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C S Hung

Publications and source records attributed to C S Hung.

At least 19 recordsLinked to original sources
PubMed2006

The impact of lesion length on angiographic restenosis after vertebral artery origin stenting.

OBJECTIVE: To evaluate the effect of lesion length on in-stent restenosis (ISR) of vertebral artery (VA) origin stenting. METHODS: We retrospectively analyzed the medical and radiological records of patients receiving VA origin stenting from March 1999 to June 2005. They were subdivided according to lesion length. ISR was defined as >50% diameter narrowing in stent. RESULTS: Eighty symptomatic patients (64 male, mean age 72 years) with 90 lesions treated with balloon expandable tubular coronary stents were enrolled. There were 34 patients with 38 short lesions (length 5 mm, <10 mm, group 2) and 9 patients with 10 long lesions (length>or=10 mm, group 3). Eighty seven bare-metal stents and 3 drug-eluting stents were implanted. Repeat angiography was done in 40 lesions (44%) at 11.7+/-9.6 months. The ISR rate in group 1, 2, 3 is 21%, 29%, and 50% (p=0.486). Multivariable Cox regression analysis showed lesion length was the only significant independent predictor of ISR (hazard ratio: 1.19, p=0.039). CONCLUSION: ISR of VA origin stenting is common. Lesion length is an important predictor of ISR in VA origin stenting.

Aged↗
PubMed2000

Review of pre-eclampsia in Taiwan: a multi-institutional study.

BACKGROUND: Because the reported frequency of pre-eclampsia in Taiwan varies significantly, the aims of this study were to measure the current incidence of pre-eclampsia and its correlated morbidity and mortality for both mothers and fetuses in Taiwan. METHODS: We retrospectively studied all reported cases of pre-eclampsia and eclampsia from January 1, 1993 to December 31, 1997 in the 14 tertiary medical centers and regional hospitals in Taiwan. Recruiting criteria were pregnancy-induced hypertension (systolic blood pressure > or = 140 mmHg or diastolic blood pressure > or = 90 mmHg) with proteinuria (> or = 300 mg of urinary protein per 24 hours) and independent part edema. RESULTS: There were 4,193 patients with pre-eclampsia and eclampsia for a frequency of 2.03% of 206,551 deliveries during the study period. Of these, 58.9% of patients were classified as having mild pre-eclampsia while 38.4% had severe pre-eclampsia. Advanced maternal age (> 35 years) (odds ratio [OR] = 4.56; 95% confidence interval [CI] = 4.23-4.90; p < 0.001), primiparity (OR = 1.71; 95% CI = 1.61-1.82; p = 0.02) and twin pregnancy (OR = 1.92; 95% CI = 1.64-2.25; p = 0.01) were significant risk factors for developing pre-eclampsia. However, multivariate analysis showed that only advanced maternal age was a significant risk factor for pre-eclampsia (OR = 3.21; 95% CI = 2.95-3.50; p < 0.001). In contrast to mild pre-eclampsia, severe pre-eclampsia resulted in significantly worse outcomes for both mothers and fetuses. Complications in patients with severe pre-eclampsia included placental abruption, acute renal failure, pulmonary edema, postpartum hemorrhage, pleural effusion, preterm labor, intrauterine growth retardation, stillbirth, neonatal mortality and low birth weight infants, all of which occurred significantly more frequently than in patients with mild pre-eclampsia (p < 0.001). CONCLUSIONS: Pre-eclampsia remains a big challenge in modern obstetrics in Taiwan. Early diagnosis and management of patients with pre-eclampsia to prevent progression would significantly improve outcomes for mothers and fetuses.

Adult↗
PubMed1999

Relationship between productive HIV-1 infection of macrophages and CCR5 utilization.

HIV-1 isolates exhibit specificity for infection of immortalized T-cell lines and macrophages. The distinct cellular tropisms have been attributed to expression of coreceptors CXCR4 or CCR5, respectively. However, it is unclear whether or not other tissue-specific determinants regulate entry. The current study uses a panel of viruses to analyze the relationship between CCR5 utilization and macrophage infection. Only chimeric viruses with the entire V3 loop from macrophage-tropic isolates, ADA or SF162, were able to infect macrophages. In contrast, chimeric viruses with smaller portions of the ADA V3 loop or the V3 loop of SF2, sufficient to allow CCR5 use, were insufficient for macrophage infection. PCR analysis showed that the defect in macrophage infection of the latter viruses was due to a defect in entry. Moreover, strains capable of infecting macrophages showed relative resistance to neutralization by anti-CCR5 antibody, 2D7, compared to strains which utilize CCR5 but are incapable of macrophage infection.

Amino Acid Sequence↗
PubMed1999

Analysis of the critical domain in the V3 loop of human immunodeficiency virus type 1 gp120 involved in CCR5 utilization.

Human immunodeficiency virus type 1 (HIV-1) infection of CD4(+) lymphocytes and macrophages involves interaction of the surface subunit of the envelope protein (gp120) with coreceptors. Isolates have been found with specific tropism for macrophages and/or T-cell lines, through the utilization of chemokine receptor CCR5 (R5) or CXCR4 (X4). The third hypervariable loop (V3 loop) of gp120 is the major determinant of tropism. Using chimeric envelopes between HXB2 (X4) and ADA (R5), we found that the C-terminal half of the V3 loop was sufficient to confer on HXB2 the ability to infect CCR5-expressing cells. A sequence motif was identified at positions 289 to 292 allowing 30% of wild-type levels of infection, whereas full activity was achieved with the conversion of Lys to Glu at position 287 in addition to the above motif. Moreover, V3 loops from either SF2 (X4R5) or SF162 (R5) also allowed infection of CCR5-expressing cells, supporting the importance of V3 loops in influencing CCR5 utilization. The effects of amino acid changes at position 287 on the level of infection via CCR5 showed that negatively charged residues (Glu and Asp) were optimal for efficient interaction whereas only bulky hydrophobic residues drastically reduced infection. In addition, sequences at the N terminus of the V3 loop independently modulated the level of infection via CCR5. This study also examined the susceptibility of chimeric envelopes to neutralization by anticoreceptor antibodies and suggested the presence of differential interaction between the chimeric envelopes and CCR5. These findings highlight the critical residues in the V3 loop that mediate HIV-1 infection.

Amino Acid Sequence↗
PubMed1999

Replication of hepatitis B virus in first-degree relatives of patients with hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) may occur in family clusters. No genetic mechanism has been identified as responsible for this familial tendency. We suspected that a longer hepatitis B virus (HBV) replication phase might be the reason for a higher risk of HCC in families with this disease. We performed liver biochemical tests, test for viral hepatitis markers and hepatitis B e antigen (HBeAg), and liver ultrasonography in relatives of patients with HCC. A total of 1,885 first-degree relatives from 688 families participated in this study. Seven hundred fifty-two relatives were found to be carriers of hepatitis B surface antigen (HBsAg) and 675 of them were tested for HBeAg. The prevalence of HBeAg was 27.4% in relatives of those with HCC and 20% in asymptomatic HBsAg carriers. The HBeAg prevalence rate was higher in relatives of those with HCC > or = 40 years old than in asymptomatic HBsAg carriers. Moreover, HBeAg was more likely to persist in men than in women > or = 40 years old. We conclude that families with HCC showed a prolonged HBV replication phase that may be one of the cofactors for a familial tendency for HCC.

Adolescent↗
PubMed1998

Undiagnosed acute myocardial infarction in the accident and emergency department: reasons and implications.

Because acute myocardial infarction causes significant morbidity and mortality, a correct diagnosis in the accident and emergency department is important so that early treatment including thrombolytic therapy can be given. The aim of this study was to evaluate the reasons for missed diagnosis of acute myocardial infarction in the accident and emergency department, and the implications. All patients admitted to our coronary care unit in 1995 with the confirmed diagnosis of acute myocardial infarction were analysed retrospectively. The demographic data, clinical profiles, diagnosis made at the accident and emergency department and feasibility of thrombolytic therapy were assessed. Analysis of the electrocardiography by the accident and emergency department doctor and the coronary care unit doctor were also compared. Forty-three out of 159 patients (27.0%) with acute myocardial infarction were missed in the accident and emergency department. The diagnoses made were mostly angina or chest pain. Absence of chest pain (25.6%) [vs. 10.2% in correct diagnosis group, p < 0.05] and lack of ST elevation in electrocardiograph (62.8%) [vs. 18.1% in correct diagnosis group, p < 0.0001] were the main predisposing factors for missed diagnosis. Because of missed diagnosis, only 25.6% (vs. 67.2% in correct diagnosis group, p < 0.01) of patients were admitted to the coronary care unit. About one-third (34.9%) of missed diagnosis patients (vs. 6.0% in correct diagnosis, p < 0.01) did not receive thrombolytic therapy because of delayed diagnosis. In the missed diagnosis group, 34.8% of them might be avoidable, if electrocardiogram interpretation was more accurate. More education and training of the involved medical personnel might improve the overall situation.

Adult↗
PubMed1995

Single giant ectopic ureter: report of two cases.

Two cases of unilateral single giant ectopic ureter are reported. In each case the child had complained of mild urinary symptoms since early childhood, but these had not been investigated. Routine physical examination revealed a palpable mass in the abdomen. Imaging studies revealed absence of the kidney on one side, with hypertrophy of the contralateral kidney and a giant tubular ureter extending from the upper abdomen to the lower abdomen behind the bladder, indenting the bladder wall and terminating at the posterior urethra. The ureters measured more than 8 cm in diameter in most parts. In both cases the giant ectopic ureters were successfully removed.

Child↗
PubMed1995

Crossed, unfused ectopic kidney with a single ectopic ureter: report of a case.

A 10-year-old girl with an ectopic kidney and a single ectopic ureter inserted into the vaginal vestibule is reported. Abdominal sonography showed a hypoplastic left kidney located in the right lower abdomen. The associated ureter was dilated and tortuous, and did not open into the bladder. Diagnosis was confirmed by retrograde urogram via the ectopic ureteral orifice on the vestibule.

Child↗
PubMed1990

Cystic dilatations within the pelvis in patients with ipsilateral renal agenesis or dysplasia.

A total of 13 cases of cystic dilatations in the pelvis with ipsilateral renal agenesis or dysplasia was detected during renal ultrasonic mass screenings among 280,000 children within the last 2.5 years. The frequency was approximately 0.00464%. These anomalies included 7 cases of Gartner's cyst and 6 of seminal vesicle cyst. Sonographically, the cystic dilatations displayed a typically cystic nature with no internal echoes. The cysts were located laterally or posteriorly to the bladder, and the cystic mass protruded into or was behind the bladder and sometimes bulged the bladder wall. The dysplastic kidney in the patients with ipsilateral cystic dilatations was not detected by sonography due to its small size and the fact that it was obscured by bowel gas or overlying tissue densities. Three cases of dilated ureter communicating with the cyst were found on sonography. Since ultrasonic examination is an excellent method to identify a fluid-filled cystic structure, ultrasonography has become an important modality in the early detection, diagnosis and followup of these cystic dilatations.

Child↗
PubMed1989

Renal abnormalities in schoolchildren.

To establish prevalence of some renal abnormalities in schoolchildren, an epidemiologic study of 132,686 schoolchildren, including 69,903 boys and 62,783 girls, was conducted from March 1987 to May 1988 in the city of Taipei. At the health station of each school, the students were screened quickly by a physician with portable real-time ultrasound equipment. When a renal abnormality was detected or suspected, the examinee was referred to Taipei Municipal Women and Children's Hospital for further investigation. Radiologic and urologic procedures were then selectively performed to establish the correct diagnosis. Renal abnormalities were detected in 645 students (approximately 0.5% of total population screened). There were 256 cases of hydronephrosis, 103 cases of unilateral renal agenesis, 128 cases of unilateral small kidney, 90 cases of renal cystic disorders, 30 cases of ectopic kidney, and 38 cases of other abnormalities. Surgically correctable lesions were demonstrated in 50 of these students. Rapid renal ultrasonography was found to effectively detect some renal abnormalities initially, and prevalence could then be established after further investigations.

Adolescent↗
PubMedDate not supplied

MR perfusion studies of brain for patients with unilateral carotid stenosis or occlusion: evaluation of maps of "time to peak" and "percentage of baseline at peak".

Maps of "time to peak" (TTP) and "percentage of baseline at peak" (PBP) were compared with maps of conventional brain perfusion parameters, namely, mean transit time (MTT) and relative cerebral blood volume (rCBV). We performed MR perfusion studies in 11 patients. All of them had occlusion or high-grade stenosis of the unilateral carotid artery. Three areas of old infarct, 4 areas of new infarct, and 10 areas of brain without infarct were evaluated specifically. In all these cases, the TTP maps appeared similar to the MTT maps. They showed increases, normal values, or decreases at the same time in all areas evaluated. Most areas of abnormally decreased CBV had increased signal in PBP maps. In conclusion, the TTP map provided the same qualitative information as MTT. PBP seemed correlated inversely to CBV and was less sensitive in demonstrating abnormality.

Aged↗
PubMedDate not supplied

[Tumors detected in renal ultrasonic screening].

A program of rapid mass screening of kidneys was conducted with ultrasound for initial detection of renal and the adjacent organ abnormalities in school children and neonates in Taipei area from March 1987 to December 1990. More than a half million population were examined and the frequency of the abnormality was approximately 0.5%. Of the patients 22 had a tumor, including 13 boys and 9 girls. Age ranges were from neonate to 15 years. The tumor site for 19 patients was in the retroperitoneal space, 6 cases from the kidney, 3 cases from the adrenal gland, 1 case from the pancreas, and 9 cases from retroperitoneal tissue. The other three cases had tumor in the mediastinum, ovary or bladder. In this series, 20 cases received surgery. Pathological examination revealed 8 cases to be malignant, and 12 to be benign lesions. This experience would seem to indicate that rapid renal ultrasonic mass screening may be useful for early detection and management of tumors of the kidney and its adjacent organs.

Adolescent↗