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Biomedical subjects

H-W Chen

Publications and source records attributed to H-W Chen.

6 recordsLinked to original sources
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

Dynamic changes of gene expression profiles during postnatal development of the heart in mice.

OBJECTIVE: To study postnatal cardiac differentiation in the mouse. HYPOTHESIS: There might be mechanisms or factors in cardiac differentiation that could be identified by systematic gene expression analysis during postnatal cardiac development. METHODS: Expression of 6144 genes was examined in mouse heart, from the newborn period (day 0), through day 7 and day 14 day, to adulthood, using the cDNA microarray approach. Northern blotting and immunohistochemical techniques were used to confirm the microarray results. RESULTS: Various cardiac development related genes involving the cell cycle (cyclin B1, proliferating cell nuclear antigen (PCNA), and Ki67), growth factors (IGF-II, pleiotrophin (PTN), and midkine (MK)), and transcriptional regulation, cytoskeleton, and detoxification enzymes were identified by microarray analysis. Some of these genes were also confirmed by Northern blotting and immunohistochemistry of their RNA and protein content. In vivo treatment with PTN (20 ng/g) increased bromodeoxyuridine incorporation (by 2.24-fold) and PCNA expression (by 1.71-fold) during day 7 to day 14, indicating that PTN induces cell proliferation in mouse heart. CONCLUSIONS: Global gene expression analysis in the whole heart may be useful in understanding the orchestrated process of postnatal development or terminal differentiation in the cardiac environment. These data are likely to be helpful in studying developmental anomalies of the heart in neonates.

Animals↗
PubMed2004

Computed tomographic virtual cardioscopy in a case of left atrial myxoma.

Computed tomographic virtual cardioscopy was used to provide clear and precise visualisation of a myxoma with a stalk arising from the interatrial septum. This technique permits the safe, reliable, and non-invasive diagnosis of intracardiac lesions. This case is presented to assist the cardiovascular surgeon in preoperative planning or in developing a simulation of robotic cardiac surgery.

Female↗