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Biomedical subjects

C Y Hsieh

Publications and source records attributed to C Y Hsieh.

At least 73 records · Page 4Linked to original sources
PubMed1995

Immunoelectrophoretic differentiation of alpha-fetoprotein in disorders with elevated serum alpha-fetoprotein levels or during pregnancy.

Our study aims to make differential diagnosis by immunoelectrophoresis for some common conditions with elevated levels of serum alpha-fetoprotein (AFP). One hundred and nine cases with elevated AFP levels were included in this study: yolk sac tumor (n = 8), hepatocellular carcinoma (n = 26), gastric cancer (n = 12), chronic hepatitis (n = 27) and normal pregnancy (n = 36). Lectin agarose gel electrophoresis, antibody-affinity blotting, and immunoreaction were used to identify the specific patterns of AFP in the respective conditions. The results showed that there were three possible bands: L1, L2 and L3. Yolk sac tumor produced a prominent L2 band and a light L3 band. Hepatocellular carcinoma produced a prominent L1 band and a light L3 band. Gastric cancer produced only an L1 band. Chronic hepatitis had a light L1 band and a pronounced L3 band. In pregnancy, the AFP pattern is similar to that of hepatocellular carcinoma. Immunoelectrophoresis is a useful method facilitating the differentiation of AFP origins.

Biomarkers, Tumor↗
PubMed1994

A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain.

STUDY DESIGN: A randomized prospective trial of manipulation, massage, corset and transcutaneous muscle stimulation (TMS) was conducted in patients with subacute low back pain. OBJECTIVES: The authors determined the relative efficacy of chiropractic treatment to massage, corset, and TMS. SUMMARY OF BACKGROUND DATA: Although all of these treatments are used for subacute low back pain treatment, there have been few comparative trials using objective outcome criteria. Patients were enrolled for a period of 3 weeks. They were evaluated once a week by questionnaires, visual analog scale, range of motion, maximum voluntary extension effort, straight leg raising and Biering-Sorensen fatigue test. The dropout rate was highest in the muscle stimulation and corset groups and lowest in the manipulation group. Rates of full compliance did not differ significantly across treatments. A measure of patient confidence was greatest in the manipulation group. RESULTS: After 3 weeks, the manipulation group scored the greatest improvements in flexion and pain while the massage group had the best extension effort and fatigue time, and the muscle stimulation group the best extension. CONCLUSION: None of the changes in physical outcome measures (range of motion, fatigue, strength or pain) were significantly different between any of the groups.

Adult↗
PubMed1994

Vascular patterns of gestational trophoblastic tumors by color Doppler ultrasound.

BACKGROUND: Destruction of uterine vasculature is a common phenomenon in gestational trophoblastic tumors. The authors categorized such uterine vasculature by color Doppler ultrasound and studied its clinical significance. METHODS: Color Doppler ultrasound was performed in 28 patients with gestational trophoblastic tumors. The vascular morphologic manifestations were recorded, and the peak systolic velocity and resistance index of uterine artery were calculated. Serum beta-human chorionic gonadotropin (hCG) levels were measured periodically to monitor chemotherapy response. Seventeen uneventful postmole uteri were used as controls. Two-tailed Student's t-test and Fisher's exact test were used for statistical analysis. RESULTS: The gestational trophoblastic tumors were categorized as diffuse type (N = 7), lacunar type (N = 16), and compact type (n = 5) according to their vascular patterns. The mean serum beta-hCG level at diagnosis in diffuse type lesions (6608 +/- 6320 mIU/mL) was significantly lower than in the lacunar type (40462 +/- 39735 mIU/mL; P = 0.04) and compact type (212114 +/- 205126 mIU/mL; P = 0.02), whereas the level in compact type lesions was significantly higher than in the lacunar type (P = 0.003). Lacunar type lesions exhibited a significantly lower uterine artery resistance index (0.51 +/- 0.13) than diffuse type (0.66 +/- 0.10; P = 0.03) or compact type lesions (0.70 +/- 0.06; P = 0.02). All lesions exhibited significantly higher peak systolic velocity than control subjects (P < 0.001); however, no significant difference was observed among them. Brief courses (< 5 cycles) of chemotherapy cured more diffuse type (6 of 7) than lacunar type (3 of 15, P = 0.006) or compact type lesions (0 of 5, P = 0.008). Histopathologic diagnosis was available for 11 lesions. They were invasive mole in seven lacunar type lesions and choriocarcinoma in four compact type lesions. CONCLUSION: Vascular morphologic patterns of gestational trophoblastic tumors by color Doppler ultrasound correlated well with beta-hCG levels, uterine hemodynamics, chemotherapy response, and possibly the histopathologic diagnosis.

Arteries↗
PubMed1994

Cell kinetics and radiosensitivity of cervical squamous cell carcinoma.

Flow cytometry analyses of tumors from 12 patients with cervical squamous cell carcinoma under radiotherapy were performed in this preliminary study. Six patients with a high (> 10%) G2/M fraction before treatment showed greater than 50% tumor reduction after initial 2000 cGy radiotherapy. Only two out of six patients with a low (< 10%) G2/M fraction before treatment responded favorably and three of them already had recurrence during the follow-up period of 33-40 months. Hyperploidy (DNA index > 1.1) was observed in 5 patients; all of them responded well to radiotherapy in contrast to three out of seven diploid tumors.

Carcinoma, Squamous Cell↗
PubMed1994

The genotypes and prognostic significance of human papillomaviruses in cervical cancer.

An integrated study on the role of human papillomaviruses (HPV) in cervical cancer has been conducted. Out of a total of 433 cases of cervical cancer, HPV-DNA was detected in 342 (79%) using the polymerase chain reaction (PCR). The incidence of HPV infection was not significantly related to histological types, although a lower incidence was noted in adenocarcinoma cases. The incidence of lymph node (LN) metastasis in adenosquamous carcinoma (55.6%) was significantly higher than in squamous cell carcinoma (SCC) and adenocarcinoma. HPV 16 was detected significantly more often in SCC than in adenocarcinoma. In contrast, HPV 18 was detected more often in adenocarcinoma than in SCC. As a whole, pelvic LN metastases were found in 24.3% of HPV+ cases, significantly higher than 11% of HPV- cases. However, the significant association of HPV-DNA with LN metastasis was only noted in stage I but not stage II. As far as histological types were concerned, the incidence of positive LN was: HPV+ SCC > HPV- SCC (p < 0.01), whereas HPV- adenocarcinoma > HPV+ adenocarcinoma (p = 0.12). Genotypes of HPV did not have any effect on nodal status. The presence of types of HPV were not associated with tumor size and distribution of clinical stage. Our results suggest that the prognostic significance of HPV-DNA on nodal status is dependent on histological types while the genotypes of HPV cannot account for prognostic significance in cervical cancer.

Adult↗
PubMed1994

Incremental angiogenesis assessed by color Doppler ultrasound in the tumorigenesis of ovarian neoplasms.

BACKGROUND: The crucial role of angiogenesis in tumor behaviour has been studied extensively in vitro. The authors assessed the in vivo angiogenesis in ovarian neoplasms by color Doppler ultrasound and waveform analysis. METHODS: The intratumor artery resistance index (RI) of 222 ovarian neoplasms referred for color Doppler ultrasound evaluation was measured, and the corresponding histopathologic diagnosis was recorded. RESULTS: Satisfactory intratumor artery waveforms were obtained at an average of 1.12 sites in 44.7% (68 of 152) of benign tumors and at 6.28 sites in 97.1% (68 of 70) of the malignant group. Great heterogeneity in RI values existed. The RI of the intratumor artery in the benign group during the follicular phase (mean, 0.678) was significantly higher (P < 0.001) than that of the luteal phase (mean, 0.414), epithelial ovarian carcinoma (n = 34; mean, 0.402), malignant germ cell tumor (n = 6; mean, 0.413), malignancy metastasized to the ovary (n = 18; mean, 0.357), and other rare malignancies (n = 4; mean, 0.435). The RI of primary ovarian malignancy (n = 41; mean, 0.411) was significantly higher than that of malignancy metastasized to the ovary (P < 0.05). The RI values of epithelium-originated neoplasms showed a significant incremental decrease from benign tumors (n = 48; mean, 0.695) toward borderline malignancy (n = 6; mean, 0.535; P < 0.01), early-stage ovarian carcinoma (n = 10; mean, 0.485; P < 0.01), and, finally, to advanced-stage ovarian malignancies (n = 29; mean, 0.398; P < 0.05). CONCLUSIONS: Angiogenesis is a common phenomenon in malignant ovarian neoplasms, but the intensity of neovascularization may depend on individual tumor characteristics. The authors documented the incremental decrease of the resistance index in ovarian neoplasms, which may reflect the increase in angiogenesis intensity as an indication of malignant potential.

Adolescent↗
PubMed1994

Human papillomavirus DNA and p53 status in stage IB bulky cervical cancer.

We used the polymerase chain reaction (PCR) to study the presence and typing of human papillomavirus (HPV) DNA, and PCR/single-strand confirmation polymorphism to survey the mutations of the p53 gene in exons 5-9 in 26 bulky stage IB cervical cancers. The HPV DNA was present in 20 out of the 21 (95%) squamous-cell carcinoma tissues, including 13 cases of HPV-16, 0 case of HPV-18, and 7 cases of other HPV types. In the other 5 adenocarcinoma tissues, 3 had HPV type-18 DNA and 2 had no detectable HPV DNA. The distribution of HPV DNA in bulky tumors was not statistically different from that in the other 228 squamous-cell carcinomas and 23 adenocarcinomas of smaller size operated upon during the same period. Out of the 26 patients, 9 (35%) had lymph node metastasis at the time of operation. During the follow-up period ranging from 19 to 48 months, 9 patients had recurrence and 7 of them died of disease. The distribution of HPV types was not related to the prognosis in these patients. There were no p53 mutations detected in all the 26 samples. Thus, HPV type and the status of p53 could not serve as additional prognostic factors in stage IB bulky cervical cancers.

Adenocarcinoma↗
PubMed1994

Infrequent mutation in tumor suppressor gene p53 in gestational trophoblastic neoplasia.

In order to determine the p53 status of gestational trophoblastic neoplasia, 24 cases of molar pregnancies and two choriocarcinoma cell lines (JAR and JEG-3) were evaluated for the presence of mutations. The evaluation involved the whole coding sequence (i.e. exons 2-11) of the p53 gene with polymerase chain reaction (PCR) amplification of genomic DNA, followed by single strand conformation polymorphism (SSCP) and sequencing. Only one case of hydatidiform mole was found to have a missense point mutation (codon 295, CCT-->CTT, i.e. proline to leucine) of the p53 gene. The results suggest that p53 mutation is rarely involved in the pathogenesis of gestational trophoblastic neoplasia.

Base Sequence↗
PubMed1994

Correlation of uterine hemodynamics with chemotherapy response in gestational trophoblastic tumors.

OBJECTIVE: To assess the uterine hemodynamics in gestational trophoblastic tumors and to correlate them with response to chemotherapy. METHODS: Using transvaginal color Doppler ultrasound, we measured the peak systolic velocity and the resistance index (RI) of the uterine arteries in 23 women with gestational trophoblastic tumors before each course of chemotherapy. Fifty-five nonpregnant women and another 15 women who had uneventful molar evacuation were enrolled as controls. Two-tailed Student t test was used for statistical analysis. RESULTS: A hyperdynamic uterine circulation was noticed at diagnosis in all gestational trophoblastic tumors, manifested as higher peak systolic velocity (mean +/- standard deviation 57.5 +/- 20.4 cm/second) of the uterine arteries compared to nonpregnant (28.3 +/- 3.41 cm/second; P < .0001) and uneventful post-mole uteri (26.8 +/- 3.08 cm/second; P < .0001). The RI values of the uterine arteries in gestational trophoblastic tumors at diagnosis ranged from 0.21-0.80. However, the mean value (0.56 +/- 0.19) was lower than those of nonpregnant (0.80 +/- 0.05; P < .0001) and post-mole uteri (0.75 +/- 0.06; P < .0001). A higher pre-treatment uterine artery RI (mean 0.71 +/- 0.09) was noted in ten patients with gestational trophoblastic tumors requiring fewer than five courses of chemotherapy, compared with the mean in 13 patients requiring longer courses of treatment (0.47 +/- 0.14; P < .0001). There was a marked decrease of peak systolic velocity during the first three courses of treatment in the former group (54.2 to 23.6 cm/second; P < .001), in contrast to no change in the latter group (60.1 to 60.5 cm/second). CONCLUSION: Uterine hemodynamic characteristics assessed by color Doppler ultrasound might predict and monitor the response to chemotherapy in gestational trophoblastic tumors.

Adult↗
PubMed1994

Persistent gestational trophoblastic tumour with partial hydatidiform mole as the antecedent pregnancy.

OBJECTIVE: A 16 year review of persistent gestational trophoblastic tumour when the antecedent pregnancy was a partial hydatidiform mole. DESIGN: Cases of persistent gestational trophoblastic tumour with partial hydatidiform mole as the antecedent pregnancy were reviewed for the period 1976 to 1992. DNA ploidy was analysed by flow cytometry. SETTING: A University Hospital which is a reference centre for gestational trophoblastic tumour. SUBJECTS: The case notes of 207 women with persistent gestational trophoblastic tumour were reviewed. MAIN OUTCOME MEASURES: A rise (or failure to fall) of beta hCG titre, or sign of metastasis. RESULTS: Six (2.9%) women had partial hydatidiform mole as the antecedent pregnancy and all were initially judged to be low risk. However, two developed pulmonary metastasis; one woman developed persistent gestational trophoblastic tumour shortly after a hysterotomy, and none developed choriocarcinoma. The geometric mean of serum beta hCG concentrations at the initiation of chemotherapy was 868 mIU/ml (95% CI 114-1524). Of the six women, one achieved remission after total abdominal hysterectomy, and five after chemotherapy. The mean interval from starting treatment to remission was 68 days (95% CI 27.9-108.0). The initial beta hCG titre and interval were not statistically different from those found in cases of persistent gestational trophoblastic tumour when the antecedent pregnancy was not partial hydatidiform mole. Of the six, the DNA content was triploid in three and diploid in two. One of the two diploid cases required multiple courses of chemotherapy to achieve remission. CONCLUSION: Partial hydatidiform mole can have malignant sequelae and can develop very soon after treatment. Its DNA content can be either diploid or triploid, the lungs being the most common site of metastasis. After evacuation of partial hydatidiform mole, immediate chest X-ray and regular follow up of the serum beta hCG level is necessary.

Adult↗
PubMed1994

Serum neuron-specific enolase levels in patients with small cell carcinoma of the uterine cervix.

Serum neuron-specific enolase (NSE) is a tumor marker for neuroendocrine tumors or tumors of neuroepithelial origin. While the clinical application of NSE in small cell lung cancer has been established, its role in small cell carcinoma of the uterine cervix is unknown. We examined serum NSE in six patients with cervical small cell carcinoma and 13 patients with cervical squamous cell carcinoma. Elevated serum NSE was noted in four of six patients (67%) with small cell carcinoma, but none of the 13 patients with squamous cell carcinoma. An extremely high NSE serum level (154.7 ng/mL) was found in one patient with recurrence of small cell carcinoma, suggesting its correlation with disease extension. Although further studies to evaluate its relevance to prognosis, treatment effect, and early detection of recurrence are in progress, this preliminary result seems promising.

Adult↗
PubMed1994

Factors contributing to the accuracy in diagnosing ovarian malignancy by color Doppler ultrasound.

OBJECTIVE: To determine whether resistance index values obtained by color Doppler ultrasound contribute to the accuracy in diagnosing ovarian malignancies. METHODS: Four hundred ten patients with ovarian neoplasms referred for color Doppler ultrasound evaluation were enrolled, excluding patients examined during the luteal phase. Resistance index of the intra-tumor arteries was measured by color Doppler ultrasound. The corresponding clinical and histopathologic information was recorded. For statistical determinations, we used the Yates corrected chi 2 analysis, Fisher exact test, Student t test, and linear regression analysis. RESULTS: Satisfactory intra-tumor artery waveforms were obtained in 96.1% (99 of 103) of ovarian malignancies. Resistance index values varied at 0.23-0.82. Regression analysis of resistance index values on tumor size and amount of ascites demonstrated a linear association (R = 0.498 and 0.362, respectively; P < .01 in both). If we regard a resistance index of 0.4 as a cutoff value, the overall sensitivity and specificity in detecting malignancy were 68.0 and 97.4%, respectively. Primary ovarian malignancies exhibited significantly more false negatives (30 of 79) than malignancies metastasized to the ovary (three of 24) (P = .018). Malignancies containing mainly cystic components exhibited more false negatives (20 of 41) than did tumors with primarily solid components (13 of 62) (P < .01). Significantly more false negatives were encountered in malignancies with larger diameters (greater than 10 cm) compared to smaller ones (27 of 63 versus six of 40; P < .01), and in malignancies accompanied by considerable ascites (greater than 1000 mL) (13 of 25 versus 20 of 78; P < .05). CONCLUSIONS: Tumor origin, size, component nature, and amount of ascites contributed to the accuracy in diagnosing ovarian malignancies using resistance index values obtained by color Doppler ultrasound.

Adolescent↗
PubMed1993

Clinical study of 381 postmenopausal bleeding patients.

In order to evaluate the etiology, incidence of malignancy, clinical risk factors and the interval between menopause and the onset of abnormal vaginal bleeding in postmenopausal women, 381 cases with a complete medical history and available histologic findings were enrolled in this study at the National Taiwan University Hospital from 1989 to 1991. The results showed that 212 (55.6%) of these women had normal histologic findings and 83 (21.9%) had benign pathologic findings, whereas 14 (3.6%) had cervical intraepithelial neoplasia (CIN), 42 (11%) had endometrial hyperplasia, 19 (5%) had cervical cancer and 11 (2.9%) had endometrial cancer. Twenty-nine (7.6%) of the cases suffered from either CIN III or cervical cancer; this number was twice as high as those with endometrial atypical hyperplasia and endometrial cancer (n = 13, 3.4%). In addition, various risk factors, especially obesity, were found to be significantly correlated with malignancy. Fractional curettage should be performed for postmenopausal bleeding patients to ensure accurate diagnosis and correct management.

Endometrial Hyperplasia↗
PubMed1993

The state of p53 in primary human cervical carcinomas and its effects in human papillomavirus-immortalized human cervical cells.

Wild-type (wt) p53 acts as a tumor suppressor, while certain mutant type (mt) p53 may exhibit 'oncogenic' function. We have recently demonstrated that human papillomavirus type 18 (HPV-18) E6 can partially overcome the growth-suppressive effects of wt p53, but it remains unclear what role p53 plays in cervical carcinogenesis. In this report, we have examined nine HPV-immortalized human cervical epithelial cell lines and 13 HPV-positive and two HPV-negative primary cervical cancers for p53 mutations by polymerase chain reaction--single-strand conformation polymorphism (PCR-SSCP). None of them contained p53 mutations in exons 5-9 where most p53 mutations in human tumors have been found. The entire p53-coding region of the two HPV-negative cervical cancers was sequenced and no mutations were noted. In order to examine the effects of wt p53 and mt p53 on HPV-immortalized human cells, we transfected HPV-immortalized cell lines with wt p53 and a mt p53 (mtp53Val-135). The results indicate that HPV-immortalized cells cannot tolerate large amounts of exogenous wt p53, while mt p53Val-135 can enhance transformation of these cells. The results support the notion that inactivation of wt p53 by E6 may be important for HPV-associated transformation and also suggests that mt p53 can act as an oncogene in HPV-immoralized human cells.

Base Sequence↗
PubMed1993

Human chorionic gonadotropin pattern in maternal circulation. Amniotic fluid and fetal circulation in late pregnancy.

This study had two purposes. One was to investigate the placental gradients and the relationship of human chorionic gonadotropin (hCG) concentrations in maternal serum (MS), amniotic fluid (AF) and fetal serum (FS). The other was to study the fetal sex effect. This study included 93 patients with normal singleton term pregnancies. AF samples contaminated with blood were excluded. Fetuses did not have any abnormalities. We measured hCG by double antibody beta hCG radioimmunoassay. We found that there were conspicuous hCG slopes in MS, AF and FS levels. The hCG level in MS was 12.9 +/- 1.3 IU/mL (mean +/- SE, n = 93). It was much higher than levels in AF or FS. AF (0.461 +/- 0.053 IU/mL, n = 25) also had higher hCG level than FS (0.038 +/- 0.0056 IU/mL, n = 93). The hCG concentrations in AF and FS were highly correlated with those in corresponding MS (P < .001 and P < .05, respectively). The concentrations in AF were also positively correlated with those in corresponding FS (P < .05). The mean of MS/AF ratios for hCG was 413.6 +/- 23.4 (+/- SE); of MS/FS, it was 37.8 +/- 9.2; of AF/FS, it was 15.3 +/- 2.6. At late pregnancy, higher hCG levels of MS, AF or FS may result in female fetuses than in male fetuses. The results revealed that there were hCG concentration gradients on both placental and fetal membranes. It also implied that hCG levels in AF may decline as gestation ages advance. For biochemical studies in FS, using pure cord venous blood may have more consistent results than using mixed blood.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Two-dimensional high-performance liquid chromatographic method to assay p-hydroxyphenylphenylhydantoin enantiomers in biological fluids and stereoselectivity of enzyme induction in phenytoin metabolism.

A two-dimensional high-performance liquid chromatographic method was developed to assay the enantiomers of a major phenytoin metabolite, p-hydroxyphenylphenylhydantoin (p-HPPH). Racemic p-HPPH was first separated from phenytoin and other interfering peaks by a reversed-phase column and monitored by an ultraviolet detector. At the retention time of p-HPPH, the racemic p-HPPH peak was automatically transferred to a chiral ligand-exchange column to separate R-p-HPPH and S-p-HPPH by a time-programmed column-switching valve. The ratio of enantiomers was measured by a second ultraviolet detector. The method can be used to assay R- and S-p-HPPH enantiomers with reasonable sensitivity and reproducibility. By using this method, the stereoselectivity of enzyme induction and inhibition of phenytoin metabolism was investigated. Male rats were treated with phenobarbital, 3-methylcholanthrene, acetone, Aroclor 1254, pregnenolone-16 alpha-carbonitrile, dexamethasone and isosafrole. Microsomes were prepared from the rat liver and phenytoin hydroxylation was measured. Pretreatment with phenobarbital, pregnenolone-16 alpha-carbonitrile or acetone induced phenytoin metabolism non-stereoselectively. Pretreatment with dexamethasone decreased R-p-HPPH formation without affecting the formation of S-p-HPPH. Liver microsomes from female rats showed a higher S-p-HPPH formation, whereas R-p-HPPH formation remained the same. Various inhibitors were added to inhibit phenytoin metabolism by control microsomes. Sulphaphenazole, ketoconazole, 4,4-di(p-methoxyphenyl)hydantoin, cimetidine and diazepam inhibited the formation of R- and S-p-HPPH. Quinidine, tolbutamide and mephenytoin showed no significant inhibitory activity. None of these inhibitors showed stereoselectivity.

Acetone↗