Biomedical subjects

Chen-Yi Hsu

Publications and source records attributed to Chen-Yi Hsu.

6 recordsLinked to original sources

PubMed2004

Serum immunoglobulins and IgG subclass levels in sinus mycetoma.

OBJECTIVE: To study the immunity of patients with sinus mycetoma by measuring serum immunoglobulins and IgG subclass levels. STUDY DESIGN AND SETTING: Thirty patients with sinus mycetoma, 71 ordinary chronic rhinosinusitis patients without nasal polyps, and 77 ordinary chronic rhinosinusitis patients with nasal polyps were collected. In all subjects, the levels of total serum immunoglobulins and IgG subclasses were measured during surgical treatment. RESULTS: Among 30 patients with sinus mycetoma, decreased IgA level was found in 1 patient, and decreased IgM level was found in another 2 patients. There were no significant differences in the levels of total serum immunoglobulins or IgG subclasses between patients with sinus mycetoma and ordinary chronic rhinosinusitis patients with or without nasal polyps. CONCLUSION: Immunologic defects cannot be detected in patients with sinus mycetoma by measuring levels of total serum immunoglobulins or IgG subclasses. SIGNIFICANCE: Immunoglobulin deficiency may not play an important role in the pathogenesis of sinus mycetoma.

Adolescent↗

PubMed2003

Phase III study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma: positive effect on overall and progression-free survival.

PURPOSE: Nasopharyngeal carcinoma (NPC) is a radiosensitive and chemosensitive tumor. This randomized phase III trial compared concurrent chemoradiotherapy (CCRT) versus radiotherapy (RT) alone in patients with advanced NPC. PATIENTS AND METHODS: From December 1993 to April 1999, 284 patients with 1992 American Joint Committee on Cancer stage III to IV (M0) NPC were randomly allocated into two arms. Similar dosage and fractionation of RT was administered in both arms. The investigational arm received two cycles of concurrent chemotherapy with cisplatin 20 mg/m(2)/d plus fluorouracil 400 mg/m(2)/d by 96-hour continuous infusion during the weeks 1 and 5 of RT. Survival analysis was estimated by the Kaplan-Meier method and compared by the log-rank test. RESULTS: Baseline patient characteristics were comparable in both arms. After a median follow-up of 65 months, 26.2% (37 of 141) and 46.2% (66 of 143) of patients developed tumor relapse in the CCRT and RT-alone groups, respectively. The 5-year overall survival rates were 72.3% for the CCRT arm and 54.2% for the RT-only arm (P =.0022). The 5-year progression-free survival rates were 71.6% for the CCRT group compared with 53.0% for the RT-only group (P =.0012). Although significantly more toxicity was noted in the CCRT arm, including leukopenia and emesis, compliance with the combined treatment was good. The second cycle of concurrent chemotherapy was refused by nine patients and was delayed for > or = 1 week for another nine patients. There were no treatment-related deaths in either arm. CONCLUSION: We conclude that CCRT is superior to RT alone for patients with advanced NPC in endemic areas.

Adult↗

PubMed2003

Outpatient weekly 24-hour infusional adjuvant chemotherapy of cisplatin, 5-fluorouracil, and leucovorin for high-risk nasopharyngeal carcinoma.

BACKGROUND: Distant metastasis rather than locoregional recurrence is the major site of failure after adequate radiotherapy in nasopharyngeal carcinoma (NPC). The aim of this study is to evaluate the toxicity and survival of outpatient weekly 24-hour infusion adjuvant chemotherapy for NPC patients with high-risk of distant failure. METHODS: Our definition of high-risk NPC included patients with (1) 1992 AJCC staging system of N3, T4N2, or N2 with one of nodal size > 4 cm; (2) supraclavicular node metastasis; and (3) residual disease after radiotherapy or neck relapse. From August 1994 to August 1997, 41 NPC patients matching the preceding criteria agreed to receive weekly PFL (cisplatin 25 mg/m(2), 5-fluorouracil 1250 mg/m(2), and leucovorin 120 mg/m(2)) adjuvant chemotherapy for a total of 18 weeks. Clinical data of another 88 patients with similar disease status who did not receive adjuvant chemotherapy during the same period were collected and analyzed for comparison. Survival analysis was investigated by the Kaplan-Meier method and the Cox proportional hazards model. RESULTS: A total of 700 weekly chemotherapy doses was delivered to 41 patients. The ratio of actual/planned dose delivery was 94.9%. Grade 3-4 toxicity of adjuvant chemotherapy included leucopenia (7.3%), anemia (2.4%), thrombocytopenia (2.4%), and nausea/vomiting (2.4%). After a median follow-up of 70 months, 26.8% (11 of 41) and 47.7% (42 of 88) of patients in PFL and no adjuvant chemotherapy groups had distant metastasis (p =.0247). The 5-year metastasis-free survival rates were 71.9% for the PFL group compared with 48.4% for no adjuvant chemotherapy patients (p =.0187). The 5-year overall survival rates were 53.7% (PFL group) and 38.3% (no adjuvant chemotherapy group), respectively (p =.0666). Multivariate Cox analysis showed PFL adjuvant chemotherapy was the independent factor that predicted metastasis-free survival after adjustment for other variables. CONCLUSIONS: Outpatient weekly 24-hour continuous infusion PFL adjuvant chemotherapy is a well-tolerated regimen with promising results in high-risk NPC patients and merits investigation in phase III studies.

Adolescent↗

PubMed2002

Revision functional endoscopic sinus surgery.

Functional endoscopic sinus surgery (FESS) has recently become a popular procedure for treating chronic sinusitis. However, there is a 2% to 24% rate of primary FESS failure. Revision functional endoscopic sinus surgery (RESS) is indicated for patients who remain symptomatic after primary FESS and optimal medical therapy have failed. A retrospective study was conducted on all patients who underwent RESS in our department between April 1988 and March 1998. During this period, FESS was performed 1,227 times to treat chronic sinusitis; among those procedures, 142 were RESS. Complications occurred in 14 RESS procedures (9.9%). After RESS, 65% patients had improved. In this study, we concluded that although RESS is more difficult than primary FESS because of distorted or missing anatomic landmarks, complications did not increase with RESS if meticulous surgical procedures were performed. However, the 65% improvement rate with RESS was lower than that of primary FESS.

Adolescent↗

PubMed2002

Correlation between bacteriology of the middle meatus and ethmoid sinus in chronic sinusitis.

In this study we report on the correlation between the bacteriology of the middle meatus and ethmoid sinus in chronic sinusitis. When patients with chronic sinusitis underwent functional endoscopic sinus surgery (FESS), swab specimens were taken from the middle meati before surgery. After removing the ethmoid bullae, swab specimens were taken from the ethmoid sinuses. Between November 1998 and February 2001, 186 pairs of middle meatal and ethmoid sinus specimens were collected from 186 patients. No bacteria were cultured from either specimen in 32 patients. The same bacteria were cultured from both specimens in another 60 patients. The culture results differed between the middle meatal and ethmoid sinus specimens in the remaining 94 patients. There was a significant difference between culture rates of 63.4 per cent for middle meatal specimens and 76.3 per cent for the ethmoid sinus specimens. In analysing bacterial species, significantly more aerobic gram negative bacteria were cultured from the ethmoid sinus specimens than from the middle meatal specimens. This study shows that the bacteriology of the middle meatus was different from that of the ethmoid sinus. Therefore, the bacteriological findings in the middle meati may not reflect the real bacteriology in chronic sinusitis.

Adolescent↗

PubMedDate not supplied

Bacteriology of chronic maxillary sinusitis in relation to sinoscopic appearance.

BACKGROUND: The bacteriology of chronic maxillary sinusitis in relation to different sinoscopic appearances is reported in this study. METHODS: When transantral sinoscopy via an anterior wall puncture was used to examine the maxillary antra in patients with chronic maxillary sinusitis, the sinoscopic appearances were divided into five types. Maxillary antra in which ostia were recognized under the endoscope and no secretion existed were classified as type 1. Maxillary antra in which ostia were not recognized and no secretion existed belonged to type 2. Maxillary antra in which seromucoid secretion existed belonged to type 3. Maxillary antra in which mucopurulent discharge existed belonged to type 4. Maxillary antra in which fungal balls existed belonged to type 5. Swab specimens of these antra were sent for aerobic and anaerobic cultures. RESULTS: Between 1988 and 1998, 493 sinoscopic appearances of maxillary antra were classified. Among them, 72 were classified as type 1, 59 were type 2, 75 as type3, 227 were type 4, and 60 were type 5. The culture rate of swab specimens from those antra with type 1 sinoscopic appearance was 56.9%. The culture rates were 59.3% for type 2, 48% for type 3, 64.8% for type 4, and 88.3% for type 5. Common cultured bacteria were similar among antra with different types of sinoscopic appearances, except type 5 antra, but less gram-negative aerobes grew from type 1 antra. CONCLUSIONS: This study shows that the bacteriology of noninvasive fungal sinusitis was different from that of ordinary chronic maxillary sinusitis. However, among ordinary chronic maxillary sinusitis, the bacteriology was similar between maxillary antra with different sinoscopic appearances except with mild disease.

Adolescent↗