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Biomedical subjects

M C Shen

Publications and source records attributed to M C Shen.

At least 73 records · Page 4Linked to original sources
PubMed1990

A subset of acute nonlymphocytic leukemia with expression of surface antigen CD7--morphologic, cytochemical, immunocytochemical and T cell receptor gene analysis on 13 patients.

An increasing number of acute leukemias coexpressed markers normally believed to be restricted to a single lineage have been found recently. This special subgroup of leukemias have drawn a lot of attention because of their biologic and clinical significance. In a study of 100 consecutive de novo ANLL patients diagnosed by FAB criteria, T-cell antigen CD7 was identified on the leukemic blasts of 13 patients, ten of whom had M1 subtype of leukemia, myeloblastic leukemia without maturation. All the patients showed positive staining with myeloperoxidase and expressed myeloid markers CD13 and/or CD33, but lacked CD11b, a marker of more mature myeloid cells. Combined staining with myeloperoxidase and CD7 of the cells from four patients revealed coexpression of both markers on the same cells. None of the patients expressed the two other T-cell antigens CD2 or CD5. All ten patients who had DNA analysis showed germline configuration of TCR beta and gamma chain genes. One patient had chromosomal translocation involving 11q23, t(11; 19) (q23; p13), which is the site frequently associated with both myeloid and lymphoid malignancies. The clinical implications of this subgroup of patients need further study on more patients, and need longer follow-up.

Adolescent↗
PubMed1990

Chromosome and bcr rearrangement in chronic myelogenous leukaemia and their correlation with clinical states and prognosis of the disease.

Among 77 unselected patients with chronic myelogenous leukaemia (CML), 70 had Philadelphia chromosome (Ph1) in blood cells. Extra chromosomal abnormalities were noted in 4%, 55% and 78% of Ph1-positive patients in chronic phase, accelerated phase and acute blast crisis, respectively. Rearrangement of the bcr was detected in 46 of 47 Ph1-positive patients studied and also in three of five Ph1-negative ones. The locations of the breakpoints were mapped to one of four zones of the bcr in 45 patients. The median duration from diagnosis of CML to onset of acute blast crisis was not significantly different between the two groups of patients with breakpoints in the 5' portion (34 months), and in the 3' portion (39 months) of the bcr. In addition, the locations of the breakpoints within the bcr did not change as the disease progressed in the six patients who had DNA analysed both in the chronic phase and subsequently in transformation. In one of them, an additional aberrant band which was not present in the beginning of the acute phase was detected in blood cells taken 2 months later. It is suggested from the studies that transformation of CML may not be related to alterations within the bcr.

Adolescent↗
PubMed1990

Clinical features of rheumatic carditis in adolescents and adults.

A retrospective study on the clinical features of acute rheumatic fever (RF) with carditis in 45 patients, 15 years of age and older (range 15-61), is described. Nineteen patients were seen at initial attack; the remaining 26 patients (28 recurrences) were admitted because of RF recurrence. Of the total 47 episodes, carditis was manifested by a significant murmur without previous RF or any known rheumatic heart disease in 40%; change in the character of a murmur under observation or the appearance of a new murmur in 15%; and acute pericarditis in 19%. Congestive heart failure of recent onset was noted in 85% of the episodes, while classical polyarthritis or polyarthralgia occurred in 57%. The aortic valve was newly damaged or preexisting aortic regurgitation worsened in 12 episodes. Twenty-nine patients were followed for 1/2-16 years. Of 11 patients with an initial attack who were maintained on regular prophylaxis (intramuscular benzathine penicillin 1,200,000 units every 4 weeks), the mitral valve murmur disappeared in 3 and none of the patients had recurrence. Of the remaining 18 patients with no or incomplete prophylaxis, 1 died from congestive heart failure 6 months later, and 3 had recurrences with involvement of the aortic valve. In conclusion, RF with carditis in adolescents and adults in our practice at the National Taiwan University Hospital is likely to show more cardiac problems and complications than that seen in the West. Although active rheumatic carditis among this patient population is relatively uncommon, recurrences with subsequent involvement of the aortic valve (aortic regurgitation) do occur.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Chromosomal characteristics of Ph-positive chronic myelogenous leukemia in transformation. A study of 23 Chinese patients in Taiwan.

Cytogenetic study was performed in the past 3 years on 23 Chinese patients with Philadelphia chromosome (Ph) positive chronic myelogenous leukemia (CML) in transformation; seven were in accelerated phase and 16 in acute blast crisis. Chromosomal abnormalities in addition to Ph were found in three (43%) of the patients at accelerated phase and 14 (88%) of the patients at blast crisis. The common nonrandom chromosomal aberrations were double Ph, trisomy 8, trisomy 19, and trisomy 21, which occurred in 47%, 41%, 35%, and 29%, respectively, of the total patients with extra chromosomal abnormalities. Isochromosome for the long arm of chromosome 17 was found in only one patient. In patients with blast crisis, the type of blast cell was characterized through morphologic, cytochemical, and immunocytochemical studies. Eleven cases were classified as myeloid and five as lymphoid transformation. Trisomy 8, 19, and 21 were detected only in patients with myeloid blast crisis. This study also revealed a high incidence of trisomy 21 and a low incidence of i(17q) in Chinese patients with transformation of CML.

Adult↗
PubMed1989

Recurrent fetal loss with circulating lupus anticoagulant: report of 2 cases.

Lupus anticoagulant (LAC), an autoantibody, in maternal circulation is responsible for a high incidence of fetal loss. We record 2 cases of recurrent fetal loss in association with LAC. The presence of LAC was diagnosed by prolonged activated partial thromboplastin time (aPTT), but was not correctable by dilution with normal plasma. During their subsequent pregnancies, these two women were treated with prednisolone and a low dose of aspirin (100 mg/day). Normal values of aPTT were achieved in both cases after treatment. Preeclampsia developed in one of the women, and a live premature infant was delivered by cesarean section. However, a successful term pregnancy was achieved in the other case. Corticosteroid and low-dose aspirin appear to improve fetal outcome in cases with LAC.

Abortion, Habitual↗
PubMed1989

Surgical management of musculoskeletal involvement in hemophilic patients.

Since the establishment of a Hemophilic Center at the National Taiwan University Hospital in 1984, all hemophilic patients have been registered. They have received regular follow-ups by specialists in appropriate fields. Orthopedic surgeons are assigned to evaluate and handle the complications of the musculoskeletal system. From January 1984 to April 1988, 20 of these patients were referred for various reconstructive procedures. Seventeen had a moderate to severe depletion of factor VIII and 2 had a severe factor IX deficiency. The indications for surgery include pain, swelling, frequent bleeding, and flexion contracture of the involved joints. Knee joints outnumbered the others. The operative procedures included: synovectomy in 7 patients, total knee replacement in 3 patients, total hip replacement in 1 patient, tendon reconstruction and supracondylar osteotomy of the femur in 3 patients, excision of a pseudotumor or cyst in 4 patients and amputation in 2 patients. Postoperatively, joint pain was relieved greatly, recurrent bleeding became rare and walking ability was significantly improved. To prevent a decrease in the arc of motion of the operated knee joint, exercise was initiated early using a continuous passive motion machine with promising results. Postoperative complications were minimal. Indications for various surgical procedures, and the details of hematological handling are discussed.

Adolescent↗
PubMed1989

Adult non-Hodgkin's lymphoma in Taiwan area: a clinicopathologic study of 123 cases based on working formulation classification.

To elucidate the clinicopathologic features of non-Hodgkin's lymphoma (NHL) in Taiwan, 123 adult patients with proven NHL were studied. They were classified according to the international working formulation as: low grade (LG), 12.2%; intermediate grade (IG), 42.3%; and high grade (HG) lymphoma, 45.5%. The most common subtypes were diffuse large cell (26.8%) and large cell immunoblastic (26.8%) lymphomas. Follicular lymphoma accounted for only 8.9% (11 cases). Complete remission rates for LG, IG and HG lymphomas were 53%, 35% and 34%, respectively. LG lymphoma had a significantly better survival than that of IG and HG lymphomas. The IG lymphoma encompassed a heterogeneous group of patients with varying prognoses but the overall survival curve was indistinguishable from that of HG lymphoma. Clinically, 66% of HG, 77% of IG and 86% of LG lymphoma presented with advanced disease. LG lymphoma had high frequencies of hepatosplenomegaly (30-50%) and bone marrow involvement (53%), whereas skin, bone and central nervous system involvement occurred exclusively in IG and HG lymphomas. Mild anemia was common and occurred in 40-50% of the patients. Hyperimmunoglobulinemia was found in 50-60% of all 3 grades of lymphoma, monoclonal gammopathy in 3 cases of IG lymphoma, and hypercalcemia in 4 cases of IG and HG lymphomas. Elevated serum lactate dehydrogenase occurred mainly in IG and HG lymphomas and was an important prognostic factor. In conclusion, the characteristic features of NHL in Taiwan include: (1) a high proportion of HG lymphoma and low proportions of LG and follicular lymphomas; (2) a heterogeneous patient composition of IG lymphoma with an unfavorable overall prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Bone marrow involvement in non-Hodgkin's lymphoma.

The frequency, pattern, extent and clinical features of bone marrow involvement in 94 cases of non-Hodgkin's lymphoma, classified according to the International Working Formulation, were reviewed. In 30% of cases there was bone marrow involvement by lymphoma at the time of diagnosis. Marrow involvement was most frequently found in the follicular small cleaved cell (57%), diffuse mixed small and large cell (56%), and lymphoblastic (56%) lymphomas. A paratrabecular pattern of marrow involvement tended to occur in low or intermediate grade lymphomas. High grade lymphomas tended to show an interstitial or diffuse pattern of marrow involvement. The results of marrow aspiration and biopsy were of equal value and complementary to each other. In 43% of cases with marrow lymphoma there was peripheral blood involvement at the time of diagnosis. Blood involvement was most frequently found in the lymphoblastic lymphoma (70%). In general, the degree of blood involvement was related to the extent of marrow involvement. Patients with marrow involvement often presented with "B" symptoms and hepatomegaly. Abnormalities in at least one of the blood counts were quite common (93%). A normal blood count made marrow involvement unlikely but not impossible. Other common laboratory findings included hyperimmunoglobulinemia (47%) and elevated serum levels of lactate dehydrogenase (56%). Patients with marrow involvement showed a significantly higher frequency of hepatomegaly and abnormal blood counts, as compared to those with negative marrows (p less than 0.05 and less than 0.001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Chromosome studies on 30 Chinese patients with acute nonlymphocytic leukemia in Taiwan.

Cytogenetic studies were performed on 32 consecutive Chinese patients with de novo acute nonlymphocytic leukemia (ANLL) in Taiwan. Of the 30 patients with adequate specimens, 20(66%) had clonal chromosome abnormalities. Structural rearrangements were detected in 18 of them. Seven (four were children) of the 16 patients with M2 ANLL had t(8;21). All six patients with acute promyelocytic leukemia (APL; M3 subtype) had t(15;17). Two patients with M4 type leukemia and abnormal bone marrow eosinophils had inv(16)(p13q22). Another M4 patient with a mild increase of morphologically normal eosinophils in the bone marrow had an abnormal chromosome #16, t(1;16)(q21;p13) in which 16q22 was not involved. One patient with M5 ANLL had t(9;11). Only two patients had a numerical change as the sole abnormality. None of the patients had loss or deletion of chromosome #5 or loss of chromosome #7, and only one had a deletion of 7q. This study revealed a high incidence of t(8;21), t(15;17), and a low incidence of -5/5q- or -7/7q- in Chinese patients with ANLL.

Acute Disease↗
PubMed1987

Clinical patterns of tumor recurrence after radical hysterectomy in stage IB cervical carcinoma.

We reviewed the cases of 31 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical carcinoma who developed recurrent disease after radical hysterectomy and pelvic lymphadenectomy between 1961 and 1982. The overall incidence of recurrence was 11.3%. Recurrence was significantly more common in patients with adenocarcinoma or adenosquamous carcinoma (17.4%) than in those with pure squamous tumors (9.2%). The median time from operation to recurrence was eight months. The median survival of patients dying of disease was 18 months. Sites of recurrence were categorized as central pelvic in 35% of cases, pelvic sidewall in 39%, and distant in 26%. Patients treated with postoperative pelvic radiotherapy for positive pelvic nodes or surgical margin involvement were more likely to develop distant recurrence. Various therapeutic modalities were used to treat recurrent disease. Twenty-two of 23 patients with central pelvic or sidewall recurrence failed radiation therapy. None of four patients with central recurrence treated by pelvic exenteration survived. No patient treated with chemotherapy survived. Overall survival for patients with recurrence was 3.2%. The dismal prognosis for this group of patients warrants evaluation of alternative treatment modalities.

Adenocarcinoma↗