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Biomedical subjects

R K Hsieh

Publications and source records attributed to R K Hsieh.

At least 55 records · Page 3Linked to original sources
PubMed1993

Rearrangement of bcl-2 genes in malignant lymphomas in Chinese patients.

BACKGROUND: Only a small percentage of Asian patients with non-Hodgkin lymphoma may have follicular type disease. According to molecular analysis done recently, the incidence of rearrangement of bcl-2 gene in patients with follicular lymphoma was lower in Japan than in the United States, suggesting possible geographic or racial differences between Asian and Western populations. The current study was undertaken to obtain data from Taiwan to compare with data from Japan, Hong Kong, and Western countries. METHODS: Using probes of genomic 5' bcl-2, major breakpoint region (mbr) and minor breakpoint cluster region (mcr) for the breakpoint cluster region of the bcl-2 gene, genomic DNA samples from 55 patients with B-cell lymphoma (17 with follicular type and 38 with diffuse type) were analyzed by Southern blot analysis. RESULTS: Eleven patients had bcl-2 gene rearrangement, including 9 of 17 (52.9%) patients with follicular lymphoma and 2 of 38 (5.3%) patients with diffuse B-cell lymphoma. Nine patients had the breakpoint located within the mbr, one at both the mbr and the 5' bcl-2 regions, and the other had bcl-2 translocation with involvement of the mcr. DNA fragment of bcl-2 was found to comigrate with JH genes in all patients with follicular lymphoma and diffuse lymphoma who had bcl-2 rearrangement at mbr. The remaining patient who had bcl-2 translocation at mcr had no comigration with JH, Jk, or C lambda genes. CONCLUSIONS: Despite the low incidence of follicular lymphoma in Chinese patients, the incidence of bcl-2 gene involvement was higher in patients from Taiwan than in those from Japan and Hong Kong, but similar to the incidence of those from Western countries.

Adolescent↗
PubMed1993

Continuous intravenous infusion of leucovorin and 5-fluorouracil for the treatment of advanced colorectal and breast cancers.

The efficacy of the protracted infusion of 5-fluorouracil (FU) 200 mg/m2/day admixed with leucovorin (LV) 20 mg/m2/day was assessed for the treatment of advanced colorectal and breast cancer patients. Of 19 patients who underwent heavy treatment, 4 patients demonstrated partial response, 13 become stable and 2 failed to respond to therapy. The overall duration of response ranged from 1.5 to 15.8 months (median 4.5 months) and the survival ranged from 1.7 to over 21.7 months (median 8.2 months). The toxic effects, specifically mucositis, oral ulcer and acral hyperpigmentation, were mild to moderate in grade. Myelosuppression with grade I leucopenia was observed in all the patients. Catheter-related complications such as thrombosis or infection occurred in 4 patients. No death relating to therapy was reported in this study. Continuous intravenous infusion chemotherapy with an admixture of LV and FU is not associated with severe toxic effects when treatment is closely monitored and appropriately administered. This treatment regimen may have some significant benefit in advanced colorectal and breast cancer patients.

Adult↗
PubMed1992

Cisplatin-based chemotherapy for the treatment of advanced transitional-cell carcinoma of the urinary tract--a preliminary report.

The CMV (cisplatin, methotrexate, and vinblastine) and M-VAC (methotrexate, vinblastine, doxorubicin, and cisplatin) regimens were used to treat 19 patients with advanced transitional-cell carcinoma (TCC) of the urothelial tract. In the CMV group, the partial response rate was 45.5% and the mean response duration was 6.3 months. No complete response was obtained in our series. The median duration of survival was 15.8 and 8.3 months in responders and nonresponders, respectively. The toxic symptoms included one case of sepsis and three cases of renal toxicity. However, nausea and vomiting were experienced by most patients and required the administration of antiemetics. In the M-VAC group, the median duration of survival for responders was longer than that of nonresponders (greater than 10.2 vs 7.2 months), although the number of patients was too small for this difference to reach statistical significance. The toxic symptoms included one case of sepsis, two cases of renal toxicity, and nausea and vomiting in most patients. Bone metastasis in three patients did not respond to chemotherapy (CMV), a finding that is compatible with the results reported by other investigators. In summary, chemotherapy with the CMV or M-VAC regimen was effective in improving the response rate of patients. However, the duration of response was short, toxicity was severe in some cases, and the efficacy against bone lesions was poor. These problems must be solved to improve the outcome of patients with TCC following chemotherapy with the CMV or M-VAC regimens.

Adult↗
PubMed1992

Bone marrow transplantation for severe aplastic anemia--a study of twenty-one Chinese patients in Taiwan.

A total of 21 multiply transfused patients with severe aplastic anemia (SAA) were treated with bone marrow transplantation between March 1985 and September 1990: 20 allogeneic and one syngeneic transplants. A positive response in mixed lymphocyte culture (MLC) was also noted in 7 allogeneic recipients. Pregraft conditioning included high-dose cyclophosphamide (CY) 200 mg/kg over 4 consecutive days, followed by 300 cGy total-body irradiation the day before BMT. Seventeen patients older than 14 years received additional donor buffy-coat cells infusion for 5 days posttransplant. A combination of methotrexate and cyclosporine was used for prophylaxis of graft-versus-host disease. Seventeen patients were alive with a functional graft, and Kaplan-Meier product limit estimates showed a 80.95% probability of survival at 67.7 months. There were 4 deaths: two died of primary graft failure, one from secondary rejection, and the other from chronic GVHD-related complications. Acute GVHD, grade I was noted in only one patient (5.6%). In contrast, chronic GVHD was observed in 10 out of 18 (55.6%) evaluable patients. Venoocclusive liver disease and interstitial pneumonitis were not diagnosed. Our findings indicate that the combination of CY/TBI/BC is well tolerated and results in a low incidence of graft failure/rejection in multiply transfused Chinese patients who received transplants for SAA. The MTX/CsA combination was confirmed as being remarkable in reducing the incidence and severity of acute GVHD. For patients with SAA under the age of 40, with an HLA-identical sibling, we highly recommend BMT as the treatment of choice.

Adolescent↗
PubMed1992

Using BITNET to access the National Library of Medicine databases.

An ongoing developmental project is described that uses the National Library of Medicine (NLM) GRATEFUL MED software on the BITNET network to access the NLM databases. The objective of the project is to improve biomedical communication capabilities to support health professionals in countries where international telecommunication services are limited. After a successful demonstration of the concept, the system was assembled and tested by the University of Chile and NLM. The full impact of this project will be measured at a later time. This paper describes the concept and testing of the system in Latin American countries.

Computer Communication Networks↗
PubMed1992

Liver disease in patients with liver dysfunction prior to bone marrow transplantation.

Twenty-two patients with previous hepatic compromise who underwent allogeneic bone marrow transplant (BMT) for treatment of hematologic malignancy or other hematologic disease between 1984 and 1990 were chosen for the present study. After transplant, 19 (86.4%) of the patients developed hepatitis, including six cases (27.3%) of acute hepatitis, 12 (54.6%) of chronic hepatitis and one uncharacterized hepatitis. Nine chronic hepatitis patients were followed-up for 7-56.5 months (medium 35.5 months) with biochemistry studies and ultrasonography. Throughout the observation period, liver cirrhosis or hepatoma were not detected and no patients developed veno-occlusive disease. Furthermore patients who developed hepatitis after transplant had worse prognoses. Based on serial serological survey of the various hepatitis B virus (HBV) antigens and antibodies, we have found that most of the recurrent viral hepatitis in transplant patients could be attributed to the reactivation of the virus. In addition, the use of immunosuppressive drugs, persisting infection by HCV and the development of graft-versus-host disease may also play a role in modulating the course of viral hepatitis in BMT patients.

Adolescent↗
PubMed1991

Menadione: spectrum of anticancer activity and effects on nucleotide metabolism in human neoplastic cell lines.

The spectrum of cytotoxicity of menadione (MD) was examined in a panel of human cancer cell lines. MD was equipotent against multidrug-resistant and parental leukemia cell lines with IC50 values of 13.5 +/- 3.6 and 18 +/- 2.4 microM respectively. A cervical carcinoma cell line resistant to the antimetabolite, methotrexate (MTX), was as sensitive to MD as its parental cell line. The interactions of fifteen clinically utilized anticancer drugs with MD were examined in vitro and the majority were found to be additive, with four agents exhibiting synergism and one agent exhibiting antagonism. MD inhibited the incorporation of radioactive thymidine, uridine and amino acids into DNA, RNA and protein, respectively, in three human cancer cell lines. Some possible reasons for the inhibition of DNA synthesis including effects of MD on intracellular deoxyribonucleoside triphosphate pools were examined and ruled out. Although results from previous studies using rat hepatocytes suggested that mitochondria may be a target of MD, no significant effect of this compound on total intracellular adenosine triphosphate (ATP) pools in human cancer cell lines was observed. Collectively, these in vitro results demonstrate that MD possesses a broad spectrum of anticancer activity and suggest the potential utility of this agent in cancer therapy. Future studies directed at elucidation of the mechanism of MD action in human cancer cells are warranted and are under study.

Antineoplastic Agents↗
PubMed1991

[CA125 in non-Hodgkin's lymphoma].

CA125 is an antigenic determinant recognized by monoclonal antibody CA125 raised against a serous ovarian cancer cell line. Elevation of this antigen has been reported in over 80% of women with epithelial ovarian cancer and many other diseases including both malignant and non-malignant ones. However, in non-Hodgkin's lymphoma (NHL) only a few reports have focused on this topic thus interesting us. In order to exploit its possible role in this field, a total of 61 eligible patients with a diagnosis of NHL were studied. Serum CA125 was measured by radioimmunoassay (RIA) prior to any operative procedures or chemotherapy. Serum CA125 above 35 U/ml was seen in 47.7% of nodal NHL (n = 44) and 70.6% of extranodal NHL (n = 17) with an overall positive rate at 54.1%. The elevation of serum CA125 correlates well with the presence of peritoneal involvement and therefore, with disease extent to some degree. No correlation between it and the histological type or with the B symptom was the rule. Avidin-biotin peroxidase stain by anti-CA125 MoAb was applied to identify the tissue content of this antigen in 15 cases of whom 11 had CA125 well above 35 U/ml. None of the 15 cases examined showed positive result. In conclusion, serum CA125 is probably no more than an indicator of peritoneal stimulation released by tumor invasion rather than a tumor product. The possible role in disease follow-up remains to be elucidated.

Adult↗
PubMed1990

Complications of bone marrow transplantation in Chinese.

Forty-three patients with hematopoietic disease were treated with intensive chemotherapy and radiotherapy, followed by allogeneic bone marrow transplantation (BMT) from 28 HLA-identical and 10 one to two antigen haploidentical sibling donors and autologous BMT (5 cases). Of these cases, there were 21 with acute nonlymphocytic leukemia (ANLL), 5 with acute lymphocytic leukemia (ALL), 6 with chronic myelocytic leukemia (CML), 2 with Hodgkin's disease (HD), 8 with severe-form aplastic anemia (SAA) and 1 with thalassemia. Complications of BMT were evaluated including acute graft-versus-host disease (GVHD), interstitial pneumonia (IP), veno-occlusive liver disease (VOD), abnormalities of liver function (LF), and alteration of hepatitis B virus (HBV) markers. In thirty-three patients who were followed up for more than 3 months, we found that the incidence of moderate to severe acute GVHD (9.1%) and IP (two cases, 4.7%) were low. No VOD occurred in our series. During the follow-up period, 27 out of 35 patients (77%) had high alanine aminotransferase (ALT)/aspartate aminotransferase (AST) levels, even up to 1000 U/liter; however, only one patient succumbed to a hepatitis-related complication. Previous hepatic damage from HBV infection before BMT does not appear to increase the risk of posttransplant morbidity and mortality.

Adolescent↗
PubMed1990

Changing of hepatitis B virus markers in patients with bone marrow transplantation.

The hepatitis B virus (HBV) infection and its resulting hepatic abnormalities are very high in prevalence among the Taiwan population. They also seem to compose a major problem to patients subjected to bone marrow transplantation (BMT) due to intensive chemoradiotherapy. In this study, the sera of 42 patients were investigated before and after BMT to detect the presence of HBV markers and to test their liver function (LF). Being followed-up for 3-12 months after BMT, 12 out of 27 were found to have altered HBV markers according to the classification of the following: seroconversion of HBsAg, clearance of HBsAb, appearance of HBeAg, clearance of HBeAb, and acute hepatitis. Thirty-seven out of 42 patients (88.1%) were found in routine LF test to develop one or more abnormality; however, 90% of them turned normal within one year after BMT. Only one patient died of complications associated with fulminant hepatitis. In conclusion, the previous hepatic damage from HBV infection appears unlikely to increase the risk of posttransplant morbidity and mortality.

Adolescent↗
PubMed1990

Gene rearrangement of cutaneous T-cell lymphoma.

Gene Rearrangement is considered to be a helpful tool for diagnosis of cutaneous T-cell lymphoma. In this study five patients with clinical diagnosis of cutaneous T-cell lymphoma were reviewed for their clinical presentation, skin biopsies and surface marker phenotypes. Southern blot analysis of DNA extracted from their skins revealed that rearrangement of T-cell receptor beta chain (TCRB) genes happened in three patients but rearrangement of immunoglobulin heavy chain genes was absent. TCRB rearrangement could also detect lymphoma involvement of lymph nodes, peripheral blood and bone marrow in our patients. In these conditions, systemic therapy is suggested.

Adult↗
PubMed1990

Metastatic malignant melanoma of upper gastrointestinal tract.

A 74-year-old male patient developed intermittent melena and anemia after he had received surgical resection for malignant melanoma of the right foot and radical dissection of the right inguinal metastatic lymph node. The source of bleeding was identified to be metastatic melanoma of stomach and duodenum by panendoscopy and biopsy. Patient refused surgical intervention and died of pneumonia two weeks later.

Aged↗
PubMed1990

Remission induction of ANLL with low dose cytosine arabinoside combined with retinoic acid.

Fourteen cases of acute non-lymphocytic leukemia (ANLL) were treated with low doses of cytosine arabinoside (LDAra-C 20 mg/m/q12h) and etretinate (all-trans-9-3, 7-dimethyl-2, 4, 6, 8 non-atetraenoate, 75 mg/d). Of which 9 were untreated, 3 were in first relapse and 2 were refractory patients. Five of the 9 patients in the first group, and all 3 patients in the second group achieved complete remission (CR). The 2 cases with refractory ANLL showed no response. The CR rates in untreated, first relapse and refractory patients were 55.6%, 100%, and 0% respectively. In all, there was significant reduction of marrow cellularity in 13 patients, 5 of whom developed bone marrow aplasia with predominantly lymphocyte and plasma cells. Only 2 cases with M5 ANLL showed evidence of differentiating into monocytes and neutrophil in hypocellular marrow phase. The efficacy of this drug combination, however, appeared to be achieved through cytotoxicity rather than differentiation. The side effects in the treated cases included cheilitis, dermatitis, fever, petechiae, and impaired liver function, which soon improved upon discontinuation or reduction of dosage. This combination treatment might be most effective in achieving remission among elderly and severely infected patients with ANLL, and could be appropriate even for patients in first relapse.

Adolescent↗
PubMed1990

Generation of lymphokine-activated killer (LAK) cells and possible implications in autologous bone marrow transplantation--a preliminary report.

Lymphokine-activated killer (LAK) cells were generated successfully without mitogen from blood mononuclear cells obtained from 14 patients with varying malignancies and 2 normal donors. Cells from both groups showed a positive cytotoxicity by a 4-hour 51-Cr-release assay against a variety of target cells including natural killer (NK) sensitive K562 myeloid leukemia, NK-resistant Raji lymphoma cell lines, and fresh/cryopreserved leukemia cells from patients refractory to standard chemotherapy but not normal blood cells. Higher cytotoxic activity was obtained with a higher effector:target ratio at 100:1 greater than 50:1 greater than 25:1 (P less than 0.01) in each setting of different targets. Experiments involving cocultures of the LAK cells with either allogeneic (9) or autologous (3) bone marrow cells disclosed no detrimental effect on the committed hemopoietic stem cells by semisolid agar colony forming unit (CFU-GM) assay. The findings suggest that LAK cells may have a potential role for the in vitro purging of the residual leukemic cells from the marrow inoculum prepared for autologous bone marrow transplantation.

Adolescent↗
PubMed1989

[Second primary cancer in hematological malignancy experience in VGH-Taipei].

Seven patients of hematological malignancy with second primary cancer had been found at Veteran General Hospital from 1983 to 1988. The second primary cancers either developed subsequently or concurrently with the hematological malignancies. Four patients were diagnosed to be non-Hodgkin's lymphoma and three of them developed squamous cell carcinoma of lung(2) and hepatocellular carcinoma (1) at 44, 20 and 45 months after the initial diagnosis of on-Hodgkin's lymphoma. All three had received chemotherapy and/or radiotherapy. Another one was found to have liposarcoma in the retroperitoneum concurrently. Three patients had chronic lymphocytic leukemia (CLL). Two of them were found to have skin squamous cell carcinoma at the same time. Another one developed cervical squamous cell cancer ten months after treatment with oral leukeran and prednisolone. Literature about synchronous and metachronous neoplasms was reviewed.

Adult↗
PubMed1989

Treatment of severe aplastic anemia: comparison of bone marrow transplantation to immunotherapy.

Between February 1985 and May 1988, sixteen patients with severe aplastic anemia (SAA) post multitransfusion were treated with either allogeneic bone marrow transplantation (BMT) (9) or immunosuppression (7). The latter group was further divided into two subgroups: horse anti-human thymocyte-lymphocyte globulin (ATG-ALG) (2) and high dose methylprednisolone (HDMP) (5). There were 8 males and 8 females, age ranged from 10 to 35 years for the BMT group and 19 to 56 for the immunosuppression group. As of analysis, 9 patients in the BMT group had been followed from 1 to 31 months after transplant (median,24). Graft rejection was noted in 2, both had positive mixed lymphocyte culture (MLC) index. Seven had full recovery of hematopoiesis. Of these 7 survivals, none developed acute graft-versus-host disease (GVHD), whereas 2 had chronic GVHD which resolved completely after a 9-month treatment with azathioprine and prednisolone. Kaplan-Meier survival probability at 31 month was 75%. In the immunosuppressive therapy group 2, who received ATG-ALG both failed the treatment, died 7 and 29 months later, respectively. There were 3 responders in the HDMP subgroup, 1 complete, 2 partial. The 1-year survival probability for this group was 42.9% compared with 75% in the BMT group (p greater than 0.10). However, the hematologic reconstitution and Karnofsky performance were complete in all 7 transplant survivals vs one of 3 in the immunosuppression group (p less than 0.01). This experience supports that for patients with SAA under the age of 40, BMT is the treatment of choice if an HLA-identical MLC-nonreactive marrow donor is available, if not, immunosuppression is an alternative approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Screening of antibodies to human T-cell leukemia virus type I (HTLV-I) in sera of blood donors and comparison of different methods].

Nine hundred and sixty five serum samples of blood donors from the blood bank of Veterans General Hospital Taipei were screened for antibodies to human T-cell leukemia virus type I (HTLV-I) by different methods. Adult T-cell Leukemia cell lines MT-1, MT-2, KH-2 and MT-2 stimulated by phorbol 12-myristate 13-acetate (PMA) were used as target cells in immunofluorescence microscopy (IF) examination with positive rates as 0.20% (2/965), 0.62% (6/965), 0.20% (2/965) and 0.51 (5/965) respectively. In addition to these, enzyme-linked immunosorbent assay (ELISA) gave a 2.59% (25/965) positive rate and particle agglutination (PA) test revealed a positive rate of 0.93% (9/965). The samples positive in IF were also positive in PA and those positive in PA were found positive in ELISA without exceptions. The 25 ELISA positive samples as well as 75 samples randomly chosen from the ELISA negative ones received Western blot (WB) analysis as a confirmation test. Only 3 of these 100 were considered positive in WB, giving a final positive rate of 0.31%, (3/965), and all of them were originally positive in both PA and ELISA. Particle agglutination test as the screening test and Western blot analysis as the confirming one were suggested to be a routine procedure for detecting anti-HTLV-I antibodies in blood banks through detailed comparison and discussion.

Adult↗