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H L Eng

Publications and source records attributed to H L Eng.

At least 73 records · Page 4Linked to original sources
PubMed1998

Serum-soluble interleukin-2 receptor concentrations in patients with breast cancer: a preliminary report.

BACKGROUND: The serum-soluble interleukin-2 receptor has been claimed to be a marker of host biological response in patients with solid malignancies. This study was designed to evaluate the biological significance of the preoperative serum-soluble interleukin-2 receptor concentration in patients with invasive breast cancer. MATERIALS AND METHODS: Venous blood samples were collected from 66 patients with invasive breast carcinoma and the serum concentrations of soluble interleukin-2 receptor were measured with an enzyme immunoassay method. Data regarding maximum tumor diameter, age, estrogen receptor status, lymph node status, distant metastasis status, histologic grade, ploidy pattern and S-phase fraction were also collected and evaluated simultaneously with the serum concentration levels of soluble interleukin-2 receptor. Fifteen age-matched healthy subjects were used as a control group. RESULTS: The mean value of serum-soluble interleukin-2 receptor in patients with invasive breast cancer was 621 +/- 145 units/ml and that of the control group was 308 +/- 59 units/ml; and the difference was significant (p = 0.000). With multivariate analysis, lymph node status (p = 0.000), distant metastasis status (p = 0.000) and maximum tumor diameter (p = 0.000) appeared as independent factors in regards to the significantly, higher serum concentrations of soluble interleukin-2 receptor. CONCLUSION: Based on our preliminary results, the preoperative serum-soluble interleukin-2 receptor concentration is closely related to lymph node status, distant metastasis status and tumor diameter in invasive breast carcinoma. This may be an additional valuable predictive factor for the diagnosis of invasive breast cancer.

Adult↗
PubMed1998

Post-transplant changes of segment 4 after living related liver transplantation.

The purpose of this study was to evaluate the outcome of the medial segment of the graft after living related liver transplantation (LRLT). Of the 12 pediatric recipients who underwent LRLT, 2 received whole left liver graft, 1 left lateral segment graft, and 9 extended left lateral segment grafts. The hepatic veins of the donor were reviewed and the volume of the medial segment and left lateral liver was measured before and 6 months after liver transplantation. The flow velocity and direction of the portal vein in the medial segment graft was also evaluated by Doppler ultrasound. The grafted livers of all recipients showed a substantial increase in volume of 9-120% 6 months after LRLT. For the left lateral segment, an increase in volume was found in all cases ranging from 21 to 245%. For the medial segment, volume increases of 5-48% were found in seven cases with normal hepatopetal flow detected inside the segment 4 intrahepatic portal vein. In four cases, the partial medial segment graft of the extended left lateral liver graft decreased in volume from 33 to 69%. Among these four cases, slow flow (n = 2) and hepatofugal flow (n = 1) were also detected in the intrahepatic portal vein of the medial segment. Mapping of the tributary of the hepatic veins of the graft revealed inadequate venous drainage of the partial segment 4 graft, which may be considered as the cause of the atrophic change of the partial segment 4 graft. In conclusion, different regenerative rates between the left lateral segment and the medial segment were noted, with a greater rate in the left lateral segment. The venous drainage of the medial segment is of primary concern in the determination of the outcome of the regeneration. Atrophic change occurs when inadequate hepatic venous drainage is encountered. Therefore, if an extended left lateral liver graft is required, the corresponding draining veins of the partial medial segment must be preserved. Otherwise, whole left liver or left lateral segment graft would be a better choice.

Blood Flow Velocity↗
PubMed1997

The prognostic significance of proliferating cell nuclear antigen in patients with lymph node-positive breast cancer.

OBJECTIVE: To evaluate the prognostic significance of proliferating cell nuclear antigen (PCNA) in patients with lymph node-positive primary breast cancer. DESIGN: A retrospective study. SETTING: A tertiary care hospital. STUDY PARTICIPANTS: A consecutive series of 123 patients with lymph node-positive primary breast cancer. INTERVENTION: The PCNA-labeling index [(PCNA-positive cells/1000 cells) x 100] was quantified in paraffin-embedded tissue specimens from 123 patients with lymph node-positive primary breast cancer by immunohistochemical staining. Other important clinicopathological variables, including estrogen receptor status, histological grade, lymph node status, primary tumor status, ploidy pattern, S-phase fraction, and TNM staging, were also identified and evaluated. MAIN OUTCOME MEASURES: The influence of the PCNA-labeling index on the disease-free survival rate and overall survival rate. RESULTS: The PCNA-labeling index of the tissue specimens tested from 123 patients ranged from 11% to 82%. The PCNA-labeling index was closely related to primary tumor status, histological grade, TNM staging, and S-phase fraction. Between patients with a high PCNA-labeling index (> 35%) and those with a low PCNA-labeling index (< or = 35%), there were significant (P < .01) differences in both 5-year disease-free survival rates (2% vs 85%) and 5-year overall survival rates (2% vs 92%). When the PCNA-labeling index and all the clinicopathologic variables were entered into a multivariate analysis for either disease-free survival or overall survival by the Cox proportional hazards model, the PCNA-labeling index emerged as an independent prognostic factor. CONCLUSION: Based on our results, the PCNA-labeling index potentially is a useful prognostic factor for lymph node-positive primary breast cancer.

Adult↗
PubMed1997

Retrograde lymphatic spread: a likely route for metastatic ovarian cancers of gastrointestinal origin.

In order to outline the pathways of gastrointestinal malignancies metastasizing to the ovaries, we reviewed 103 cases of metastatic ovarian tumors, and also performed para-aortic lymph node sampling on 11 patients at operation for metastatic ovarian tumors. Of the 103 patients, 74% (26/35) with gastric cancer and 67% (45/67) with colorectal cancer had lymph node metastasis at or before the diagnosis of ovarian tumor. Intraperitoneal metastases presented in 49 and 42% of patients with gastric and with colorectal cancers, respectively. Twenty-three percent of gastric cancer patients and 25% of colorectal cancer patients presented with both lymph node and intraperitoneal metastases. The ovary was the first or among the early metastatic organs diagnosed in 51 of the 53 patients with metachronous ovarian metastases. Only 4 patients with colorectal cancer and none with gastric cancer showed parenchymal organ metastases. These 4 patients also showed intraperitoneal lesions, and 3 of these 4 patients had node metastasis. Among the 11 patients who underwent prospective para-aortic lymph node sampling during operation for the ovarian tumors, only 1 had enlarged para-aortic nodes depicted by computed tomography, 2 had grossly enlarged (>/=1.5 cm) para-aortic lymph nodes noted at surgery, and 6 of the 7 patients with gastric cancer and all 3 with colorectal cancer had metastatic nodes histologically. Among the 58 nodes taken from these patients, 67% showed metastatic foci. We concluded that lymph node metastasis is frequently seen in patients with metastatic ovarian tumors of gastrointestinal origin, and hypothesized that retrograde lymphatic spread is a likely route for the metastases.

Adult↗
PubMed1997

Tuberculous arthritis of the elbow.

Twenty-three patients with tuberculous arthritis of the elbow were treated and followed up for 3 to 8 years. The diagnosis was established by finding mycobacterium tuberculosis in the aspirate or in a surgical specimen in 18, and by histology in 5. A long history of symptoms and extensive involvement of bone and joint are associated with poor results. Early diagnosis and adequate treatment can be followed by good functional results. Postoperative continuous passive motion is valuable in improving the range of movement in elbows with extensive osteoarticular tuberculosis.

Adult↗
PubMed1997

Serum concentration of tumor necrosis factor in patients with breast cancer.

BACKGROUND: The outcome of breast cancer is usually determined by multiple factors. Serum tumor necrosis factor alpha concentration has been found to be increased in the circulation of patients with malignancy. This study was designed with the aim to investigate any correlation between the serum tumor necrosis factor alpha and the clinicopathological features and furthermore evaluate the prognostic significance of serum tumor necrosis factor alpha concentration in breast cancer. METHODS: Forty consecutive patients with invasive breast cancer undergoing modified radical mastectomy were prospectively included and evaluated. Venous blood samples were collected before the surgery. Sera were obtained by centrifugation, and stored at -70 degrees C until assayed. The control group consisted 30 healthy, age-matched subjects. Serum concentrations of tumor necrosis factor alpha were measured by the quantitative sandwich enzyme immunoassay technique. The data on tumor size, age, estrogen receptor status, lymph node status and TNM staging were reviewed and recorded. RESULTS: The mean value of serum tumor necrosis factor alpha in patients with invasive breast cancer was 1.47 +/- 0.58 pg/ml and that of the control group was 0.98 +/- 0.37 pg/ml, and the difference was significant (P < 0.01). With univariable analysis, patients with maximum tumor size of 5 cm or larger (P = 0.03), more advanced TNM staging (P < 0.01); and more advanced lymph node status (P < 0.01) were shown to have significantly higher serum concentrations of tumor necrosis factor alpha. However, with multivariable analysis, TNM staging appeared as the only independent factor (P < 0.01) predicting the significant, higher serum concentrations of tumor necrosis factor alpha. CONCLUSION: Preoperative evaluation of serum tumor necrosis factor alpha concentrations may be a valuable parameter for reflecting the severity of staging for invasive breast cancer.

Adult↗
PubMed1997

Unusual imaging presentations in renal transitional cell carcinoma.

PURPOSE: To report on unusual imaging presentations in renal transitional cell carcinoma (TCC). MATERIAL AND METHODS: Imaging studies of 140 cases of pathologically proven renal TCC were retrospectively studied with the focus on unusual presentations. RESULTS: Unusual imaging manifestations were found in 20 cases (14.3%). These findings were classified into 5 categories: perirenal abscesses or perirenal hematomas in 6 cases; parenchymal masses in 5; undue thickening of the hydronephrotic wall in 4; "tuberculoid" pyelograms in 3; and tumors with massive necrosis in 2. CONCLUSION: Deceptive imaging presentations may occur in renal TCC. Recognition of these presentations may help to prevent delay in diagnosis.

Abscess↗
PubMed1997

Living related donor liver transplantation.

Living related liver transplantation (LRLT) has been developed in response to the paediatric organ donor shortage. According to the International Living Donor Registry, 521 transplants had been performed in 515 patients between December 8 1988 and January 19 1996 in 30 centres worldwide. The overall actuarial patient and graft survival rates were 82.7 and 80%, respectively. Between June 17 1994 and November 30 1996, the authors performed 11 LRLT at the Chung Gung Memorial Hospital. The living donors consisted of 10 mothers and one father. The mean graft weight was 303 g and the mean graft recipient weight ratio was 2.2%. Donor hepatectomy was performed without vascular inflow occlusion. The intra-operative blood loss ranged from 30 mL to 120 mL with an average of 61 mL, and blood transfusion was not required in all donors both intra-operatively and during the postoperative period. Underlying diseases of the recipients were biliary atresia (n = 10) and glycogen storage disease (n = 1). The mean graft cold ischaemia time was 106 min, the mean second warm ischaemia time was 51 min and the mean interval between portal and arterial reperfusion was 81 min. The initial LRLT results were promising with all donors having been discharged without complication. The recipients experienced a few complications, all of which were manageable with early intervention. All 11 recipients are alive and well. These are encouraging results and the authors hope to expand the use of live donors for liver transplantation to cope with demand.

Adolescent↗
PubMed1997

Prevalence of human papillomavirus in middle ear carcinoma associated with chronic otitis media.

Squamous cell carcinoma of the middle ear (MESCC) is an uncommon tumor and is associated with a history of long-term chronic otitis media (COM) in most cases. Although the human papillomaviruses (HPVs) have been implicated in many human neoplasms, its role in the pathogenesis of MESCC has not been studied. Polymerase chain reaction (PCR) using consensus primers for the detection of HPV types 6, 11, 16, 18, 31, 33, 52b, and 58 was applied in screening fourteen cases of MESCC from archival material. Further subtyping was performed by restriction enzyme digestion of PCR products and by in situ hybridization method on tissue sections. Of the fourteen cases of MESCC, eleven were found to have HPV DNA. HPV-16 was detected in all positive cases. Five cases revealed both HPV-16 and -18. A history of long-term COM (> 3 years) was found in thirteen of the cases. This is the first report to localize HPV-16/18 in MESCC on both the tissue level and the molecular level. The high prevalence of HPV in COM-associated MESCC therefore provides a good model to explain the pathogenesis of chronic-inflammation-related human malignancies.

Adult↗
PubMed1997

Castleman's disease: a case report.

Castleman's disease is a rare, benign disorder most commonly located in the mediastinum as a solitary mass. It is a lymphoid tissue disorder characterized by lymphoid proliferation. In this paper we describe a case of asymptomatic interlobar fissure tumor, localized Castleman's disease, hyaline vascular type, in a 30-year-old female. The tumor arose from the interlobar fissure between the right middle and lower lobes. Laboratory data revealed hypochromic microcytic anemia, similar to that found in iron deficiency, and an elevated erythrocyte sedimentation rate. She underwent video-assisted thoracic surgery for excision of the tumor. Anemia disappeared two months after surgery. No recurrence of the lung tumor was seen 19 months following surgery and she remains well.

Adult↗
PubMed1997

Malakoplakia of the prostate: a case report.

Malakoplakia is an unusual chronic inflammatory disease that was first discovered in the urinary bladder but has subsequently been described in other sites. Characteristic gross and microscopic features of the lesions have been well described. The diagnosis of this tumor-like lesion can only be established by pathologic examination of the involved tissue. A case of prostatic malakoplakia with characteristic gross and microscopic features is reported in a 59-year-old man who presented with urinary frequency and a diminished urinary stream. Clinically the condition mimicked carcinoma of the prostate gland and the patient underwent a radical retropubic prostatectomy. Postoperative recovery was uneventful. The clinical and pathological findings, differential diagnosis and pertinent literature are reviewed. Preoperative needle biopsy or intraoperative frozen section for tissue diagnosis is recommended to avoid unnecessary radical surgery for this type of tumor-like lesion.

Humans↗
PubMed1996

Circulating intercellular adhesion molecule-1 (ICAM-1) in patients with hepatolithiasis.

We evaluated the role of circulating intercellular adhesion molecule-1 in the pathogenesis of hepatolithiasis. From December 1994 to May 1995, 40 patients with hepatolithiasis were included. All the patients met the following criteria: (1) presence of hepatolithiasis, (2) no obvious clinical evidence of an associated intrahepatic cholangiocarcinoma, (3) no clinical manifestation of cholangitis for at least 72 hr, (4) no immunomodulatory agents in the last three weeks, and (5) no blood transfusion in the last three weeks. Venous blood samples were collected both before surgery and at least three months after complete clearance of the stones, and the serum concentrations of circulating intercellular adhesion molecule-1 were measured with a sandwich enzyme immunoassay method. Fifteen healthy subjects were used as a control group. Bile specimens routinely obtained during surgery were cultured for aerobes and anaerobes. The x-ray films of cholangiography were all reviewed in detail. The mean value (834 +/- 128 ng/ml) of circulating intercellular adhesion molecule-1 (ICAM-1) in the patient group before surgery was significantly higher than that (346 +/- 68 ng/ml) of the control group (P < 0.01). The mean value (677 +/- 139 ng/ml) of circulating ICAM-1 in the patient group at least three months after complete clearance of the stones was significantly lower than that (834 +/- 128 ng/ml) of the patients before surgery (P < 0.01), but this mean value (677 +/- 139 ng/ml) was still significantly higher than that (346 +/- 68 ng/ml) of the control group (P < 0.01). Bacteria was present in the bile of all patients. The total number of bacterial species was 135, and there were an average of 3.4 bacterial species cultured per patient. Intrahepatic stricture was demonstrated in cholangiography in 33 patients (82.5%). In addition to the high incidence of intrahepatic bile duct strictures and bile infection, a significant elevation in circulating intercellular adhesion molecule-1 (sICAM-1) was shown in patients with hepatolithiasis. Our preliminary results seem to be promising and the real role of sICAM-1 deserves further investigation and elucidation.

Adult↗
PubMed1996

Smooth muscle tumors of the gastrointestinal tract: analysis of prognostic factors.

BACKGROUND: The survival rates and therapeutic approaches to gastrointestinal leiomyoma and leiomyosarcoma vary widely. This review analyzes the clinical symptoms and signs, the results of the pathologic examination, and the DNA makeup of these tumors and determines the factors that affect the prognosis of patients who have leiomyosarcoma. METHODS: Flow cytometric DNA analysis was performed in 80 patients with gastrointestinal smooth muscle tumors to establish the correlation of DNA ploidy with tumor size and stage and histologic grade. Using univariate and multivariate analyses, we investigated tumor size, histologic grade, association with gastrointestinal bleeding, DNA makeup, operative procedure, age, gender, and tumor necrosis as they affect the long-term survival of 45 patients with leiomyosarcoma. The Kaplan-Meier method was used to determine the survival rates and the log-rank method was used to compare survival rates between the two groups. RESULTS: Between 1986 and 1992, operations were performed on the 80 gastrointestinal smooth muscle tumors--esophageal 1, stomach 32, intestinal 33, colonic 2, and rectal 12. The most common symptoms and signs were gastrointestinal bleeding (43.8%), abdominal mass (37.5%), and abdominal pain (21.3%), and the tumors were classified as leiomyoma 35, low-grade leiomyosarcoma 24, and high-grade leiomyosarcoma 21, according to the cellular atypia and mitotic rate. DNA ploidy correlated with histology grade (r = 0.70, p < 0.01) and tumor size (r = 0.31, p < 0.01) but not with localized or advanced tumors. Only one patient with leiomyoma died of liver metastasis during the follow-up period. In univariate analysis of the 45 patients with leiomyosarcoma, the survival rate was poor in men with tumor sizes greater than 5 cm, incomplete resections, advanced tumors, and high-grade tumors. With multivariate Cox regression analysis only advanced tumors (p < 0.01) and high-grade tumors (p < 0.01) were the independent factors that affected survival. CONCLUSIONS: Leiomyosarcomas usually measure more than 10 cm. In univariate analysis the significant factors affecting the survival rate of patients with leiomyosarcoma are maleness, size greater than 5 cm, inadequate resection, and advanced-stage and high-grade disease. In multivariate Cox regression analysis advanced-stage and high-grade leiomyosarcoma are the only independent factors affecting survival. DNA ploidy correlates with the size and the grade of gastrointestinal smooth muscle tumors but not with tumor stage. DNA ploidy does not affect independently the survival of leiomyosarcoma.

Adolescent↗
PubMed1996

Oral tuberculosis.

Tuberculous lesions of the oral cavity have become so infrequent that it is virtually a forgotten disease entity and may pose a diagnostic problem. Fifteen patients with conditions that were histologically diagnosed as oral tuberculosis were reviewed. All were men ranging in age from 29 to 78 years. The most common clinical presentation was odynophagia with a duration from less than 1 week to several years. The most frequently affected sites were the tongue base and gingiva. The oral lesions took the form of an irregular ulceration or a discrete granular mass. Mandibular bone destruction was evident in two patients. Two patients had a fever, and four had cervical lymphadenopathy. Eight cases were clinically suspicious for malignancy before biopsy. Only four patients had a history of tuberculosis, but 14 of the 15 patients were later found to have active pulmonary tuberculosis. Acid-fast bacilli were demonstrated in all patients. Tuberculosis should be considered in patients with an inflamed ulcer lesion. A biopsy specimen for histologic study, acid-fast stains, and cultures should be obtained for confirmation and differential diagnosis with other conditions. If a tuberculous lesion is suspected, a chest radiograph is indicated to investigate the possibility of pulmonary involvement.

Adult↗
PubMed1996

Paediatric liver transplantation: a 10 year experience in Taiwan.

Between March 1984 and August 1994, 13 orthotopic liver transplantations were performed in 13 patients < or = 25 years of age. The indications included Wilson's disease (n = 7), biliary atresia (n = 4), choledochal cyst (n = 1) and hepatitis C cirrhosis (n = 1). Technical variants included full-size (n = 11), reduced-size (n = 1) and living-related (n = 1) liver transplantation. These recent technical innovations have offered an expanded donor pool for earlier transplantation, shorter waiting times and excellent quality grafts. Surgical complications occurred in six patients; all required additional surgery. Biliary complications were encountered more commonly in our earlier patients. Our actuarial patient and graft survival rate is 92% at 2 years. The long-term follow-up of our liver-transplanted Wilson's disease patients provides confirmatory evidence that orthotopic liver transplantation cures the underlying metabolic defect with complete normalization of biochemical abnormalities of copper metabolism, reversal of neurological impairments and the disappearance of Kayser-Fleischer corneal rings. The high rate of patient survival and excellent rehabilitation indicate that with prudent clinical judgement, liver transplantation can be achieved with an acceptable rate of morbidity, mortality and cost in a setting where manpower and donor organs are very limited.

Adolescent↗