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Biomedical subjects

S Hsueh

Publications and source records attributed to S Hsueh.

At least 91 records · Page 5Linked to original sources
PubMed1993

Prognostic factors and impacts of adjuvant therapy in early-stage cervical carcinoma with pelvic node metastases.

Three hundred seventy cases of clinical stage Ib-II cervical carcinoma treated with radical abdominal hysterectomy and bilateral pelvic lymphadenectomy at Chang Gung Memorial Hospital between 1981-1986 were reviewed retrospectively. Of these, 105 patients had pelvic lymph node metastases. Clinicopathological variables including flow cytometric DNA analysis and the use of adjuvant therapy were studied. Recurrence-free survival was significantly worse among patients with positive pelvic nodes by parametrial extension, increasing number of positive nodes, and DNA index greater than 1.3. In patients with positive nodes and negative parametria, the number of positive nodes remained a significant predictor of survival. Utilizing these significant variables, we identified three distinct risk groups. Those patients who had negative parametria, only one positive node, and a DNA index not greater than 1.3 were categorized as the low-risk group. Those who had either positive parametria or more than three positive nodes were categorized as the high-risk group. All the others fell into the intermediate-risk group. Five-year recurrence-free survival rates were 84.6, 71.6, and 42.1%, respectively (P = 0.0006). Applying this risk group classification and the significant risk factors, we may select more appropriate subsets of patients and good stratification for future prospective trials in surgically treated early-stage cervical carcinoma patients with pelvic node metastases.

Antineoplastic Agents↗
PubMed1993

Acute nephropathy of organotin compounds.

Three patients who developed acute nephropathy following ingestion of triphenyltin acetate (TPTA) are described. All of them had significant proteinuria, azotemia, and polyuria. Mild neurological manifestations in all patients were also noted. Hematuria and pyuria were noted in 1 severely poisoned patient. Evidence for hepatitis was present in 2 patients, and for pancreatitis in 1. Renal biopsy showed focal fusion of glomerular cell processes and proximal tubular damage with cellular necrosis. Two patients survived with complete recovery of renal functions. One old patient died of aspiration pneumonia. Acute nephropathy following organotin intoxication appears to result mainly from proximal renal tubular damage with a benign and reversible clinical course.

Adult↗
PubMed1993

Glutathione concentration and distribution in cervical cancers and adjacent normal tissues.

Intracellular glutathione (GSH) has been shown to play an important role in modulating the cellular response to many cytotoxic agents, including radiation and chemotherapeutic drugs. In this study, individual glutathione levels from contiguous blocks of cervical cancer tissue were determined in order to investigate the intratumor GSH distribution and variation, as well as the difference between tumor and its normal counterpart. The GSH content of a squamous cell carcinoma of the cervix was twofold higher than its normal counterpart, but there was no obvious difference in a case with adenoid cystic carcinoma. The tumor margin adjacent to normal tissue has a higher GSH content than the tumor center in a large tumor. Although the intertumor variation in GSH is different in these two tumors, a common coefficient of variation, 26, is observed, which may be used to estimate the range of tumor GSH if it can only be determined by a biopsy.

Carcinoma, Adenoid Cystic↗
PubMed1993

Squamous cell carcinoma complicating tibial osteomyelitis treated with local wide excision and staged microvascular reconstruction.

Squamous cell carcinoma is a complication of chronic tibial osteomyelitis treated with limb-preserving surgery. A 61-year-old man with 42-year history of chronic osteomyelitis of the left tibia was found to have malignant change. A curettage procedure was performed by a general surgeon. He then was referred to the osteomyelitis service; local wide excision was followed by staged microvascular latissimus dorsi muscle flap and fibular osteoseptocutaneous flap transfer. The patient remains well 36 months later with no clinical or radiologic evidence of local recurrence or distant metastasis. This kind of limb-sparing treatment is an excellent alternative treatment for malignancy.

Carcinoma, Squamous Cell↗
PubMed1992

Neoadjuvant chemotherapy with cisplatin, vincristine, and bleomycin and radical surgery in early-stage bulky cervical carcinoma.

Neoadjuvant chemotherapy consisting of 2-3 courses of cisplatin, vincristine, and bleomycin was used in the primary treatment of 36 consecutive patients with locally advanced early-stage cervical carcinoma [International Federation of Gynecology and Obstetrics (FIGO) stages Ib or IIa; tumor size, greater than or equal to 4 cm]. The effectiveness of the preoperative chemotherapy was evaluated in the surgical specimens. Among the 33 evaluable patients, the overall clinical response rate was 84.8%, which included a complete response in 8 patients (24.2%) and a partial response in 20 subjects (60.6%). No residual tumor was found in the surgical specimens obtained from 2 complete responders. This therapy induced varying degrees of tumor shrinkage and rendered radical surgery feasible in all evaluable cases despite the initial bulky size of the lesions. No significant difference was observed in the response rate according to age and disease stage. Lymph-node metastases were found after chemotherapy in 18.2% (6/33) of the patients. Grade II and III hematological toxicities occurred in 23.3% of the 90 chemotherapy cycles completed. Nausea and vomiting occurred to a mild to moderate degree in 75 (83.3%) cycles. These preliminary results suggest that the administration of induction chemotherapy involving two to three courses of cisplatin, vincristine, and bleomycin prior to surgery is effective in reducing the tumor volume and in providing better circumstances for surgical removal of the early yet bulky cervical tumors and results in tolerable toxicity. This protocol is now undergoing prospective randomized trials to test its impact on long-term survival.

Adult↗
PubMed1992

Small cell carcinoma with neurosecretory granules arising in an ovarian dermoid cyst.

A rare small cell carcinoma with neurosecretory granules arising in an ovarian dermoid cyst with 7 years survival after conservative surgery and adjuvant chemotherapy with cisplatin, adriamycin, and cyclophosphamide is described. Light microscopy showed the typical uniformly small cells with hyperchromic nuclei and scanty basophilic cytoplasm within the mature cystic teratoma. Although none of the immunohistochemical stains were reactive, electron microscopy demonstrated the membrane-bound neurosecretory granules in some tumor cells. The related literature is reviewed and the issues concerning treatment options in this unusual malignancy are discussed.

Adult↗
PubMed1992

Human papillomavirus in benign and malignant ovarian and endometrial tissues.

Ovarian and endometrial cancer tissues were examined for the presence of human papillomavirus (HPV) and the results were compared with the findings in normal tissues by polymerase chain reaction. Putative DNA of HPV types 16 and 18 that target DNA sequences from paraffin-embedded tissues were amplified with paired oligonucleotide primers that encode the E6 gene of HPV. The amplified DNA sequences were then detected with Southern blot hybridization analysis. The HPV DNA sequences were detected in both benign (50% ovarian, 70% endometrial) and malignant ovarian (27.2%) and endometrial (37.5%) tissue samples. Interestingly, eight hepatoma samples were also analyzed as tissue controls. The results were negative in seven, but positive in one with repeated tests. The results suggest that the spread of HPV in the upper genital tract may not be uncommon. The explanation of a positive liver tissue study result will have to await further study.

Adenocarcinoma↗
PubMed1992

Choriocarcinoma of the cervix.

The incidence of primary cervical choriocarcinoma is extremely low, with only approximately 60 cases reported. We present a case of primary cervical choriocarcinoma, which was originally mis-diagnosed as a cervical pregnancy. After failure of conservative treatment with methotrexate, the patient underwent a hysterectomy, followed by chemotherapy with actinomycin-D. After twenty months of follow-up, the patient is in good condition and her serum beta-hCG levels are normal.

Adult↗
PubMed1992

Cardiac tamponade resulting from recurrent small-cell carcinoma of the uterine cervix temporarily responding to CE/CAV chemotherapy: report of a case.

A case of recurrent small-cell carcinoma of the uterine cervix, initially presenting with cardiac tamponade, is reported. After pericardiotomy, the patient was treated with an alternating combination of chemotherapy, which included cisplatin plus etoposide (CE) and cyclophosphamide, adriamycin plus vincristine (CAV). A partial response, with relief of a cough and diminishing metastatic pulmonary lesions, was noted from serial chest roentgenographs after the initial three cycles of chemotherapy. The patient did not receive any further treatment and the recurrent cough and dyspnea were noted two months later. In spite of the same chemotherapeutic regimen and chest radiotherapy, the patient died nine months after the initial diagnosis of metastasis.

Adult↗
PubMed1992

Therapeutic effect of carbon dioxide laser versus single application of trichloroacetic acid for koilocytic squamous papillae.

This paper reports the treatment results of 50 symptomatic females who had clinical features of squamous papillae and histologic evidence of koilocytosis. Either a carbon dioxide laser or a single application of trichloroacetic acid (TCA) was used to treat these patients. All of the patients were alternately and prospectively randomized into one of two groups. Twenty-three of the 25 women treated by laser and 10 of the 25 women treated by TCA had resolution of either the symptoms or the vulvar lesions in a follow-up period ranging from six to 22 months. Hence, we were able to control the symptoms and lesions in 92% of the women following initial laser treatment and 40% of the women following a single application of TCA. In addition, cosmetic results were satisfactory, and complications were minimal in the laser-treated group of patients. However, human papillomavirus DNA was still detected three to four weeks after treatment in 24% of the women treated by laser and 64% of the women treated by TCA. Whether they are at a higher risk of recurrence as compared to those without detectable viral DNA remains to be determined.

Adolescent↗
PubMed1992

Loop excision for cervical intraepithelial neoplasia.

We report the results of a prospective trial using a loop electrosurgical excision procedure (LEEP) on 97 patients with cervical intraepithelial neoplasia. In the LEEP group the mean cutting time and whole procedure time were 6.2 +/- 1.9 seconds and 12.7 +/- 3.5 minutes, respectively. The average blood loss was 3.6 +/- 1.9 mL. In the control group (39 cases) using laser conization, the mean cutting time and whole procedure time were 11.7 +/- 3.5 minutes and 44.9 +/- 8.9 minutes, respectively. The average blood loss in the control group was 11.2 +/- 3.1 mL. The differences between the two groups were statistically significant. During LEEP surgery, four cases had accidental vaginal excision. There were three cases of late cervical bleeding after surgery; the surface of the cervix was smooth, and no adhesion or crypt formation was noted after re-epithelialization. Eight patients became pregnant after the loop excision and no cervical incompetence was noted during antenatal care. After a one-year follow-up period in the colposcopy clinic, there was no recurrence of cervical intraepithelial neoplasia in either group. We advise that among the modalities of treatment for cervical intraepithelial neoplasia, LEEP appears to offer patients several benefits such as less bleeding, precise specimens, local anesthesia, less cost and less discomfort. It is particularly suitable for treating younger women who have not yet completed their families.

Adult↗
PubMed1992

Abdominal embryonal rhabdomyosarcoma. A case report.

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood, but it is rare in young adults. It usually occurs in the pelvis or genito-urinary tract. We report a case of abdominal embryonal rhabdomyosarcoma who received a combined treatment modality with radical pelvic surgery and combination chemotherapy of vincristine, actinomycin-D and cyclophosphamide (VAC). She is well with no evidence of tumour recurrence for 3 years after primary surgery.

Abdominal Neoplasms↗
PubMed1992

Contact Nd:YAG laser and CO2 laser for cylindrical excision of the cervix. A comparative study.

An excess of blood loss and persistence of intraepithelial neoplasia after cervical conization occur with some frequency. Contact Nd:YAG laser conical excision of the uterine cervix is a new technique designed to remedy those problems. In this study, 36 women with histologically confirmed cervical intraepithelial neoplasia were treated with cylindrical excision of the uterine cervix with a contact Nd:YAG laser. The results were compared with those in 30 women who had similar lesions and were treated with the CO2 laser. Use of the Nd:YAG laser resulted in less intraoperative blood loss (mean +/- SD, 3.12 +/- 0.28 vs. 30.3 +/- 2.12 mL for the CO2 laser, P less than .01) and less postoperative blood loss. The volume of early bleeding was 6.23 +/- 1.21 vs. 20.13 +/- 2.24 mL for the CO2 laser (P less than .01), and that of late bleeding was 5.22 +/- 2.21 vs. 31.24 +/- 0.05 mL for the CO2 laser (P less than .01). The operative time was similarly less for the contact Nd:YAG laser (6.2 +/- 2.2 vs. 20.2 +/- 1.2 minutes for the CO2 laser, P less than .01). The dimensions of the excised specimens were similar. These findings suggest that the contact Nd:YAG laser offers distinct advantages over the CO2 laser in performing cylindrical excision of the cervix.

Blood Loss, Surgical↗
PubMed1991

Human papillomaviruses and small cell carcinoma of the uterine cervix.

The in vitro DNA amplification technique of polymerase chain reaction was used to evaluate the possible presence of human papillomavirus (HPV) in small cell carcinoma of the uterine cervix. None of the 12 cases examined contain detectable amounts of either HPV type 16, 18, 31, or 33 DNA. On the other hand, HPV types 16 and 18 DNA were found in 14 (93.3%) and 9 (60.0%) of 25 invasive cervical squamous carcinoma tissues. The results seem to suggest that these types of HPV are not present or are present in extremely small quantities in cervical small cell carcinoma. Such an absence of HPV DNA makes it unlikely that these types of HPV play any etiological role in the pathogenesis of cervical small cell carcinoma.

Adult↗
PubMed1991

Evidence of human papillomavirus deoxyribonucleic acid in vulvar squamous papillomatosis.

Squamous papillae of the vulva represent a controversial lesion. Forty-six women with histologically confirmed vulvar squamous papillae and koilocytosis were studied at Chang Gung Memorial Hospital. Vulvar washings were analyzed by the filter in-situ technique using biotin-labeled probes for typing human papillomavirus DNA. Forty of 46 women (87%) were symptomatic. Human papillomavirus (HPV) DNA was detected in 76% (35 of 46) of women, including type 6/11 in 21.7%, type 16/18/31/33 in 45.6%, and both types in 8.6%. Furthermore, intraepithelial neoplasia was found in the epithelium of squamous papillae in two women. This study suggests the potential value of histologic examination and HPV DNA typing in separating anatomic variation from pathologic squamous papillae. We suggest that those squamous papillae with histologic evidence of koilocytosis be designated as squamous papillomatosis.

Adult↗
PubMed1991

Malignant mixed müllerian tumor of the fallopian tube. Case report and review of the literature.

Malignant mixed müllerian tumor of the fallopian tube is extremely rare, with less than 50 cases recorded in the English literature. Another case is reported and discussed. This 66-year-old female patient complained of profuse watery vaginal discharge for one month. Vaginal cytology was positive for malignancy while the endometrial curettage and cervical biopsy were both negative. Gynecologic sonography revealed a left adnexal mass of 6 cm in diameter. She underwent exploratory laparotomy after complete oncologic survey. The main tumor was confined to one tube but the peritoneal washing cytology was positive for adenocarcinoma cells. She tolerated the maximal debulking surgery very well but refused to receive adjuvant chemotherapy. Pathology proved that the tumor was composed of poorly differentiated adenocarcinoma and sarcoma. There were focal areas of rhabdomyoblastic differentiation with cross striation in immunoperoxidase stain. Carcinomatosis peritonii occurred 12 months after primary surgery and she expired one month later.

Aged↗
PubMed1991

Peripartum cardiomyopathy: report of a case.

Peripartum cardiomyopathy is defined as the development of heart failure during the later part of pregnancy or during the first three to six postpartum months, without an obvious underlying cause or prior evidence of cardiac disease. We present one case of peripartum cardiac failure which occurred in a 25-year-old primigravida with twin gestation. The patient underwent an emergency Cesarean section followed by successful medical treatment. An endomyocardial biopsy was performed 12 days after delivery and the pathological changes were consistent with the diagnosis of peripartum cardiomyopathy.

Adult↗