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C-T Wu

Publications and source records attributed to C-T Wu.

13 recordsLinked to original sources
PubMed2004

Frequent allelic deletion at the FHIT locus associated with p53 overexpression in squamous cell carcinoma subtype of Taiwanese non-small-cell lung cancers.

The fragile histidine triad (FHIT) gene, encompassing the FRA3B fragile site at chromosome 3p14.2, is a tumour suppressor gene involved in different tumour types including non-small-cell lung cancers (NSCLCs). In the current study, we examined for allelic deletion at the FHIT locus in 58 primary and microdissected NSCLCs, for which a clinicopathologic profile was available. We found a loss of 87.7% in heterozygosity (LOH) frequency at one or more microsatellite markers (D3S1289, D3S2408, D3S1766, D3S1312, D3S1600). Allelic deletion of D3S1766 was related to tumour histology in 10 of 11 squamous cell carcinomas (90.9%) displaying LOH compared with nine of 17 adenocarcinomas (52.9%; P=0.049). Besides, in the subset of adenocarcinomas, a higher rate of LOH at D3S1289 was observed in male (six out of eight, 75%) than in female patients (four out of 17, 23.5%; P=0.028). However, FHIT LOH was not correlated overall with a variety of clinical parameters including sex, smoking status, staging, lymph node metastasis and survival. These results indicated that the high frequency of FHIT gene disruption was important in the development of both squamous cell carcinomas and adenocarcinomas. Furthermore, there was no association between LOH at FHIT and protein expression, suggesting the presence of complex mechanisms of Fhit inactivation. On the other hand, the association between FHIT LOH and p53 protein overexpression assessment reached statistical significance (P=0.026), implying that common alterations affect the two genes in tumour progression.

Acid Anhydride Hydrolases↗
PubMed2004

A precious experience of lobar transplantation in a teenager with end-stage chronic hypersensitivity pneumonia: case report.

Pulmonary fibrosis inevitably develops in patients with chronic hypersensitivity pneumonia (CHP). Lobar transplantation may be a viable option for pediatric and small adult patients with end-stage CHP and life-threatening respiratory decompensation. We describe a 16-year-old girl experiencing end-stage pigeon breeder's hypersensitivity pneumonia with right heart failure, who received left allograft lobar transplantation and had an uneventful convalescent course for 1 year after transplantation. Histopathologically the excised native lung revealed diffuse infiltration of lung parenchyma by CD3+ and CD8+ cells with an absence of CD4+ cells, whereas T-lymphocyte subsets analysis revealed no abnormalities in the blood. This finding is consistent with the contribution of a local type IV immune reaction to the pathogenesis. In addition, the observation of specific cellular distribution of bronchus-associated lymphoid tissue suggests that chronic antigenic stimulation and /or inflammation in CHP may cause bronchus-associated lymphoid tissue development, which is likely to play an important role in the mucosal immune response of this disease.

Adolescent↗
PubMed2004

Clinical experience of mycophenolate mofetil in the treatment of chronic allograft nephropathy in kidney transplantation: three-year follow-up.

BACKGROUND: Mycophenolate mofetil (MMF) in conjunction with calcineura antagonists has been shown to prevent acute rejection in renal allograft recipients. Its role in treatment of chronic rejection or allograft nephropathy is still controversial. We initiated the study to investigate the effect of adding MMF to a cyclosporine plus prednisolone regimen in renal recipients with chronic allograft nephropathy. MATERIALS AND METHODS: We retrospectively studied 36 patients with chronic allograft nephropathy, defined clinically as increased of serum creatinine, proteinuria, and hypertension. Renal function, cyclosporine level, renal biopsy, and renal scan were regularly done as indicated. MMF was added to 20 recipients after initial treatment with cyclosporine and prednisolone. The other 16 recipients were managed without adding MMF. Serum creatinine was monitored for 3 years. RESULTS: The demographic characteristics of the patients in the two groups were comparable. The average dose of prednisolone was unchanged throughout the study and the trough level of cyclosporine was maintained in the range of 100 to 150 ng/mL. The serum creatinine decreased initially in the group on MMF, but renal function deteriorated progressively after 6 months. There was a difference in serum creatinine between the two groups but this did not reach statistical significance. CONCLUSION: MMF therapy tender to improve renal function initially but did not attenuate significantly the impairment in chronic allograft nephropathy.

Creatinine↗
PubMed2004

De novo cancer occurrence after renal transplantation: a medical center experience in Taiwan.

INTRODUCTION: Renal transplantation has been advocated as the treatment of choice for end-stage renal disease. Organ transplantation increases the incidence of cancer through unclear mechanisms. A literature review showed that the most common neoplasms are of skin origin, which are uncommon in Eastern people. We reviewed cancer patterns in our renal transplant series. MATERIALS AND METHODS: From July 1981 to December 2002, among 560 renal transplantations performed in this hospital, we retrospectively surveyed cancer incidence, types, and usage of immunosuppressants. RESULTS: Twenty nine cancer cases 5.18% (incidence) included hepatocellular carcinoma (HCC) as the highest mortality rate (9 of 13 cases). Eight of these 13 cases were hepatitis B carriers. All four hepatitis C carriers expired three of them with unresectable multinodular tumors at diagnosis in Posttransplantation lymphoproliferative disorder (PTLD) was the second most common cancer (seven cases); all but one survived with reduced doses of or changes in immunosuppressants. No skin cancer other than four Kaposi's sarcomas with skin manifestations was detected in our series. DISCUSSIONS: HCC was the main cancer in our series. Accepting hepatitis B carriers as candidates for renal recipients and donors may be one of the causes. PTLD was the second most common cancer, while there were no skin cancers.

Adult↗
PubMed2004

Outcome of renal transplantation in children with pericardiopleural effusion.

INTRODUCTION: Children with end-stage renal disease may present with pericardiopleural effusion secondary to volume overload and overhydration. The present study was designed to investigate the efficacy and safety of renal transplantation in these pediatric patients. METHODS: From 1981 to 2001, six of 20 patients (30%) under 18 years old who received renal transplants showed pericardiopleural effusion after serial pretransplant imaging studies. These patients also displayed associated diseases, such as congestive heart failure (n = 3), ascites (n = 2), and splenomegaly (n = 2). The recipients included five boys and one girl of mean age of 12.7 years (range, 8 to 17 years), all of whom had undergone hemodialysis before transplantation. The waiting time for grafts ranged from 1.3 to 6 years (mean = 2.6 years). Episodes of acute pulmonary edema had been observed in three patients pretransplant. RESULTS: One recipient died with a functioning graft due to heart failure with acute pulmonary edema at 4 months after transplantation. Acute rejection episodes were observed in three, and chronic rejection in two children. The median follow-up was 11 years (range = 6 to 16 years) in the other five recipients, all of whom presently survive with functioning grafts. The posttransplant mean serum creatinine levels at 1 year, 3 years, and 5 years were 1.54 +/- 0.44, 1.74 +/- 0.56, and 1.92 +/- 0.56 mg/dL, respectively. CONCLUSION: Renal transplantation in children displaying pericardiopleural effusion was associated with a high success rate. However, these patients must be followed closely with regular cardiopulmonary evaluation since their condition may deteriorate.

Adolescent↗
PubMed2004

Does mycophenolate mofetil increase the incidence of infections in stable renal transplant recipients initially treated with a two-drug regimen?

BACKGROUND: A drug regimen including a calcineurin inhibitor (cyclosporine or tacrolimus) and prednisone has been the mainstay of maintenance immunosuppression in our renal transplant recipients for more than 10 years. After the introduction of mycophenolate mofetil (MMF), a new, potent immunosuppressant that may reduce the incidence of late rejection in renal transplant recipients, the immunosuppressive protocol in some recipients was changed to an MMF-based regimen. We sought to ascertain whether the addition of MMF lead to greater susceptibility to infectious complications. PATIENTS AND METHODS: Between May 1991 and November 2002, all renal transplant recipients who received a two-drug regimen initially for more than 6 months were changed to an MMF-based regimen. The study includes patients with functional grafts for more than 6 months thereafter. Differences in the incidence, etiology, and outcome of infections were compared during the non-MMF versus the MMF periods. RESULTS: Eighty patients of mean age of 38.6 years (range 13 to 69) included 43 men and 37 women. The mean daily MMF dose was 663 mg/patient (range 250 to 1500 mg). The mean follow-up time of non-MMF period and MMF periods were 3.4 and 2.1 years, respectively. The overall incidence of infections in the two periods was similar (0.2 infections/patient in the non-MMF period and 0.25 infections/patient in the MMF period, P = .57). No mortality was associated with these infectious complications. In conclusion, addition of MMF, a more potent immunosuppressive protocol, did not increase the incidence of infections in stable renal transplant recipients initially treated with a two-drug regimen.

Bacterial Infections↗
PubMed2004

Risks and quality-of-life changes in living kidney donors.

INTRODUCTION: Although the benefits of living donor organs for recipients are well documented, the risks and quality-of-life changes in living kidney donors are seldom reported. METHODS: From July 1992 to June 2002, all living kidney donors underwent regular follow-up at our hospital. The MOS 36-item short-form health survey (SF-36), a standardized questionnaire to measure quality of life, was used in this study. Furthermore, donor renal function and associate complications were assessed. RESULTS: Seventeen donors answered the questionnaire, including eight men and nine women of mean age of 41 years (range = 25 to 56). No perioperative mortality was noted. No proteinuria or hematuria was found during long-term follow-up. The mean serum creatinine level was 0.95 +/- 0.22 mg/dL before the operation. The postoperative mean serum creatinine levels at 6 months, 1 year, and 3 years were 1.22 +/- 0.34, 1.19 +/- 0.20, and 1.29 +/- 0.21 mg/dL, respectively. Two cases underwent scar revision and one complained long-term wound pain for more than 1 year. One donor became depressed because of graft failure in her son. The SF-36 scores were 84.4 +/- 4.4 (physical function), 84.0 +/- 4.7 (role-physical), 78.4 +/- 8.0 (body pain), 81.5 +/- 5.9 (general health), 83.2 +/- 3.7 (vitality), 83.9 +/- 5.9 (social functioning), 79.9 +/- 4.1 (role-emotional), and 78.6 +/- 2.3 (mental health), respectively. CONCLUSION: The quality-of-life changes and risks after donation are low; most donors are concerned about cosmetic problems and pain-related scar formation.

Adult↗
PubMed2004

Sirolimus (rapamycin) reduces the incidence of acute rejection episodes in renal transplantation: an initial experience in Taiwan.

BACKGROUND: Acute rejection is the major cause of graft loss in renal transplantation. Sirolimus (rapamycin) inhibits the effects of cytokines on T and B cells; therefore, it provides prophylaxis against acute renal rejection. This open-label trial assessed the incidence of biopsy-confirmed acute rejection episodes, variation in renal function, as well as graft and patient survival rates up to 12 months posttransplantation when using sirolimus in combination with cyclosporine and prednisolone as immunosuppressants. METHODS: Ten kidney transplant recipients received sirolimus 2 mg daily after a 6-mg loading dose. Doses were then adjusted to keep the whole-blood trough level between 5 and 20 mg/mL. All patients received sirolimus in combination with cyclosporine and prednisolone. RESULTS: At 12 months after renal transplantation, the graft and patient survival rates were 90% and 90%, respectively. One patient died at 2 months due to sepsis with a functioning graft. The mean serum creatinine levels at 1, 3, and 6 months were 1.59 mg/dL, 1.71 mg/dL, and 1.65 ml/dL, respectively. There was no biopsy-confirmed acute rejection episode within 12 months. CONCLUSIONS: Sirolimus in combination with cyclosporine and prednisolone significantly protected kidney transplant recipients from acute rejection for up to 1 year of follow-up.

Acute Disease↗
PubMed2004

Laparoscopic donor nephrectomy: new combination of hand-assisted and standard approaches.

BACKGROUND: Although laparoscopic live donor nephrectomy (LLDN) was conceived to decrease morbidity and reduce donor disincentives, it requires considerable experience. We present a new combination of hand-assisted and standard laparoscopic approaches to live donor nephrectomy. METHODS: Between March 2002 and February 2003, ten LLDNs were performed with the new procedures. Using the new methodology the surgeon can withdraw his hand and insert a trocar through the hand-assisted device whenever he desires. Although the hand-assisted procedure was performed in most patients, we attempted to dissect the renal hilum without hand assistance in the final patient, successfully procuring the kidney. RESULTS: Mean operation time was 245 minutes and warm ischemic time was 179 seconds. No vascular, renal parenchymal, or ureteral injuries occurred. The patient with multiple left renal arteries had a longer warm ischemic time and delayed graft function. Mean predonation creatinine was 0.97 mg/dL, it increased to 1.44 and 1.15 mg/dL at 7 days and 3 months postdonation, respectively. One patient had chylous ascites and another had a transient left brachial plexus paralysis. CONCLUSIONS: Both pure laparoscopic and hand-assisted LLDN have advantages and disadvantages. In our modification, the free conversion from hand-assisted to a purely laparoscopic approach allows the surgeon to practice two procedures simultaneously. With this combination, 90% of the LLDN were accomplished, with pure laparoscopy in the last case.

Humans↗
PubMed2004

Laparoscopic live donor nephrectomy in a patient with duplex inferior vena cava.

BACKGROUND: Modern imaging, such as CT and MRI, improves the preoperative assessment for variants of renal vasculature. We present a kidney donor with a duplex inferior vena cava. In conjunction with CT and hand-assisted laparoscopic surgery, live donor nephrectomy was performed successfully. METHODS: A 35-year-old woman wished to donate a kidney to her son. Preoperative CT showed normal functional kidneys without uretal duplication. A duplex inferior vena cava was noted below the level of the left renal vein. A hand-assisted transperitoneal laparoscopic left nephrectomy was performed. Blood loss was minimal and the warm ischemia time was 3 minutes. Renal transplantation was performed with good initial perfusion and urine output. RESULTS: The donor was discharged in good condition at 3 days postoperatively. Both donor and recipient are alive with good renal function and without late surgical complications at 9 months. CONCLUSIONS: Live donor nephrectomy is unique as it involves two different patients. Benefits from laparoscopic operation include less pain, shorter hospital stay, earlier resumption of normal food intake, and earlier return to full activity. Graft function was not deleteriously affected and the survival of graft and recipient was not affected. Vascular anomalies, although uncommon, had a significant influence on live renal transplantation. Our patient represents a case of a rare venous anomaly, which has an an incidence rate of 0.5% to 3%. Helical CT with reconstruction of vascular anatomy helped in evaluating donor vasculature. In conjunction with modern imaging techniques and laparoscopic operation, live donor nephrectomy can be performed safely, even in patients with vascular anomalies.

Adolescent↗
PubMed2004

Analgesic effects of preincisional administration of dextromethorphan and tenoxicam following laparoscopic cholecystectomy.

BACKGROUND: Pre-incisional treatment with either N-methyl-D-aspartate (NMDA) receptor antagonists or non-steroidal anti-inflammatory drugs (NSAIDs) improves postoperative pain relief. This study examines the effect on postlaparoscopic cholecystectomy (LC) pain of a combination of dextromethorphan (DM), a NMDA-receptor antagonist, and tenoxicam, a NSAID, given preoperatively. METHODS: Eighty-eight ASA I or II patients scheduled for LC were entered into a randomized, double-blind study and randomly allocated to one of four groups. Controls received 20 mg (4 ml) of chlorpheniramine maleate (CPM) IM and 4 ml of normal saline (N/S) IV. Group DM received 40 mg of DM (containing 20 mg of CPM) IM and 4 ml of N/S IV. Group T were given CPM 20 mg IM, and tenoxicam 40 mg (4 ml) IV. Group DM + T were given DM 40 mg (containing 20 mg of CPM) IM, and tenoxicam 40 mg IV. All treatments were given 30 min before skin incision. Analgesic effects were evaluated by Visual Analog Scale (VAS) pain scores at rest and during coughing, at 1, 2, 4, 12, 24 and 48 h after surgery. The time to the first request for meperidine for pain relief, and total meperidine consumption, were recorded for 48 h after surgery. RESULTS: Compared to controls, patients given DM and DM + T first requested meperidine significantly later, had lower meperidine consumption, made fewer requests for meperidine, and had lower pain scores. There were significant differences between the DM + T and T groups at 2 and 4 h in both resting and incident VAS pain scores, the incidence of meperidine requests and the time to first meperidine injection. There were significant differences between groups DM and T at 1 h for resting pain and at 2 and 4 h for incident pain. Except for a significant difference in the incident pain score 1 h after surgery, there were no other differences in pain scores between the DM and DM + T groups. Neither synergistic nor antagonistic interaction was observed between DM and tenoxicam. CONCLUSIONS: The results suggest that pretreatment with DM, but not tenoxicam, provides significant pre-emptive analgesia for postoperative pain management in patients after LC surgery. Combining DM and tenoxicam also gives good pain relief.

Adult↗
PubMed2003

Roles of Fhit and p53 in Taiwanese surgically treated non-small-cell lung cancers.

Abnormalities of fragile histidine triad (FHIT) and TP53 have been found frequently in nonsmall cell lung cancers. In the current study, 263 primary nonsmall cell lung cancers were investigated for the expressions of Fhit and p53 by immunohistochemistry. Marked reduction of Fhit immunoreactivity (<10% positivity) in 156 (59%) tumours and overexpression of p53 protein (>10% positivity) in 89 (34%) tumours were found. Reduced Fhit expression was also noted in most squamous cell carcinomas (80 out of 99, 81%), and in a smaller fraction of adenocarcinomas (76 out of 164, 46%; P<0.001). p53 nuclear staining was demonstrated in 54 out of 99 (55%) squamous cell carcinomas and in 35 out of 164 (21%) adenocarcinomas (P<0.001). The loss of Fhit expression and p53 overexpression was significantly more common in tumours occurring in smokers (93 out of 113, 82% and 56 out of 113, 50%) than in those of nonsmokers (63 out of 150, 42%; P<0.001 and 33 out of 150, 22%; P<0.001). Notably, p53 overexpression was associated with distant metastasis of patients in the whole series (P=0.027) and in adenocarcinoma (P=0.001). It was also associated with a poorer survival of patients with adenocarcinoma (P=0.032).

Acid Anhydride Hydrolases↗