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Biomedical subjects

C Y Hsieh

Publications and source records attributed to C Y Hsieh.

At least 91 records · Page 5Linked to original sources
PubMed1992

The role of blocking factors and antipaternal lymphocytotoxic antibodies in the success of pregnancy in patients with recurrent spontaneous abortion.

OBJECTIVE: To elucidate the role of mixed lymphocyte reaction blocking factors (BF) and complement-dependent antipaternal lymphocytotoxic antibodies on the outcome of pregnancy in unexplained recurrent spontaneous aborters. DESIGN: A controlled study of immunotherapy in which the treated group was immunized with the husband's or a third party donor's lymphocytes and the control group received autologous lymphocytes. SETTING: Tertiary care institution. PATIENTS: Forty-three patients in the control group and 48 patients in the treated group. INTERVENTION: The before and after immunization levels of BF and antipaternal lymphocytotoxic antibodies were measured. MAIN OUTCOME MEASURES: The existence or changing pattern of BF and antipaternal lymphocytotoxic antibodies levels before and after immunization had no influence on the pregnancy outcome in either group of patients. CONCLUSION: Neither BF nor antipaternal lymphocytotoxic antibodies is essential for successful pregnancy. They probably reflect the immunological response of the mother to exposure to fetal antigens.

Abortion, Habitual↗
PubMed1992

Treatment and outcome of unexplained recurrent spontaneous abortions in subclinical autoimmune disorders.

Patients with a history of three or more fetal losses before a gestational age of 20 weeks were examined. Only patients with normal chromosomal, hormonal and anatomic findings were included in this study. These patients were tested for the antinuclear antibody, the C3 and C4 levels, anti-ENA [Ro(SSA), La(SSB), SM, RNP, scl-70], anti-single-stranded DNA and anti-double-stranded DNA, lupus anticoagulant, anticardiolipin and antiphosphotidylserine. All of these patients were free of any symptoms, except for the repeated abortions. The results showed that 10 out of 213 (4.7%) patients with unexplained recurrent spontaneous abortions had abnormal serologic tests, and 28% of the abortions (nine out of 32 abortions) occurred during the second trimester. With treatment of low-dose aspirin alone, or in combination with prednisolone, two out of 11 pregnancies in these 10 patients resulted in repeated abortions (18%), which was significantly lower than their previous abortion rate where 32 out of 33 pregnancies resulted in abortions (97%). Four babies (three term and one premature) were delivered without any abnormalities and the other five pregnancies are beyond the 28th week of gestation and are progressing smoothly. This study revealed that subclinical autoimmune disorders may play a role in recurrent spontaneous abortions and adequate treatment can improve the pregnancy outcome.

Abortion, Habitual↗
PubMed1992

Conization with a carbon dioxide laser as a uterine-preservation operation for patients with preinvasive cervical carcinoma.

Preinvasive cervical carcinoma (PCC) is a disease entity of the uterine cervix resulting from carcinoma in situ and various degrees of dysplasia. These cases are conventionally treated by a total abdominal hysterectomy. Effective management that can preserve the uterus is more desirable than hysterectomy. In this report, we present the results and complications of laser conization as a uterine-preservation treatment. At our dysplasia clinic, cases of reproductive age diagnosed with PCC can voluntarily undergo laser conization. From June 1985 to May 1988, there were 26 cases who received this treatment. After treatment, they were regularly followed up for more than three years. Before and after surgery, these cases were evaluated by a Pap smear for cytology, colposcopy, a cervical punch biopsy and endocervical curettage for histopathology. Eighteen cases with a satisfactory colposcopy were treated by laser vaporizing conization. Eight cases with an unsatisfactory colposcopy were treated by laser excisional conization. Their mean age was 35.8 (SD 7.7) years, and parity was 1.5 (SD 0.9). The instrument used was a Sharplan CO2 laser model 720. The power density was around 1,000 W/cm2 for vaporization, and 1,500 W/cm2 for excisional conization. During the operations, there was little bleeding. No case required a blood transfusion. The vaginal discharge decreased within four days after treatment. The cervical epithelium on the operated wound began growing after the second week, and the cervix healed well in four to six weeks. After healing, the squamocolumnar junction in each case was visible on colposcopy. No case suffered from cervical stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Secondary ovarian malignancy of extragenital origin: clinical analysis of 42 cases.

Forty-two patients with secondary ovarian cancer from extragenital sites encountered in the past 14 years at the National Taiwan University Hospital were retrospectively analyzed. They accounted for 11.6% (42/362) of all ovarian cancers. The mean age was 43.7 years, and 32 patients were premenopausal. Gastric cancer was the most frequent primary malignancy (50.0%); other sites of extragenital primaries were colon (23.8%), breast (11.9%), rectum (4.8%), and indeterminate (9.5%). Bilateral ovarian involvement was found in 78.6% of patients. The most common presenting symptom was abdominal distension (52%). All patients received surgical intervention as the primary treatment; 30 patients had subsequent chemotherapy and four patients had postoperative radiotherapy. However, the outcome was poor; more than half of the patients died within one year, with a two-year survival rate of 22.5%.

Adult↗
PubMed1992

Pregnancy after transfer of frozen-thawed human embryos.

Cryopreservation of human embryos has been successfully applied in in vitro fertilization (IVF) and embryo transfer (ET) programs at the National Taiwan University Hospital since 1988. Our preliminary results with 120 frozen-thawed embryos in 31 transfer cycles showed that the survival rate of frozen embryos was 66%. Following transfer, the implantation rate and clinical pregnancy rate were 6.5% and 13%, respectively. Four clinical pregnancies and one preclinical pregnancy following a frozen-thawed embryo transfer were achieved. Two normal male babies have been delivered and another pregnancy is progressing without any problem.* Unfortunately, one pregnancy was terminated due to intrauterine fetal death discovered at the 10th week of gestation; chromosome abnormality (47, XX, +5) of the fetus was found. The single preclinical pregnancy showed an elevation of serum beta-human chorionic gonadotropin levels for three consecutive weeks following ET, but no definite gestational sac was visualized by transvaginal ultrasound.

Adult↗
PubMed1992

Binding and growth-stimulation of cervical cancer cell lines by prolactin.

Two cervical cancer cell lines CC7-T and Si-Ha were employed to observe the relationship between cervical cancer and prolactin. By immunocytochemical and indirect immunofluorescent assays using two prolactin monoclonal antibodies PRL-149 and PRL-151, both cell lines with added prolactin (10 ng/mL) were noted to be positive for PRL-151, but negative for PRL-149. The control cell lines from ovarian cancer and the myeloma lines were both stained negative. By using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, it was noted that CC7-T and Si-Ha grew better in the presence of various added concentrations of prolactin, ranging from 0.1 to 1,000 ng/mL, suggesting that prolactin may enhance the growth of cervical cancer. The degree of stimulation appears to depend on cell differentiation. However, prolactin levels in the cultured supernatant were undetectable by the enzyme immunoassay (EIA) method. We postulate that prolactin can bind and stimulate the growth of some cervical cancer cell lines, probably through the prolactin receptor rather than by autocrine regulation.

Animals↗
PubMed1992

Functional outcomes of low back pain: comparison of four treatment groups in a randomized controlled trial.

The revised Oswestry Low Back Pain Questionnaire (ROLBPQ) and Roland-Morris Activity Scale (RMAS) were compared in a randomized controlled trial of chiropractic manipulation, stroking massage, corset and transcutaneous muscular stimulation (TMS). This trial employed specific inclusion and exclusion criteria, including nonspecific low back pain for a duration of 3 wk to 6 months and ages between 18 and 55. We had the opportunity to ask 85 patients to answer the questionnaires. Sixty-three patients, who completed the initial and final evaluations, were used for data analysis. Both ROLBPQ and RMAS showed good internal consistency with alpha coefficients ranging from .77 to .93. Both instruments showed a significant difference between the chiropractic manipulation and massage groups (p less than .05). RMAS was able to further show significant differences between the chiropractic manipulation and TMS groups, and between the corset and massage groups, but the ROLBPQ failed to do so. RMAS also showed that chiropractic manipulation had a better but nonsignificant result than corset, possibly due to insufficient sample size and/or duration of treatment. We conclude that both instruments are reliable for measuring low back pain disability, and chiropractic manipulation has a superior short-term benefit when compared to stroking massage and TMS in subacute low back pain patients. In addition, it appears that RMAS is preferable in a clinical trial situation for subacute low back pain because it is more sensitive than ROLBPQ to detect changes.

Adolescent↗
PubMed1991

Stereoselective inhibition of diphenylhydantoin metabolism by p-hydroxyphenyl-phenylhydantoin enantiomers in rats.

Different doses of rac-p-HPPH (0.4 and 4 mg/h) were given repeatedly to rats infused with [14C]phenytoin. The serum levels of 14C-labeled and unlabeled p-HPPH, and [14C]phenytoin were measured by an HPLC method and radiometric analysis. The clearance of phenytoin and p-HPPH was determined by rate of dosing divided by the steady-state concentration. The phenytoin clearance was significantly lower in the high dose p-HPPH injection group than in the low dose group (87 versus 262 ml/h), whereas p-HPPH clearance showed no difference. The formation clearance of [14C]p-HPPH was also significantly lower in rats injected with high dose of p-HPPH (35 versus 169 ml/h). The clearance of other elimination pathways was also lower in rats with high dose of p-HPPH (53 versus 89 ml/h). The serum protein binding of phenytoin was lower in rats injected with high dose of p-HPPH. The result indicated that injections of rac-p-HPPH mainly inhibited on the formation of p-HPPH itself. The formation of (R)-p-HPPH and (S)-p-HPPH in microsomal preparation was measured by a ligand-exchange chromatographic method. The formation of (S)-p-HPPH or (R)-p-HPPH was not only inhibited by the enantiomer itself, but also cross-inhibited by the other enantiomer. To the formation of either (S)-p-HPPH or (R)-p-HPPH, (S)-p-HPPH showed a higher inhibitory activity. The use of rac-p-HPPH to inhibit phenytoin metabolism in vivo involved several mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

The prevalence of recurrent spontaneous abortions, cancer, and congenital anomalies in the families of couples with recurrent spontaneous abortions or gestational trophoblastic tumors.

This study extends our previous work on the genetics of recurrent spontaneous abortion and of gestational trophoblastic tumors in an ethnically homogeneous population of Chinese in Taiwan by comparing the prevalence of recurrent spontaneous abortions, cancer, and congenital anomalies in the first-, second-, and third-degree relatives of the index couples to that of normally fertile couples from the same population. The rationale for this study was to provide another test for our hypothesis that genes linked to the major histocompatibility complex are responsible for the diseases in the index couples. If they are, these genes should segregate with a higher frequency in the relatives of the index couples than in the relatives of normally fertile couples and lead to a higher prevalence of these diseases in the extended families. Such a difference was found and adds support to our hypothesis that major histocompatibility complex-linked genes affect growth, development, and susceptibility to cancer.

Abortion, Spontaneous↗
PubMed1991

Restriction fragment length polymorphism analysis to study the genetic origin of complete hydatidiform mole.

To determine the genetic origin of the complete hydatidiform mole, 20 abnormal pregnancies were studied with restriction fragment length polymorphism with five genomic probes: EJ 6.6, beta-globin gene, 3'alpha-hypervariable region, J-Bir, and St14. In the 12 cases of molar pregnancy, pure paternal origin was proved in 11 cases, but both maternal and paternal inheritance were shown in only one case. In the cases with pure paternal origin, all of the restriction fragment length polymorphisms were homozygous, although those of the fathers were heterozygous at 15 loci. In the four cases that mimicked hydatidiform mole but were diagnosed as hydropic change of villi, both paternal and maternal inheritance were noted. In the four pregnancies with blighted ovum, both paternal and maternal inheritance were shown in three cases; and in one case with a balanced translocation between chromosomes 13 and 14, only paternal inheritance was noted. This study showed that most of the complete hydatidiform moles were caused by fertilization of an empty egg by a duplicated haploid sperm, but rare exceptions may exist.

Adult↗
PubMed1991

Immunotherapy for recurrent spontaneous abortions in a Chinese population.

The efficacy of immunotherapy for the treatment of recurrent spontaneous abortions was tested in patients selected from the same ethnically homogeneous population of Chinese in Taiwan in whom the immunogenetics of gestational trophoblastic tumors and of recurrent spontaneous abortion had been studied. The patients, who included both primary and secondary aborters, were randomly assigned to three groups: those who were immunized with their own lymphocytes (controls) (49); those who were immunized with their husbands' lymphocytes (39); and those who were immunized with third party lymphocytes (11). The data were analyzed individually for the primary and secondary aborters and collectively for both groups combined. The number of babies born, the number of current pregnancies, and the number of recurrent abortions were not statistically significantly different between the control and the immunized groups, and a similar small number of congenital abnormalities (4-9%) occurred in both the control and immunized groups. The increase in the blocking effect for the mixed lymphocyte reaction was not related to the success of the postimmunization pregnancies. Thus, this study does not show any significant improvement in the rate of livebirths in women immunized with their husbands' lymphocytes or with third party lymphocytes compared to that in a placebo-controlled group of women.

Abortion, Habitual↗
PubMed1991

Change in human chorionic gonadotropin in gestational trophoblastic disease observed during the course of chemotherapy.

This study investigates the physicochemical characteristics of human chorionic gonadotropin (hCG) in gestational trophoblastic disease (GTD), with special reference to the clinical course of chemotherapy and prognosis. In gel high performance liquid chromatography (HPLC), the hCG molecules from normal pregnancy and from the hydatidiform mole had the same molecular form as standard purified hCG, whereas hCG from choriocarcinoma was inconsistent in molecular form, containing molecules which are smaller, the same or larger than those of standard purified hCG. In two fatal choriocarcinoma patients, large hCG and large hCG alpha were found in the urine samples collected within one month prior to death. In a chromatofocusing study, the chromatofocusing pattern of hCG from GTD was acidic and similar to that of early pregnancy. The chromatofocusing patterns did not alter or were altered only slightly during the course of chemotherapy. In a Concanavalin A-Sepharose (Con A) chromatography study, the Con A binding shifted from low to high binding in patients with GTD who were responsive to chemotherapy. In summary, the molecular form, electric charge and Con A binding of hydatidiform mole hCG are similar to those of early pregnancy hCG and standard purified hCG, whereas the molecular form and Con A binding of choriocarcinoma are different from those of early pregnancy hCG and standard purified hCG. The presence of smaller or larger molecular forms of hCG may be an ominous sign, whereas the presence of high Con A binding may be a favorable sign. The chromatofocusing pattern seems to be unrelated to the clinical course of chemotherapy.

Choriocarcinoma↗
PubMed1991

Experience of human chorionic gonadotropin assays in gestational trophoblastic tumors.

From May 1979 through December 1988, 146 patients with gestational trophoblastic tumors (71 hydatidiform mole, 3 partial mole, 15 choriocarcinoma and 57 persistent trophoblastic tumors) were studied. A total of 1178 daily urine samples were collected before and/or after treatment, and in the course of follow-up. H93 RIA (an HCG specific assay), H80 RIA (an assay detecting hCG and hLH) and a hCG alpha assay measured levels in the urine specimens. Three hCG declining patterns (pattern D, P and R) based on the H93 RIA assay were noted. Patients showing pattern D had the most favorable outcome (no mortality at all). However, pattern P and R had a 10% and 14.3% mortality rate, respectively. The ratios of H80/H93, hCG alpha/H93, hCG alpha/H80 in the urine specimens were similar in both pattern D and R (excluding samples from a patient who expired later). However, the ratios of H80/H93, hCG alpha/H93, hCG alpha/H80 of samples from the patient (CK) who expired later were significantly different from those of the pattern D and R. This was suggestive of a marked unbalanced secretion of hCG and its subunit in the urine specimens of patient CK. The molecular forms in pattern D were similar to the standard hCG. However, the molecular form in pattern R of 3 fatal choriocarcinomas showed a great variation, from smaller to larger than the standard hCG. The isoelectric points of hCG in pattern D and R were all acidic. In clinical practice, we can measure the ratios of H80/H93, hCG alpha/H93 and hCG alpha/H80, molecular forms, and isoelectric points of hCG.(ABSTRACT TRUNCATED AT 250 WORDS)

Chorionic Gonadotropin↗
PubMed1991

Treatment of patients with unexplained infertility: gamete intrafallopian transfer (GIFT) versus tubal embryo transfer (TET).

This study compares the results of 65 cycles of gamete intrafallopian transfer (GIFT), and 19 cycles of tubal embryo transfer (TET) in couples with unexplained infertility (UI). Oocyte retrievals were carried out by laparoscopy in GIFT and transvaginally in TET, in which the embryos were transferred by laparoscopy into the fallopian tubes 48 hours later. The mean age, duration of infertility, serum estradiol levels on the day of human chorionic gonadotropin administration, number of large follicles (mean diameter greater than 10 mm) and the number of oocytes recovered were similar between these two groups. From the 65 GIFT cycles, 20 clinical pregnancies resulted (30.8%). From the 19 cycles of TET, 10 conceptions occurred (52.6%). The implantation and pregnancy rates after TET were higher than that after GIFT, but the differences were not statistically significant. The data suggest that GIFT has a similar success rate to TET in couples with UI.

Adult↗
PubMed1991

Malignant mixed müllerian tumor of the fallopian tube.

Malignant mixed Müllerian tumor (MMMT) of the fallopian tube is an extremely rare neoplasm with a poor prognosis. To date, only 37 cases have been reported. The primary treatment for this tumor is surgery. Chemotherapy has been used with some success. The role of radiotherapy is less clear. A case of malignant mixed Müllerian tumor of the fallopian tube occurring in a 63- year- old woman, presenting with postmenopausal vaginal spotting for 7 months, is reported.

Fallopian Tube Neoplasms↗