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Articles by C. H Chen
Total Records ( 6 ) for C. H Chen
  J. N Al Swiahb , C. C Huang , F. M Fang , H. C Chuang , H. Y Huang , S. D Luo , C. H Chen , C. M Chen and C. Y. Chien

Objective  To evaluate the prevalence of human papillomavirus (HPV) and the prognostic significance of epidermal growth factor receptor (EGFR), p53, and p16 among patients with oropharyngeal carcinoma.

Design  Retrospective study.

Setting  Academic Institute of Otolaryngology, Kaohsiung, Taiwan.

Patients  Two hundred seventy-four patients who were diagnosed as having oropharyngeal carcinoma underwent testing for the presence of the HPV genome in the nuclei of their tumor cells from January 1, 1992, through March 31, 2008.

Interventions  The HPV genome was detected by performing polymerase chain reaction–based assays and in situ hybridization on tumor tissue from paraffin blocks. Immunohistochemistry staining for p16, p53, and EGFR was also performed.

Main Outcome Measures  We used the Fisher exact test to evaluate the correlation between the clinicopathological variables and the presence of HPV in tumor cells. Survival analysis was based on the Kaplan-Meier method.

Results  We detected HPV in 45 of the 274 patients (16.4%); of these, HPV-16 and -18 were identified in 42 (93.3%) of the HPV-positive tumors. The HPV-positive oropharyngeal cancers were more likely to occur in females, nonsmoking individuals, and those who did not chew betel quid. The HPV-positive tumors significantly expressed p16 and were inversely associated with EGFR and p53 expression (all, P < .001). In addition, patients with tumor tissue that was positive for HPV (P = .008) and had negative expression of EGFR (P = .01), low expression of p53 (P = .01), and high expression of p16 (P = .04) had a better prognosis.

Conclusion  Our results suggest that HPV, EGFR, p53, and p16 are useful biomarkers in predicting the clinical outcomes of oropharyngeal cancer.

  H. J Chen , Y. H Yu , C. Y Tu , C. H Chen , T. C Hsia , K. D Tsai , C. M Shih and W. H. Hsu

The aim of this study was to reevaluate the clinical significance of sonographic appearances, in particular the application of color Doppler ultrasound imaging, in discriminating peripheral air-fluid lung abscess from empyema.


We retrospectively studied patients who had had peripheral air-fluid lesions due to empyema or lung abscess and who had undergone color Doppler ultrasound and grayscale ultrasound examinations between January 2003 and October 2007. A total of 34 patients with confirmed lung abscess and 30 patients with empyema were identified. The four sonographic characteristics observed and analyzed were the wall characteristics of the lesions (wall width, luminal margin, outer margin, and chest wall angle), split pleura sign, internal echogenicity (suspended microbubble sign, complex-septated effusions, and passive atelectasis), and identification of color Doppler ultrasound vessel signals in pericavitary lesions (consolidation or atelectasis).


Among the sonographic characteristics, complex-septated effusions and passive atelectasis were specific for empyema, but the sensitivity was only 40% (n = 12 of 30) and 47% (n = 14 of 30), respectively. The identification of color Doppler ultrasound vessel signals in pericavitary consolidation was the most useful and specific for identifying lung abscesses. In our series, if we define the identification of color Doppler ultrasound vessel signals in a pericavitary consolidation as a predictor for peripheral lung abscess, we can achieve sensitivity, specificity, positive predictive value, and negative predictive value of 94%, 100%, 100%, and 94%, respectively.


Color Doppler ultrasound is a powerful tool for differentiating the peripheral air-fluid abscess from empyema, with high specificity and without any risk.

  H. Y Lin , K. W Chong , J. H Hsu , H. C Yu , C. C Shih , C. H Huang , S. J Lin , C. H Chen , C. C Chiang , H. J Ho , P. C Lee , C. H Kao , K. H Cheng , C Hsueh and D. M. Niu

Background— Fabry disease is a treatable lysosomal storage disorder, which is often misdiagnosed or belatedly diagnosed.

Methods and Results— To determine the disease incidence in the Taiwan Chinese population, a Fabry disease newborn screening study was initiated. A total of 110 027 newborns were screened by assaying the -galactosidase A (-Gal A) activity using dry blood spots. Low plasma -Gal A activity and presence of a Fabry mutation was demonstrated in 45 neonates (3 females). Eight different mutations were identified, including 3 known missense mutations (R112H, A143T, and R356W), 4 novel missense mutations (G104V, M296L, G360C, and K391T), and one known intronic mutation (IVS4+919G->A). The IVS4+919G->A mutation was most common (82% of patients). A total of 20 maternal grandparents of infants harboring this intronic mutation were evaluated by echocardiography, mutation analysis and -Gal A activity assay. The intronic mutation was found in 9 grandfathers and 11 grandmothers. Of these grandparents, 3 grandfathers (33%) but none of the grandmothers had hypertrophic cardiomyopathy. Additionally, 16 males who had been diagnosed with idiopathic hypertrophic cardiomyopathy were screened by mutation analysis and -Gal A activity; 4 (25%) showed deficient plasma -Gal A activity in combination with the intronic mutation.

Conclusion— We found an unexpected high prevalence of the cardiac variant Fabry mutation IVS4+919G->A among both newborns (1 in 1600 males) and patients with idiopathic hypertrophic cardiomyopathy in the Taiwan Chinese population. The early identification of undiagnosed patients allows timely therapeutic intervention providing a better clinical outcome.

  C. H Chen , C. H Kang and P. H. Chiang

Patients with penile cancer sometimes refuse surgery under the consideration of cosmetic and functional impact. The efficacy of intra-arterial (IA) chemotherapy for penile cancer has not been well defined.


Five patients with penile cancer, receiving at least two courses of IA chemotherapy, were analyzed from January 2005 to January 2009. These patients all refused surgery initially. The drug combinations were as follows: methotrexate, mitomycin C, bleomycin, cisplatin and 5-fluorouracil. Carboplatin was used instead of cisplatin for one patient with renal insufficiency.


The overall response rate (complete or partial) was 100%. One case achieved complete remission and four cases achieved partial remission. Among the partial responders, three cases underwent subsequent partial penectomy to preserve partial appearance. Mild (Grades I–II) anorexia is the most common adverse effect of IA chemotherapy. Hematological toxicity included two episodes of Grade III anemia and one episode of Grade III febrile neutropenia.


Organ- and function-sparing approaches are proposed using combination therapies, especially for those with huge tumor burden. Our preliminary data indicated that a combination of IA neoadjuvant chemotherapy and surgery may have the potential to achieve the goal in the treatment of penile cancer with negative lymph node.

  C. H Kang , C. H Chen and P. H. Chiang

In this study, we assessed the clinical and pathological characteristics of urothelial cancers of the upper urinary tract (UUT) in patient under dialysis and evaluated the efficacy and complications of surgical management of the disease.


A total of 70 dialysis patients with primary urothelial carcinoma (UC) of the UUT were identified with 5-year follow-up after surgery (61–122 months). Potential factors were analysed to determine the risk factors of subsequent tumours and unfavourable prognostic factors of overall survival. Incidence of urothelial tumours and overall survival of 7503 dialysis patients were also evaluated.


The incidence of primary UC of the UUT in dialysis patients in Taiwan was 0.93%. The 2-year and 5-year overall survival rates of dialysis patients with primary UC of the UUT were 74.3% and 42.9%, respectively. Subsequent bladder tumours and contralateral UUT tumours developed in 52.6% and 37.9% patients, respectively. No significant risk factor could be identified to predict subsequent tumours in dialysis patients. Pathological stage (P = 0.021) and grade (P < 0.001) were the unfavourable prognostic factors in the log-rank test. No significant difference was observed in perioperative mortality and overall survival between patients receiving one-stage nephroureterectomy and those receiving two-stage bilateral nephroureterectomy; however, the cystectomy procedure increased perioperative mortality according to the 2 test (P = 0.042).


Closely monitoring the residual urinary tracts after nephroureterectomy in dialysis patients with primary UC of the UUT should be performed. There is no statistical difference for overall survival between one-stage and two-stage bilateral nephroureterectomy.

  T. M Yu , Y. H Chen , J. Y Hsu , C. S Sun , Y. W Chuang , C. H Chen , M. J Wu , C. H Cheng and K. H. Shu

Background. Pulmonary hypertension (PH) is an overlooked cardiovascular morbidity in patients undergoing haemodialysis. Inflammation has been demonstrated to play a significant role with certain types of PH in non-uraemic patients, but studies analysing the mechanisms in dialyzed patients with PH are rare. Hence, we investigated systemic and local inflammation biomarkers associated with PH in uraemia patients to elucidate the potential mechanism.

Methods. A cross-sectional study was conducted in which 97 haemodialysis patients were initially evaluated in our hospital. Twelve inflammatory cytokines were measured using a cytometric beads assay in patients with and without PH. FENO (fractional exhaled nitric oxide) was checked by a chemiluminescence analyser in patients with and without PH as well as by normal controls.

Results. Thirty-nine eligible patients were enrolled. Compared to patients without PH (group A), patients with PH (group B) had significantly higher serum levels of hs-CRP, IL-1β, TNF- and IL-6. FENO was also measured. Though the pre-dialysis FENO levels were elevated in both groups; group B patients had significantly higher pre-dialysis FENO levels than group A patients (39.9 ± 16.7 versus 31.8 ± 10.3, P = 0.045). The post-dialysis FENO levels returned to normal in group A while the remaining were significantly higher in group B (30.3 ± 10.3 versus 20.1 ± 10.9, P = 0.003).

Conclusions. Our study revealed that dialyzed patients with PH had a significantly higher level of airway FENO as well as serum levels of acute phase reactive protein and cytokines, including IL-1β, TNF- and IL-6. A chronic inflammation might play an important role in the pathogenesis of PH in patients undergoing haemodialysis.

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