Boron and lipiodol concentrations were determined by inductively coupled plasma-atomic emission spectroscopy and neutron activation analysis, respectively. RESULTS: The boron concentration in B-lipiodol drug could reach 2500 ppm. B-lipiodol could be stably retained in serum and culture medium. HepG2 cells appeared proficiently at internalization and persistent retention of B-lipiodol. The boron concentration reached 3.5 micrograms/10(6) cells without approaching saturation at 48 h treatment. CONCLUSION: Hepatoma cells could actively uptake B-lipiodol and a sufficient amount of boron was retained inside the HepG2 cells which could be used for neutron capture therapy.

Animals↗
PubMedDate not supplied

Poorer prognosis in young patients with gastric cancer?

BACKGROUND/AIMS: Although the relationship between prognosis and age of patients with gastric cancer is controversial, a poorer prognosis in young patients has been suggested by most investigators. To further examine the hypothesis, a retrospective study was undertaken to analyze a large series of patients with gastric cancer in Taiwan. METHODOLOGY: A total of 1,642 consecutive patients diagnosed with gastric cancer and receiving further management at one medical center from 1988 to 1993 were reviewed. The gender, TNM tumor stage, rate of curative resection and survival of the patients were compared in the young age group (< or = 39 years) and the old age group (> 39 years). Survival was estimated with the product-limit method and difference in survival was tested by the log-rank test. Multivariate analysis was done by the Cox proportional hazard model. RESULTS: Among the 1,642 patients, 61 patients were in the young age group and 1,581 patients were in the old age group. There was no significant difference for the 2 groups of patients in the distribution of TNM stage (stage I: 20%; II: 8%; III: 13%; IV: 59% vs. 19%, 11%, 25% and 45% respectively, in the old age group, p = 0.098) and rate of curative resection (38% vs 51% in the old age group, p = 0.059). The overall 5-year survival showed no significant difference between the 2 groups (25% vs. 29% in the old). Subgroup analyses showed that survival after curative resection and survival without curative treatment (including palliative resection and no resection) also had no difference in the 2 groups. Multivariate analysis also showed that age was not an independent factor. CONCLUSIONS: Although most reports suggested a dismal prognosis in young patients with gastric cancer, based on our findings, young patients (< or = 39 years) do not have a worse prognosis than older patients.

Adult↗