Biomedical subjects

Chia-Hsiang Lin

Publications and source records attributed to Chia-Hsiang Lin.

6 recordsLinked to original sources

PubMed2004

Histopathologic confirmation of complete cancer-cell kill in excised specimens after renal cryotherapy.

We present the first case of complete documentation of total cancer ablation in a previously cryoablated human renal tumor. A 61-year-old patient with metachronous bilateral renal cell carcinoma was treated with open partial nephrectomy and subsequently laparoscopic cryoablation. His renal function deteriorated, prompting bilateral radical nephrectomy before renal transplantation. Detailed histopathologic examination of the specimen did not reveal any evidence of malignancy in two cryoablated sites 36 months (left kidney) and 19 months (right kidney) after the respective cryoablations.

Adenocarcinoma, Clear Cell↗

PubMed2004

Laparoscopic live donor nephrectomy in the presence of circumaortic or retroaortic left renal vein.

PURPOSE: Laparoscopic live donor nephrectomy is now an accepted alternative to open surgery in donors with normal renal vasculature. However, the suitability of laparoscopy for donors with anomalous vasculature is less well known. We compared the donor and recipient outcome data of 16 patients with circumaortic or retroaortic left renal vein to 20 recent patients with normal left renal venous anatomy undergoing laparoscopic donor left nephrectomy. MATERIALS AND METHODS: Of 170 patients undergoing laparoscopic donor nephrectomy at our institution from October 1997 to October 2002, 18 (10.6%) had either a circumaortic or retroaortic left renal vein (group 1). Demographic and perioperative parameters of these donors and their recipients were retrospectively compared to a contemporary cohort of 20 recent patients with a normal single left renal vein (group 2). RESULTS: All laparoscopic procedures were completed successfully without open conversion. Groups 1 and 2 were similar in regard to operative time (199 vs 226 minutes, p = 0.90), blood loss (125 vs 100 cc, p = 0.45), warm ischemia time (3.4 vs 3.9 minutes, p = 0.14) and hospital stay (2.9 vs 3.2 days, p = 0.45). Length of allograft renal artery and vein was similar between groups. Cold ischemia and revascularization times were also comparable between groups. Recipient serum creatinine was comparable at 5 days (1.7 vs 1.6 mg/dl), 3 months (1.5 vs 1.4 mg/dl) and 1 year (1.5 vs 1.5 mg/dl). CONCLUSIONS: Presence of a circumaortic or retroaortic renal vein is not a contraindication to laparoscopic live donor left nephrectomy. A left kidney with vasculature anatomically adequate for transplantation can be achieved with excellent donor and recipient outcomes.

Adult↗

PubMed2003

Ha-ras overexpression mediated cell apoptosis in the presence of 5-fluorouracil.

By using a mouse NIH3T3 derivate designed 7-4 harboring the inducible Ha-ras oncogene, we demonstrated the close relationship between Ha-ras expression level and sensitization of 5-flurouracil (5-FU)-treated cells. Further studies revealed that the cells susceptible to 5-FU treatment died of apoptosis, which was demonstrated by caspase-3 activation, loss of mitochondria membrane potential (MMP), and DNA fragmentation. The 7-4 cells coexpressing dominant negative Ras (Ras(Asn17)), dominant negative Raf-1 (Raf-1(CB4)), Bcl-2, or active form of phosphatidylinositol 3-kinase (PI3K) became resistant to 5-FU, and apoptosis was prevented. In contrast, the cells coexpressing dominant negative Rac 1 (Rac1(Asn17)) or dominant negative Rho A (RhoA(Asn19)) showed no change of sensitivity to 5-FU. These results indicate that Ras, Bcl-2, as well as Raf-1 and PI3K pathways play pivotal roles in 5-FU-induced apoptosis under Ha-ras-overexpressed condition. Aberrant levels of cyclin E and p21(Cip/WAF-1) expression as well as Cdc 2 phosphorylation at Tyrosine 15 suggest that perturbation of G1/S and G2/M transitions in cell cycle might be responsible for 5-FU triggered apoptosis. Sensitization of Ha-ras-related cells to 5-FU was also demonstrated in human bladder cancer cells. Through understanding the mechanism of 5-FU induced apoptosis in tumor cells, a new direction toward the treatment of Ha-ras oncogene-related cancers with 5-FU at more optimal dosages is possible and combinational therapy with other drugs that suppress PI3K and Bcl-2 activities can also be considered.

3T3 Cells↗

PubMed2003

Migration of a dislodged tip of an ultrasound lithotripter probe to the pulmonary artery: a rare complication of percutaneous nephrolithotomy.

A 44-year-old man underwent percutaneous nephrolithotomy for a left renal staghorn stone. During the procedure, the tip of the ultrasound lithotripter dislodged from the probe rod when the renal stone was being disintegrated. The tip immediately disappeared from the field of nephroscopic vision. Despite a thorough search, the tip could not be found. Postoperative chest radiography revealed a foreign body, shaped like a lithotripter probe tip, located in the lingular branch of the left pulmonary artery. Eventually, left thoracotomy was performed to remove the foreign body. To our knowledge, this rare complication has never been reported before.

Adult↗

PubMed2003

Laparoscopic upper pole partial nephrectomy with concomitant en bloc adrenalectomy.

OBJECTIVES: To report our experience with laparoscopic partial nephrectomy for renal tumor with concomitant adrenalectomy. An upper pole renal tumor may contiguously involve the adrenal gland, requiring concomitant adrenalectomy. Although commonly performed in the setting of laparoscopic radical nephrectomy, concomitant adrenalectomy has not been described during laparoscopic partial nephrectomy. METHODS: Four patients with an upper pole renal tumor and suspected adrenal involvement underwent laparoscopic partial nephrectomy with concomitant ipsilateral adrenalectomy. Preoperative three-dimensional computed tomography revealed the renal tumor to be closely abutting the adrenal gland in 3 patients and a 4-cm adrenal mass in 1 patient. The mean renal tumor size was 3.2 cm (range 1.4 to 6.6). To maintain oncologic principles, our transperitoneal laparoscopic technique excises the adrenal gland en bloc with the renal tumor. As such, adrenalectomy is performed first, followed by partial nephrectomy, incorporating hilar control, tumor excision, and sutured renal reconstruction. RESULTS: All four procedures were performed without open conversion or intraoperative complications. The mean renal warm ischemia time was 36 minutes, estimated blood loss 169 mL, total operating time 3.9 hours, and hospital stay 3.2 days. One patient developed a transient urinary leak postoperatively. Pathologic examination of the renal tumor revealed renal cell carcinoma (n = 1), dystrophic calcification with ectopic bone formation (n = 1), adult mesoblastic nephroma (n = 1), and subcapsular heterotopic adrenal cortex with cyst (n = 1), all with negative surgical margins. Pathologic examination of the adrenal gland revealed adenoma in 1 case and a normal adrenal gland without malignant involvement in 3 cases. All patients were disease free at last follow-up (mean 6.2 months, range 2 to 12). CONCLUSIONS: In patients with an upper pole renal tumor and radiologically suspected adrenal involvement, laparoscopic partial nephrectomy with concomitant adrenalectomy can be performed efficaciously respecting oncologic principles.

Adenoma↗

PubMed2002

Internal bladder retractor for laparoscopic cystectomy in the female patient.

PURPOSE: To overcome difficult dissection of the vascular pedicles during laparoscopic radical cystectomy we used a novel technique of internal bladder retraction. MATERIALS AND METHODS: An internal bladder retractor was used to facilitate dissection of the vascular pedicles during laparoscopic radical cystectomy in a female patient. RESULTS: The application of the retractor is easy and it allows more precise control of the vascular pedicles and ureters. It also helps to overcome the space limitation when dissecting the perivesical structures. Laparoscopic cystectomy with hysterectomy was accomplished in 2.5 hours. CONCLUSIONS: We successfully used a novel internal bladder retractor to facilitate laparoscopic radical cystectomy in a female patient.

Carcinoma, Transitional Cell↗