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Wen-Rei Kuo

Publications and source records attributed to Wen-Rei Kuo.

42 records · Page 3Linked to original sources

Effect and correlation of serum total IgE, eosinophil granule cationic proteins and sensitized allergens in atopic dermatitis patients with or without rhinitis.

To understand the relevance of serological parameters and eliciting allergens in the patients with atopic dermatitis (AD) and patients with atopic dermatitis in combination with rhinitis (ADR), we compared the serum total IgE, major basic protein (MBP) and eosinophil cationic protein (ECP) levels and identified the sensitized allergens in these two groups. The serum levels of total IgE, MBP and ECP were not significantly different in these two groups. Patients with ADR had a higher positive rate of aeroallergens including housedust, mite (D.F), mite (D.P) and cockroach than patients with AD. However, a high positive rate of seafood allergens (include crab, shellfish and shrimp) was observed in patients with AD. The serum IgE level correlated well with serum MBP level (r = 0.603, P = 0. 019) in patients with ADR. There was a strong correlation between serum MBP and ECP level (r = 0.773, P = 0.005) in patients with AD and in patients with ADR (r = 0.721, P = 0.008). We also found that numbers of sensitized allergens correlated well with total IgE in patients with AD (r = 0.760, P = 0.001) and in patients with ADR (r = 0.487, P = 0.004). These results suggested that the aeroallergens are the most important allergens causing and aggravating atopic diseases in Taiwan. Seafood may play an important role in the pathogenesis of AD. We suggest the measurement of serum total IgE combined with Multiple Allergens Simultaneous Test-Chemiluminescent Assays(AST-CLA) test could be helpful in the diagnosis of atopic diseases.

Adolescent↗

Space infection of the head and neck.

Deep neck infection may be lethal, especially when life-threatening complications occur. We conducted a retrospective analysis of 184 patients with deep neck infection who were treated at Kaohsiung Medical University Hospital during the past 6 years. Factors such as age, sex, hospitalization days, clinical presentations, involved spaces, imaging studies, microbiology, and treatment method were analyzed. There were 122 men and 62 women with a mean age of 41.7 years. The average hospitalization was 8.4 days. The involved spaces, determined by physical examination and radiologic findings, were the peritonsillar space (59 patients), parapharyngeal space (77 patients), submandibular space (55 patients), and retropharyngeal space (20 patients). Of the 49 patients for whom the origin of infection was identified, 29 were infected via the upper respiratory tract and 13 had infection of odontogenic origin. The most common isolated organism was Klebsiella pneumoniae. One hundred and thirty-seven patients (74.5%) underwent surgery, including repeated needle aspiration (87 patients) and surgical drainage (50 patients). The remaining 47 patients recovered uneventfully with antibiotic therapy alone. Eighteen patients developed life-threatening complications, such as descending mediastinitis, sepsis, airway obstruction, and jugular vein thrombosis. Two patients died of septic shock. The combination of accurate diagnosis, effective antibiotic therapy, airway maintenance, and intensive surgical debridement for those who fail to respond to conservative treatment will lead to a good prognosis.

Adolescent↗

Foreign-body-induced otitis media: a case report.

Unilateral ear discharge is one of the usual complaints of the patients who visited the otolaryngology clinics, especially those patients who suffered from external or middle ear disease. We present a 33-year-old female patient who suffered from persistent ear discharge of the left ear. The local findings showed a yellowish to greenish discharge and fetid odor from her left ear canal, occupied by a large amount of granulation tissue. Wide removal of the diseased granulation tissue and tympanoplasty were performed in the patient. Four pieces of cotton were found in the external auditory canal and middle ear cavity during the operation. For more than 2 years of follow-up at our clinic, the patient has had a dry ear and her hearing ability also improved. Foreign-body-induced otitis media in adults is very rare. Therefore, we present this rare case and review the reported literature so that the clinical symptoms and signs, imaging findings, clinical treatment, prognosis, and hearing change in foreign-body-induced otitis media may be recognized and understood.

Adult↗

Aspergillosis: a nidus of maxillary antrolith.

We present a case of polypoid sinusitis with maxillary sinus antrolith, which is composed of Aspergillus species. Unlike most muddy or necrotic fungal balls, this first reported fungal antrolith is solid and extremely hard. Aspergillus served as a central fungal nidus associated with long-standing sinusitis, and poor sinus drainage could be a possible pathophysiology for the formation of a sinus stone. Aspergillosis infection should be considered in the differential diagnosis of a radiopaque paranasal sinus lesion. The endoscopic sinus surgery can be a reliable and minimally invasive method not only for the removal of the stone, but also for the restoration of ventilation and drainage of the diseased sinus.

Aspergillosis↗

Correlation between proliferating cell nuclear antigen and p53 protein expression and 5-year survival rate in nasopharyngeal carcinoma.

PURPOSE: To assess the prognostic significance of p53 protein and proliferating cell nuclear antigen (PCNA) expression in nasopharyngeal carcinoma. MATERIALS AND METHODS: This study included 79 patients who had received treatment and regular follow-up for at least 5 years at a single institute. We used immunohistochemistry staining to assess p53 protein expression and PCNA labeling index (LI). Analyses were conducted on the association between each of the 2 biomarkers and pathological subtypes, TNM stage, the presence of locoregional recurrence, and 5-year survival rate. RESULTS: p53 protein nuclear staining was positive in 49 patients (62%). The mean PCNA LI was 55.6%, ranging from 3.35% to 92.9%. High PCNA LI (>55.6%) might contribute to higher 5-year survival rate, but it did not reach statistical significance (P = .09). Positive p53 protein staining and low PCNA LI were associated with the presence of locoregional recurrence. No statistical significance was found between p53 protein expression and PCNA LI and pathological subtypes and TNM stage. CONCLUSION: p53 protein and PCNA LI were not an ideal prognostic indicator in predicting 5-year survival rate in nasopharyngeal carcinoma. Future work will direct toward searching for other potential biomarkers with the hope to reinforce prediction of prognosis.

Adolescent↗

Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases.

PURPOSE: The incidence of deep cervical space infections has decreased after the introduction of antibiotics and improvement of oral hygiene, but they still may be lethal especially when life-threatening complications occur. In this article, we try to find out whether there are predisposing factors related to complicated deep cervical space infections and prolonged hospitalization. MATERIALS AND METHODS: We conducted a retrospective analysis of medical records of 196 patients with deep neck infections during the period from March 1996 to February 2002. Among the 196 patients, 15 patients developed lethal complications. As for data analysis, multiple regression and logistic regression with dummy variable were used. RESULTS: In multiple regressions, patients with older age or with neck swelling, trismus, underlying diseases, complications, and C-reactive protein more than 100 microg/mL stayed longer in the hospital, and the P value reached statistical significance (P <.05). In logistic regression, male patients and patients with neck pain had negative correlation, and the P value reached statistical significance (P <.05). Patients with neck swelling and patients with respiratory difficulty had positive correlation, and the P value reached statistical significance (P <.05). That means female patients, patients with neck swelling, and patients with respiratory difficulty were more likely to have complicated deep neck infections. CONCLUSION: Complicated deep neck infections remain potentially fatal, but the morbidity and mortality can be reduced. Doctors should pay more attention to those high-risk patients; they are female patients, patients with neck swelling, and patients with respiratory difficulty.

Adolescent↗