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Biomedical subjects

C Y Hsieh

Publications and source records attributed to C Y Hsieh.

138 records · Page 8Linked to original sources

Straight-leg-raising test. Comparison of three instruments.

The purpose of this study was to compare three instruments in the assessment of the passive straight-leg-raising test: a standard plastic goniometer, a flexometer, and a tape measure. Hip flexion angles at the initial point of pelvic tilt were measured in 10 healthy subjects. All three methods showed excellent intrasession reliability with alpha coefficients greater than .94. The intersession reliabilities were identical for the goniometer and the flexometer (.88) and were higher than the reliability of the tape measure (.74). The tape measure had improved intersession reliability (.93) when a distance was used for calculation of the angle. Significantly lower hip flexion angles were obtained with the trigonometric method through use of tape measures than from use of either of the other two instruments. The flexometer is recommended for use in assessment of passive straight leg raise because it permits measurement by a single therapist without assistance.

Adult↗

Cytomegalovirus infection of the uterine cervix: local cervical infection and antibody response.

Thirty-three women were examined on three or more occasions, each at 2-month intervals. The overall recovery rate of cytomegalovirus (CMV) was 28% (60/215). CMV was recovered from 53% of the cases where the local antibody was 1 : 64 or greater but the greatest difference occurred below titers of 1 : 32. Below that level virus was recovered in less than 5%, compared to a prevalence of 35% for cases with a titer of 1 : 32 (P less than 0.001). Twenty-eight cases in whom CMV was sought underwent colposcopy examination and had cytologic smears examined by the papanicolaou method. The external uterine cervix with columnar cells only yield a CMV prevalence of 3/17 (18%). However, if colposcopy showed either atypical transformation or metaplasia the prevalence was 4/11 (36%). Similarly, it is provocative that the prevalence of CMV appears to increase with abnormal cytologic findings to 33% recovery in severe dysplasia or carcinoma in situ.

Antibodies, Viral↗

Case report. Cervical carcinoma with selective IgA deficiency.

A patient with cervical carcinoma was found to have selective IgA deficiency. The intact cell-mediated immunity, normal levels of IgG and IgM, and the absence of serum and salivary IgA established the diagnosis. Contrary to those of normal persons, salivary IgM was elevated and salivary IgA was not detectable in this patient. The patient had no signs attributable to IgA deficiency, but she always had dryness of the mouth. The association between cervical carcinoma and selective IgA deficiency was discussed.

Carcinoma, Squamous Cell↗

Carcinosarcoma of ovary associated with previous radiotherapy.

Carcinosarcoma is a rare neoplasm which, in the female genital tract, arises mainly in the endometrium. Although the pathogenesis remains obscure, there is an apparent association between pelvic irradiation and uterine sarcomas. There have been sporadic case reports of the development of carcinosarcomas of the cervix, vagina, and extragenital areas, but not of the ovary, after previous pelvic irradiation. We describe a case of ovarian carcinosarcoma arising in a 74-year-old female who had pelvic irradiation 33 years previously. Exploratory laparotomy showed a 25 x 18 x 9 cm left ovarian tumor with adjacent organ invasion including peri-uterine serosa and rectum. The patient was treated by optimal cytoreduction, followed by chemotherapy with adriamycin and cisplatin. However, acute hepatitis caused by reactivation of hepatitis B virus infection developed just before the fifth course of chemotherapy. She died of hepatic failure two weeks later.

Aged↗

Reproductive and infectious risk factors for invasive cervical cancer in Taiwan.

A community-based case-control study was carried out to assess multiple risk factors for invasive cervical cancer in Taiwan. All of 183 cases of pathologically confirmed cervical cancer cases and 293 healthy neighborhood controls were recruited from Taipei metropolitus. Healthy controls were matched with cervical cancer cases for age and residence. Multiple risk factors for cervical cancer were obtained from study subjects through standardized interviews according to a structured questionnaire. Serotiters of antibodies to Chlamydia trachomatis (CLT), human cytomegalovirus (HCMV) and human herpes simplex virus type 2 (HSV-2) were determined by enzyme-linked immunosorbent assay. Multiple logistic regression analysis were used to derive maximum likelihood estimates of multivariate-adjusted odds ratios (AOR) and confidence intervals (CI). After adjustment for potential risk factors, parity and number of vaginal delivery were associated with an increased risk of invasive cervical cancer. The higher the number of vaginal delivery, the higher the risk of developing cervical cancer (AOR = 6.2, 95% CI = 1.7-22.6 for 7 or more deliveries compared with 0-2 deliveries as the referent group). Increased cervical cancer risk was also significantly associated with the history of chronic cervicitis (AOR = 2.1, 95% CI = 1.1-3.8) and elevated serotiters of CLT (AOR = 7.0, 95% CI = 1.7-28.9), HCMV (AOR = 4.1, 95% CI = 1.5-11.3) and HSV-2 (AOR = 2.3, 95% CI = 1.1-4.6). The use of diaphragm for contraception was found to be associated with a decreased risk of cervical cancer (AOR = 0.4, 95% CI = 0.1-1.0).

Adenocarcinoma↗

Characterization of chemoresistance mechanisms in a series of cisplatin-resistant transitional carcinoma cell lines.

We explored the mechanisms of cisplatin resistance in a series of bladder transitional carcinoma cells that are either sensitive or progressively resistant to cisplatin. Resistant lines were raised by chronic exposure of the parental cells to progressively increased concentrations of cisplatin. The cisplatin IC50s of the sensitive and the three resistant cells were 4.3, 25.0, 40.4, and 52.2 microM, respectively. The expressions of glutathione S-transferase pi (GST-pi) and multidrug resistance-associated protein (MRP) were enhanced in a dose-response manner as cells acquired progressive cisplatin resistance. Expression of mdr-1 transcript was detected in the three resistant lines but not in the sensitive line. Glutathione contents were increased in resistant cells, yet the trend of increase did not reach statistical significance (p = 0.061). In conclusion, transitional carcinoma cells may gain cisplatin resistance through multiple pathways including up-regulation of GST-pi, MRP and possibly mdr-1. Glutathione contents may play a less significant role in cisplatin chemoresistance.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions.

Curcumin (diferuloylmethane), a yellow substance from the root of the plant Curcuma longa Linn., has been demonstrated to inhibit carcinogenesis of murine skin, stomach, intestine and liver. However, the toxicology, pharmacokinetics and biologically effective dose of curcumin in humans have not been reported. This prospective phase-I study evaluated these issues of curcumin in patients with one of the following five high-risk conditions: 1) recently resected urinary bladder cancer; 2) arsenic Bowen's disease of the skin; 3) uterine cervical intraepithelial neoplasm (CIN); 4) oral leucoplakia; and 5) intestinal metaplasia of the stomach. Curcumin was taken orally for 3 months. Biopsy of the lesion sites was done immediately before and 3 months after starting curcumin treament. The starting dose was 500 mg/day. If no toxicity > or = grade II was noted in at least 3 successive patients, the dose was then escalated to another level in the order of 1,000, 2,000, 4,000, 8,000, and 12,000 mg/day. The concentration of curcumin in serum and urine was determined by high pressure liquid chromatography (HPLC). A total of 25 patients were enrolled in this study. There was no treatment-related toxicity up to 8,000 mg/day. Beyond 8,000 mg/day, the bulky volume of the drug was unacceptable to the patients. The serum concentration of curcumin usually peaked at 1 to 2 hours after oral intake of crucumin and gradually declined within 12 hours. The average peak serum concentrations after taking 4,000 mg, 6,000 mg and 8,000 mg of curcumin were 0.51 +/- 0.11 microM, 0.63 +/- 0.06 microM and 1.77 +/- 1.87 microM, respectively. Urinary excretion of curcumin was undetectable. One of 4 patients with CIN and 1 of 7 patients with oral leucoplakia proceeded to develop frank malignancies in spite of curcumin treatment. In contrast, histologic improvement of precancerous lesions was seen in 1 out of 2 patients with recently resected bladder cancer, 2 out of 7 patients of oral leucoplakia, 1 out of 6 patients of intestinal metaplasia of the stomach, I out of 4 patients with CIN and 2 out of 6 patients with Bowen's disease. In conclusion, this study demonstrated that curcumin is not toxic to humans up to 8,000 mg/day when taken by mouth for 3 months. Our results also suggest a biologic effect of curcumin in the chemoprevention of cancer.

Adult↗

Forefoot pain associated with muscle strain in the lower extremity.

A case of forefoot pain at the first metatarsophalangeal joint is discussed. Local treatment with ultrasound failed to bring significant relief. However, dramatic and lasting relief occurred when treatment was applied to the muscle belly of the extensor hallucis longus. The patient also suffered from hallux valgus with mild foot pronation. Two years after therapy, the patient stated she had not experienced any foot pain since the last treatment, and she continued to wear the prescribed flexible foot orthotics on a daily basis.

Chiropractic↗

Measurement of human chorionic gonadotropin by carboxyl terminal peptide assay in patients with cervical neoplasm.

The aim of this study was to investigate whether human chorionic gonadotropin (hCG) is produced by preinvasive cancer and the early stages of invasive cancer. One hundred and fifty-two patients with either various grades of preinvasive cervical carcinoma or microinvasive carcinoma, and 46 normal women used as controls, were enrolled in this study. A carboxyl terminal peptide beta-hCG (CTP-beta-hCG) assay with a sensitivity of 0.2 mIU/mL was used to measure serum levels. The results showed that the serum beta-hCG levels among normal control, preinvasive carcinoma and microinvasive carcinoma patients were not statistically different. Among the factors tested, including the interval since the last menstrual period, age, menopausal status, contraception method and diagnosis, serum hCG levels only correlated with the first factor. Preinvasive cervical carcinoma and microinvasive carcinoma did not result in significantly increased hCG secretion. At present, the CTP-beta-hCG assay is of limited value in the diagnosis of these diseases.

Adult↗

Range of motion of the lumbar spine required for four activities of daily living.

OBJECTIVE: To assess the range of motion of the lumbar spine required for four activities of daily living. DESIGN: Descriptive study. SETTING: Chiropractic college research laboratory. SUBJECTS: Forty-eight young and healthy subjects. INSTRUMENTATION: OSI CA-6000 computerized spinal motion analyzer. RESULTS: The intraclass correlation coefficient ranged from .99-.95 for peak flexion measurements. Stand-to-sit and sit-to-stand activities required approximately 56-66% of lumbar flexion. Putting on socks required about 90% of lumbar flexion. Picking an object off the floor required almost full lumbar flexion (95%). Analysis of variance showed significant differences among all four activities (p < .001). Scheffe tests revealed that the differences were found between sit/stand activities and picking up an object from the floor, and also between sit/stand activities and putting on socks. CONCLUSION: We showed that four activities of daily living could be reliably measured by an OSI CA-6000 motion analyzer. Putting on socks and picking up an object off the floor were found to require more lumbar flexion motion than sit/stand activities. Also, different strategies were observed in performing these activities. Future research shall address these activities and their changes in low back pain patients.

Activities of Daily Living↗

Increased sister chromatid exchange frequency in peripheral lymphocytes of nasopharyngeal carcinoma and cervical cancer patients.

The specific aim of this study was to compare the frequency of sister chromatid exchange (SCE) in peripheral lymphocytes using it as a biomarker of integral exposures to carcinogens in 14 untreated newly-diagnosed nasopharyngeal carcinoma (NPC) patients, 16 untreated newly-diagnosed cervical cancer patients, and 30 healthy controls matched with patients on age, sex, cigarette smoking and alcohol drinking. Peripheral lymphocytes were cultured in RPMI 1640 medium containing 20% fetal calf serum and 6 microM phytohemagglutinin. After culture for 24 hours, 20 microM 5-bromo-2-deoxyuridine was added into the medium. Colcemid solution was further added after 70 hours. Harvested cells were stained with Hoesch 33258, illuminated, and restained with Giemsa. The SCE frequency was scored by two readers independently and blindly. The results showed a significantly increased SCE frequency in lymphocytes for NPC patients (mean +/- standard error = 14.7 +/- 1.7 SCEs/cell) compared with their matched controls (10.1 +/- 0.7 SCEs/cell) and for cervical cancer patients (12.0 +/- 0.9 SCEs/cell) compared with their matched controls (9.2 +/- 0.7 SCEs/cell). These results suggest that NPC and cervical cancer patients have a higher integral exposures to both viral and chemical carcinogens than matched controls.

Adult↗