Search PubMed⌕ Search

Biomedical subjects

Wen-Rei Kuo

Publications and source records attributed to Wen-Rei Kuo.

At least 37 records · Page 2Linked to original sources
PubMed2004

Epidermal growth factor expression in middle ear cholesteatoma.

Middle ear cholesteatoma is destructive to auditory ossicles and temporal bone, and treatment usually requires surgical removal of all epithelial content. Epidermal growth factor (EGF) can stimulate the growth and differentiation of a variety of mammalian cells, including epithelial cells. Our study used the avidin-biotin complex technique to evaluate the expression of EGF in 40 cases of middle ear cholesteatoma (active cholesteatoma, 31 cases; inactive cholesteatoma, 9 cases) and 34 normal postauricular skin samples. In middle ear cholesteatoma, EGF was expressed in squamous epithelium in 21 cases (53%), fibroblasts in two cases (5%), and cholesteatoma endothelium in two cases (5%). In normal postauricular skin, EGF was expressed in squamous epithelium in 14 samples (41%), fibroblasts in one sample (3%), and endothelium in none. No statistical difference in EGF expression was found between cholesteatoma and normal postauricular skin samples. These results show that the distribution of EGF in middle ear cholesteatoma is not deranged and that the progression of cholesteatoma might be induced by the release of factors from the cholesteatoma matrix via autocrine stimulation, or by inflammatory cells of the subepithelial tissue through paracrine stimulation, or in both of these ways.

Adult↗
PubMed2004

Fibro-osseous lesion of the external auditory canal: a case report.

The aim of this study was to differentiate a novel type of benign circumscribed bone lesion of the external auditory canal from lesions described previously, such as exostoses and osteomas. We present a 43-year-old male patient who suffered from ear discharge of the right ear. Local findings showed bloody discharge from his right auditory canal, which was occupied by a mass-like tissue. Computerized tomography (CT) carried out before resection of the lesion disclosed the absence of a bony connection to the underlying structures. The pathologic findings showed lesions consisting of an osteoma-like bone formation with sparse osteoblastic areas. Mature lamellar bone and bone marrow containing adipose tissue were also noted. There was no evidence of a relationship to the cartilaginous tissue or bony structures of the external auditory canal. Therefore, we present this rare case and review the reported literature in which clinical, CT, surgical, and pathologic findings suggest that this lesion was unlike those previously known, and may be related to ossifying reactions in other parts of the organism.

Adult↗
PubMed2004

Multiple symmetric lipomatosis (Madelung's disease): report of two cases.

Multiple symmetric lipomatosis (Madelung's disease) is a rare disease characterized by non-encapsulated adipose deposits in the neck, the superior part of the trunk and, very rarely, in the limbs. It is common in middle-aged Caucasian Mediterranean males but very rare in Chinese people. We describe two cases of Madelung's disease: both patients presented complaining of a development of a painless neck mass that was increasing in size. Panendoscopy was normal. Both underwent incisional biopsies that revealed benign adipose tissue characterizing Madelung's disease. We discuss the clinical presentation, associated morbidity, and treatments for Madelung's disease.

Adult↗
PubMed2004

Schwannoma of the nasal septum: a case report.

Schwannoma is a neurogenic tumor arising from the sheath of myelinated nerves. Only 4% of schwannomas located in the head and neck region involve the sinonasal tract, and those arising from the nasal septum are exceedingly rare. We report a case of a 55-year-old male who presented with only right nasal obstruction. Computerized tomography and clinical examination suggested a benign tumor before the tumor was completely removed by transnasal endoscopic surgery. When encountering a mass in the nasal cavity, schwannoma should be borne in mind in the differential diagnosis. We discuss the clinical presentation, histologic features, differential diagnosis, and therapeutic options for such a rare lesion.

Diagnosis, Differential↗
PubMed2004

Cerebral radionecrosis with cystic degeneration following radiotherapy for nasal cavity squamous cell carcinoma: a case report.

A 31-year-old man with nasal cavity squamous cell carcinoma was treated in our hospital with two courses of radiotherapy (120 Gy total dose) followed by surgical tumor resection. Three years after the last irradiation, he developed seizures as well as changes in behavior and consciousness. Medical therapy with diphenylhydantoin (Dilantin) terminated the seizures. Dysphagia, unsteady gait, and right-side limb weakness developed 37 months after the onset of seizures. Magnetic resonance imaging showed a large, cystic mass in the left temporal lobe with left to right midline shift. Following craniotomy with decompression of the cystic mass, the patient improved clinically. No malignant cells were found in the specimen. No further progression of neurologic symptoms was noted after a 1-year follow-up. Cerebral radionecrosis is an uncommon late complication of radiotherapy and needs to be differentiated from tumor recurrence or metastasis if the irradiation field covers the cerebral region in patients with head and neck malignancies.

Adult↗
PubMed2004

Risk of vocal palsy after thyroidecitomy with identification of the recurrent laryngeal nerve.

The purpose of this study was to assess the risk of vocal palsy after thyroidectomy with identification of recurrent laryngeal nerve (RLN) during surgery. In all, 521 patients treated by the same surgeon were enrolled in this study. Temporary and permanent vocal palsy rates were analyzed for patient groups classified according to surgery for primary benign thyroid disease, thyroid cancer, Graves' disease, and reoperation. Measurement of the vocal palsy rate was based on the number of nerves at risk. Twenty-six intentionally sacrificed RLNs were excluded from analysis. Forty patients developed postoperative unilateral vocal palsy. Complete recovery of vocal palsy was documented for 35 of the 37 patients (94.6%) whose RLN integrity had been ensured intraoperatively. Recovery from temporary vocal palsy ranged from 3 days to 4 months (mean, 30.7 days). The overall incidences of temporary and permanent vocal palsy were 5.1% and 0.9%, respectively. The rates of temporary/permanent vocal palsy in groups classified according to underlying disease were 4.0%/0.2% for benign thyroid disease, 2.0%/0.7% for thyroid cancer, 12.0%/1.1% for Graves' disease, and 10.8%/8.1% for reoperation. Surgery for thyroid cancer, Graves' disease, and recurrent goiter were associated with significantly higher vocal palsy rates. Most patients without documented nerve damage during the operation recovered from postoperative vocal palsy. Total lobectomy with routine RLN identification is recommended as a basic procedure in thyroid surgery.

Adolescent↗
PubMed2004

A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy.

OBJECTIVE: To study the long-term sensorineural hearing status after radiotherapy in patients suffering from nasopharyngeal carcinoma. STUDY DESIGN: A prospective study of 220 patients (395 ears) with a median follow-up of 36 months. SETTING: A university hospital. PATIENTS: Four criteria were needed. The patient had to have had at least 12 months of audiologic follow-up, no concurrent chronic ear disease, no direct tumor invasion of ear, and no significant sensorineural hearing loss before radiotherapy. INTERVENTION: Pure-tone audiography and impedance audiometry-which were performed before and at the third month after completion of radiotherapy and at a yearly interval thereafter-formed the basis of the study. MAIN OUTCOME MEASURES: The significance level in this study was defined as a bone conduction threshold increase of more than 10 dB between the initial audiogram and those obtained after the completion of radiotherapy. An increase of more than 30 dB was defined as severe loss. RESULTS: Paired t test indicated that the mean bone conduction threshold before and after radiotherapy were significantly different (paired t test, p < 0.05). Logistic regression showed that patient age was related to the significant loss at speech frequency but not to the loss at 4 kHz. The presence of postradiation otitis media with effusion, preirradiation hearing status, and addition of chemotherapy were found to be not influential on hearing change. CONCLUSION: Hearing deterioration may begin as early as 3 months after the completion of radiotherapy. Early change may be transient, but the effect of radiation on hearing tended to be chronic and progressive.

Acoustic Impedance Tests↗
PubMed2004

Microsurgical pressing excision technique for vocal nodules and simple epithelial hyperplasia of the vocal fold.

Precise bimanual microsurgical excision of sessile, thin benign epithelial lesions of the vocal folds can be difficult. During microlaryngeal surgery, the potential risks of over-excision and under-excision are of major concern. We introduce a microsurgical technique using horizontally-opening curved microforceps and microscissors, instead of the conventional vertically-opening microinstruments, to remove vocal nodules and simple epithelial hyperplasia. The treatment results were satisfactory, with 208 (90.8 per cent) of patients retaining a satisfactory/normal (G(0)) voice. No patient had a worsened voice after the procedure. This microsurgical pressing excision technique is an alternative precise method for microlaryngosurgery.

Epithelium↗
PubMed2004

Deroofing surgical treatment for pseudocyst of the auricle.

OBJECTIVES: Pseudocyst of the auricle is characterized by asymptomatic swelling caused by an intracartilaginous accumulation of fluid. If left untreated, permanent deformity of the pinna may occur. Many modalities of treatment have been reported, but problems regarding recurrence and appearance remain. The purpose of this study was to introduce more reliable treatment for pseudocyst of the auricle. DESIGN: Retrospective chart review. SETTING: Department of Otolaryngology, Kaohsiung Medical University, Kaohsiung, Taiwan. METHODS: The population used for the present report consisted of 10 patients with auricular pseudocyst that was unresponsive to aspiration followed by intralesional steroid injection or who declined conservative treatment. All patients were treated surgically with the deroofing method under local anaesthesia. MAIN OUTCOME MEASURES: Postoperative clinical outcome and recurrence of the lesion. RESULTS: All patients had excellent cosmetic outcomes, and no recurrence or complication occurred. CONCLUSIONS: Deroofing surgery for pseudocyst of the auricle is a safe, easy, and reliable procedure. If conservative measures fail or are declined by the patient, removal of the anterior cartilaginous leaflet of the lesion is an alternative method that can yield excellent results.

Adult↗
PubMed2003

Hearing loss in patients with nasopharyngeal carcinoma after chemotherapy and radiation.

In light of the possible adverse effects of radiation on hearing, we conducted a study to evaluate the long-term sensorineural hearing status following radiotherapy (RT) in patients suffering from nasopharyngeal carcinoma. Audiologic examinations were performed at regular intervals before and after RT. We also analyzed the effects of age, chemotherapy, pre-RT hearing status, and post-RT otitis media with effusion (OME) on post-RT hearing change. A total of 150 patients (261 ears) were enrolled in this study and followed up for a mean of 43.8 months. After RT, 8.9-28.8% of ears had at least a 10 dB loss in bone conduction threshold at speech frequency, which was defined as an average of hearing threshold at 0.5 kHz, 1 kHz, and 2 kHz, while the percentage was 18-34.2% at 4 kHz. Patient age was related to these changes at speech frequency, and the presence of post-RT OME was related to significant loss at both speech frequency and 4 kHz. Pre-RT hearing status and chemotherapy did not influence hearing change. To sum up, sensorineural hearing loss began as early as after completion of RT. Early changes may be transient, but the effect of radiation on hearing tended to be chronic and progressive.

Adolescent↗
PubMed2003

Expression of epidermal growth factor receptor in human middle ear cholesteatoma.

Middle ear cholesteatoma is destructive to auditory ossicles and temporal bone, and treatment usually includes surgical removal of all epithelial content in the tympanomastoid cavity. Epidermal growth factor receptor (EGFR) is a 170 kd to 180 kd transmembrane glycoprotein and its distribution density is related to the ability of the keratinocytes to differentiate and their state of differentiation. We used the avidin-biotin complex technique and EGFR monoclonal antibody to evaluate the expression of EGFR in 29 cases of cholesteatoma and 34 samples of normal postauricular skin. Of patients with cholesteatoma, 79% (23 cases) had EGFR-positive cells in the basal layer, 66% (19 cases) in the parabasal layer, and 62% (18 cases) in the upper layer of the epithelial tissue. Among patients with normal postauricular skin, 85% (29 cases) had EGFR-positive cells in the basal layer, 79% (27 cases) in the parabasal layer, and 79% (27 cases) in the upper layer of the epithelial tissue. No statistical difference in EGFR expression between each layer of cholesteatoma and postauricular skin was noted. However, there was an intensity gradient of positive EGFR immunoreactivity from the basal to the higher layers in cholesteatoma. Our results showed that the distribution of EGFR in middle ear cholesteatoma is not deranged, but is similar to that in normal skin tissue.

Adult↗
PubMed2003

Sinonasal NK/T-cell lymphoma with upper gastrointestinal bleeding: a case report.

Natural killer (NK)/T-cell lymphoma is the most common malignant lymphoma among sinonasal lymphomas. Diagnosis is difficult and prognosis is poor. Herein, we report the case of a 22-year-old male patient with sinonasal NK/T-cell lymphoma who first presented with nasal obstruction and left facial swelling. There was a mushroom-like mass over the hard palate, diffuse mucosal swelling in the left nasal cavity, and left orbital cellulitis. The patient underwent a Caldwell-Luc operation, functional endoscopic sinus surgery, and wide excision of the palate tumor. Pathologic examination of the maxillary sinus, nasal cavity, and palate tumor showed an NK/T-cell lymphoma. Two days after the operation, the patient suddenly had bloody stool and suffered hematemesis. A series of examinations revealed a small intestinal hemorrhage. Emergent exploratory laparotomy showed an ulcerative tumor mass with bleeding over the jejunum. Pathologic examination of the mass showed that it was the same as the sinonasal mass, an NK/T-cell lymphoma. We reviewed previous studies on nasal NK/T-cell lymphoma and found no report discussing patients with NK/T-cell lymphoma of both nasal and non-nasal origins. From this case, we learned that in patients with sinonasal NK/T-cell lymphoma, other sites may be involved.

Adult↗
PubMed2002

Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment.

PURPOSE: To evaluate the health-related quality of life (HR-QOL) of nasopharyngeal cancer (NPC) patients with cancer-free survival after treatment and to investigate the factors correlated with their HR-QOL. METHODS AND MATERIALS: One hundred eighty-two NPC patients with cancer-free survival of more than 2 years after treatment were enrolled in the study. Data from the same number of people without a history of cancer, who had come to the hospital for health checkups, were also collected for comparison. The Chinese SF-36 questionnaire and nine items about head-and-neck functional impairments (HNFI) were self-reported by all participants at the clinics. Data relating to sociodemographic factors, cancer stage, and treatment of NPC survivors were analyzed. RESULTS: Psychometric tests revealed the excellent internal reliability (Cronbach's alpha: 0.87-0.96) and discriminative validity of the Chinese SF-36 used in Taiwan. Most functional domains of the Chinese SF-36 and all nine HNFI items were significantly worse in NPC survivors than in control subjects. No cancer or treatment-related variables significantly correlated with any functional domains of SF-36 or any items of HNFI for NPC survivors. Economic status, educational level, occupational status, and the number of comorbidities were the variables that significantly correlated with most functional domains of SF-36 for NPC survivors. Patients with more sufficient economic status, higher educational levels, with employment, or without comorbidity tended to enjoy better HR-QOL as detected by the SF-36. Salivation, hearing, and swallowing dysfunctions were the top three HNFI that disturbed NPC survivors. Economic status remained the most significant variable correlated with HNFI, including salivation, swallowing, neck stiffness, taste, and phonation. Survivors with better economic status reported less severe HNFI. CONCLUSIONS: NPC survivors had worse HR-QOL than healthy control subjects in the study. Socioeconomic status was the most significant variable that correlated with the HR-QOL of NPC survivors. This result might indicate that patients' superior individual characteristics and financial resources are important variables determining their ability to cope with cancer and treatment complications affecting their HR-QOL.

Adult↗
PubMed2002

Ancient schwannoma of the infratemporal fossa.

This article describes a case of ancient schwannoma of the infratemporal fossa. Ancient schwannoma is a rare variant of the neurilemmoma, which clinical findings and radiographic features suggest is a slow-growing, benign tumour. Histopathologic features such as hypercellularity with nuclear atypia can make accurate diagnosis of this tumour difficult. The treatment of this tumour is complete resection, and the prognosis is good.

Adult↗