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Biomedical subjects

S H Kuo

Publications and source records attributed to S H Kuo.

At least 109 records · Page 6Linked to original sources

Changes in DNA content of lung adenocarcinoma cells following exposure to anti-cancer drugs.

To investigate the changes in the nuclear DNA content of lung adenocarcinoma cells following exposure to chemotherapeutic agents, malignant cells obtained from either tumor biopsies or pleural effusions of 12 patients with primary lung adenocarcinoma were cultured in vitro and exposed to adriamycin, vincristine, cisplatin or a placebo. Cytophotometric measurements of the nuclear DNA were performed. In 10 cases, the DNA histograms revealed that the modal values of the lung adenocarcinoma cells ranged from 4.0C to 4.6C. The remaining 2 cases were 3.2C and 2.2C, respectively. After exposure, three response patterns in the DNA content were found: (1) the cells maintain their original cell cycle distributions, this was seen in cultures resistant to the drugs or in cultures showing extensive cell killing; (2) the cells accumulate with their DNA content in the S and G2M phase; and (3) the cells lose their modal values and become aneuploidy. We conclude that cytophotometric analysis of DNA content can offer useful information on the chemosensitivity of tumor cells. However, since there may be various response patterns, the corresponding percentage of cell killings, as assessed by morphologic observation or by a dye exclusion test, is necessary for interpreting the results.

Adenocarcinoma↗

Ultrasonic evaluation of cervical lymphadenopathy.

Seventy-seven patients with various underlying diseases underwent real-time ultrasonographic study of the neck. The sonography of lymph nodes can be round or ovoid shaped, discrete hypoechoic nodules, or multiple confluent lobulated heterogeneous or homogeneous hypoechoic masses. Venous invasion by a malignant lymph node can also be demonstrated by ultrasonography as a loss of echogenicity in the vessel wall. Twenty-five patients with malignant cervical lymph nodes showed homogeneous discrete hypoechoic nodules. Eleven patients with malignant lymph nodes showed a multiple confluent lobulated hypoechoic picture, among them, 2 patients also had discrete hypoechoic nodules. Eight patients with multiple confluent lymph nodes showed evidence of venous invasion. Among 42 patients with a clinically palpable neck mass, 1 showed venous thrombosis in the internal jugular vein, 2 had abscesses, and 3 had normal musculo-skeletal tissues. Among 35 patients with clinically impalpable cervical lymph nodes, 5 patients had cervical lymphadenopathy. All 41 patients with sonographically detectable lymph nodes underwent aspiration cytology or biopsy, and 36 of these showed malignancy, 4 TB lymphadenitis and 1 nonspecific inflammation. No complication was observed in this series. We conclude that ultrasonography is a valuable tool to evaluate cervical lymphadenopathy and to clarify the histopathological features of the affected lymph nodes with the aid of aspiration cytology.

Adolescent↗

Sonographic presentation in autoimmune thyroiditis.

We used real-time ultrasonography to examine 60 patients with autoimmune thyroiditis, then correlated the ultrasonic pictures with thyroid function, thyroid autoantibodies and fine needle aspiration cytology. In these 60 patients, 45 (75%) showed diffuse goiter, 6 (10%) showed multinodular goiter, and 9 (15%) had a solitary thyroid nodule sonographically. One of the 9 patients with a solitary nodule was a case of autoimmune thyroiditis combined with papillary carcinoma. The echogenicity of the thyroid was more than, the same as, or less than that of the adjacent muscles in 17, 22, and 21 patients, respectively. The groups were classified as hyperechoic, isoechoic, and hypoechoic, respectively. The mean serum T4 level was significantly lower in the hypoechoic group than in the hyperechoic or isoechoic groups (p less than 0.01 and p less than 0.05, respectively), and the incidence of hypothyroidism was significantly higher in the hypoechoic group than in the hyperechoic or isoechoic groups (p less than 0.001 and p less than 0.005, respectively). In addition, high titers of the antithyroid microsomal antibody (greater than or equal to 1280) were present more frequently in the hypoechoic group than in the hyperechoic or isoechoic groups (p less than 0.01 and p less than 0.05, respectively). There was no significant correlation between the cytomorphology and echogenicity of the thyroid in these cases. We conclude that sonography has two major uses in evaluating autoimmune thyroiditis: First, it is useful in excluding the coexistence of thyroid nodules; and second, marked hypoechogenicity of the thyroid implies an active cytotoxic autoimmune process and possibly a hypothyroid state.

Humans↗

Tumor markers of lung cancer: carcinoembryonic antigen and TuMark.

To assess the value of tumor marker determinations in diagnosing lung cancer and monitoring the response to therapy in lung cancer patients, we tested the serum concentration of TuMark-reactive protein and carcinoembryonic antigen (CEA) in 78 patients with lung cancer and 81 patients with non-malignant diseases. The sensitivity of TuMark in detecting the presence of lung cancer was 63.8%, compared to 37.2% for CEA (p less than 0.05). The specificity was 91.3% for TuMark and 97.5% for CEA. The combination of TuMark and CEA increased the sensitivity to 74.3%. The sensitivity of TuMark for non-small cell carcinoma was significantly higher than that for small cell carcinoma (67.6% vs 30.0%) (p less than 0.05). The incidence of positive TuMark reactivity did not correlate with the stages of lung cancer. Since the incidence of positive CEA reactivity was lower in the limited stage than in the extensive stage of lung cancer (20.0% vs 43.1%), the sensitivity of TuMark with regard to the detection of early stage lung cancer appeared far superior to CEA (65.0% vs 20.0%, p less than 0.05). Serial monitoring of TuMark levels in 32 patients with all types of lung cancer showed that 84% correlated with their clinical courses. Six patients with stage I or II disease received complete surgical resection of tumors. All showed a decline of the TuMark level to normal levels in 17 to 48 days (average of 32 days). These results suggested that the TuMark test may be a useful new marker for diagnosing lung cancer and monitoring response to therapy, especially for non-small cell lung cancer.

Adolescent↗

Ultrasonography in complete chest X-ray opacification of hemithorax.

To assess whether ultrasonography is valuable in the diagnosis and management of patients with complete chest X-ray opacification of hemithorax, chest ultrasonography was conducted in 65 patients. There were 54 patients (83.1%) with massive pleural effusion with or without other pathology, six (9.2%) with tumors, two (3.1%) with organized fibrothorax, two (3.1%) with consolidation or atelectasis and one (1.5%) with pseudocyst of the pleura in the sonographic diagnosis. Sonography differentiated effusion from tumor, consolidation and fibrosis. The effusion showed a hypoechoic area with floating fibrin strands and changed shape on respiration. The tumor revealed a homogeneous iso- or hypoechoic mass with a sharp margin. Consolidation or atelectasis showed a lobar or segmental area of heterogeneous isoechoic density with air-bronchogram. The pleural showed an area of hypoechoic density without floating fibrin or a changed shape on respiration. In 24 (37%) patients we could demonstrate complex pathology addition to the pleural effusion. Twenty-one patients had a hidden tumor beneath the effusion. Three patients had consolidation or atelectasis with effusion. In 13 patients, aspiration biopsy was performed under ultrasonic guidance from the tumor and the histological diagnosis was confirmed in 12 patients. We conclude that ultrasonography is a very useful, noninvasive tool in the differential diagnosis of complete chest X-ray opacification of hemithorax. Complex pathology is also easily detected by sonography. Sonographic findings can also be used as a guideline for an appropriate approach to the patient's management.

Adolescent↗

Anaplastic thyroid carcinoma: review of 24 cases, with emphasis on cytodiagnosis and leukocytosis.

Twenty-four cases of anaplastic thyroid carcinoma seen in the National Taiwan University Hospital from 1980 to 1988 were reviewed. The median age was 61.5 years. The ratio of men to women was 1:1.4. A preceding history of long-standing goiter could be obtained in 14 patients (58.3%) with a median duration of 20 years. Twenty patients (83.3%) presented with a rapid-growing neck mass with a median duration of 1.3 months. Nine out of 19 patients (47.4%) had white blood cell (WBC) counts over 10,000/microliters, which were closely related to the presence of fever (p less than 0.02). Serial follow-up showed that WBC and platelets gradually increased but red blood cells and hemoglobin decreased. Fever was noted at the time of diagnosis in 8 out of 24 patients (33.3%), and was closely related to the presence of abundant neutrophils in the cytologic smears of thyroid aspirates (p less than 0.01). Fever was not due to bacterial infection. Three out of 10 patients (30.0%) had calcification in the thyroid shown on neck X ray, and 7 out of 18 patients (38.9%) had lung metastasis shown on chest X ray. The ultrasonographic images of thyroid anaplastic carcinoma done in 6 patients were heterogeneous and hypoechoic. Fine-needle aspiration cytology was done in 20 patients. Anaplastic thyroid carcinoma was easily diagnosed in 18 patients (90.0%). One was misdiagnosed as acute thyroiditis. Another one was diagnosed as papillary carcinoma cytologically, which combined with anaplastic carcinoma shown on histology. The median survival was 2.2 months, ranging from 0.2 to 25.3 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Cell kinetics, DNA content and TSH receptor-adenylate cyclase system in differentiated thyroid cancer.

The purpose of this study was to elucidate the changes of the TSH receptor-adenylate cyclase system in differentiated thyroid carcinomas, and their relationships with nuclear DNA content, cell kinetics and clinical stage. The results showed that the papillary carcinomas had an impaired TSH receptor-adenylate cyclase system. The production of cAMP stimulated by TSH was decreased when compared with non-cancerous tissue and high-affinity TSH receptors were reduced in number or even completely lost (nine in 24 cases). Follicular carcinomas also showed a reduction in, or even complete loss, of high-affinity TSH receptor (one in five cases). However, the responses to the stimulation of TSH, Gpp (NH)p and forskolin were not different from those in non-cancerous tissue. Papillary and follicular cancer cells showed more proliferative activity than those in non-cancerous tissue. Follicular carcinomas contained more hyperploid cells (DNA content greater than 2.5 C) than papillary carcinomas. There were no differences in cell kinetics, DNA content or the effects of Gpp (NH)p or forskolin on adenylate cyclase activity between those papillary carcinomas with high-affinity TSH receptor and those without. However, the presence of high-affinity TSH receptors had higher cAMP generation stimulated by TSH. The patients having papillary carcinomas in the absence of high-affinity TSH receptors were all in clinical stage III. These studies suggest that TSH receptors are the major sites influenced in the TSH receptor-adenylate cyclase system in papillary carcinomas. The TSH receptor-adenylate cyclase system of papillary carcinomas differs more from normal than does that of follicular carcinomas.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

Ultrasonography of Pancoast tumor.

Eleven patients with Pancoast tumor, who failed to yield diagnostic materials by conventional sputum cytology and fiberoptic bronchoscopy, were studied by real-time linear-array and sector ultrasonography. The sector scanner through the supraclavicular approach adequately visualized the external profile and the internal texture of the lesions in all 11 patients, which is a significant improvement (p less than 0.05) over what can be accomplished with linear-array scanner through the intercostal approach. All patients received percutaneous transthoracic aspiration under ultrasound guidance. Positive cytologic diagnosis was established in ten of the 11 patients (91 percent). Additional biopsies performed in seven patients under similar ultrasonic guidance also provided concordant results. No complications were observed in this series. This study has clearly shown that ultrasound-guided aspiration biopsy can be a safe and useful means for obtaining materials for pathologic confirmation of Pancoast tumor. It may also assist in defining the tumor extension to pleura and adjacent structures.

Aged↗

DNA clonal heterogeneity of hepatocellular carcinoma demonstrated by Feulgen-DNA analysis.

To demonstrate DNA clonal heterogeneity of hepatocellular carcinomas (HCC), the DNA histographic pattern of both primary HCCs and their recurrent or metastatic lesions were studied among 36 patients (33 men and 3 women). Thirty-six paired aspirations or imprints taken from primary, recurrent or metastatic lesions were stained, using the modified Feulgen method, and the DNA content was measured with a scanning microdensitometer at a wavelength of 550 nm. Paired aspirations or imprints taken from different parts of the same HCC were examined in 17 cases; the DNA distribution patterns were similar in 15 (88%) and differed in only two (12%). A similar DNA histogram was also shown among different tumors in 10 (71%) of 14 patients with multiple HCCs, with a DNA ploidy discrepancy in only four (29%). Two of two subcutaneous metastases and two of three recurrent tumors showed DNA distribution patterns similar to those in their primary HCCs. In summary, a DNA clonal heterogeneity of HCC was found in 19% (7/36). In contrast, the similar DNA histographic patterns found in most instances among different parts of the HCC and between the primary and recurrent or metastatic lesions suggest that HCC may derive from a single cell clone in the majority of cases.

Adult↗

Plasmacytoma of pleural origin associated with Bence Jones proteinuria.

A 33-year-old male presented with right side pleural plasmacytoma with secretion of Bence Jones (BJ) protein and deposition of amyloid. The pleural effusion contained a prominent peak of kappa-type BJ protein on the background of polyclonal gammopathy. Pleural biopsy disclosed features of plasmacytoma with amyloid deposition. A small peak of BJ protein was also present in serum electrophoretogram on the background of increased polyclonal IgG and IgA. Kidney function was impaired and urine protein ranged from 7.8 to 19.1 g/day with 92.5% bimodal BJ protein. There were no bone lesions by systemic bone survey, and repeated bone biopsies and marrow aspirations showed plasma cells of less than 5%. The clinical course worsened progressively; over the next five months the pleurisy became bilateral and peritoneal involvement supervened. This is believed to be the first report of primary plasmacytoma involving successively pleurae and peritoneum.

Adult↗