Hsin-Hsu Chou

Chia-Yi Christian Hospital, Chia-i-hsien, Taiwan, Taiwan

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Publications (8)17.3 Total impact

  • Hsin-Hsu Chou · Mei-Ju Chen · Yuan-Yow Chiou
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    ABSTRACT: Background: The objective of this study was to examine the long-term efficacy and complications associated with use of enteric-coated mycophenolate sodium (EC-MPS) for treatment of pediatric lupus nephritis (LN). Methods: This was a retrospective analysis of pediatric patients treated between 1995 and 2008. Comparisons were made between patients with LN who were and were not treated with EC-MPS (MPS and non-MPS groups). The primary endpoint was survival. The secondary endpoint was time to stage 3 chronic kidney disease (CKD). Response rates, laboratory parameters, and complications were determined. Results: There were 33 patients in the MPS group and 19 patients in the non-MPS group. The MPS group had more patients with complete/partial response (72.7 vs. 31.6 %; P < 0.001) and a significantly higher survival rate (0.0 vs. 42.1 %, P < 0.001), but the groups had similar rates of stage 3 CKD. The rebound of complement 3 was more rapid in the MPS group. There were no significant between-group differences in the incidence of complications, including gastrointestinal complications. Conclusion: A limitation of this study is the heterogeneity in the timing of treatment and in the duration of follow-up. Nonetheless, our findings suggest that EC-MPS can be an effective treatment for pediatric LN.
    Clinical and Experimental Nephrology 10/2015; DOI:10.1007/s10157-015-1171-6 · 2.02 Impact Factor
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    ABSTRACT: This study aims to examine the characteristics of Taiwanese children with chronic kidney disease (CKD) and delineate the factors that lead to disease progression in this population. We reviewed the records of the Taiwan Pediatric Renal Collaborative Study, a multicenter database of Taiwanese children with CKD. Multivariate regression analysis was used to identify the main factors associated with disease progression. A total of 382 children aged 1-18 years were included in the study (median age was 10.6 years; interquartile range: 6.4-13.8). There were 197 males (51.6%) and 185 females. CKD Stage 1 was diagnosed in 159 children (41.6%), Stage 2 in 160 (41.9%), Stage 3 in 51 (13.4%), and Stage 4 in 12 (3.1%). Fifty-six children (14.7%) experienced CKD progression. A multivariate analysis for all patients indicated that the risk for disease progression was increased in children with CKD secondary to a structural abnormality, genetic disease, anemia, elevated diastolic blood pressure, or elevated blood urea nitrogen. Compared with children with Stage 1 CKD, those with Stage 2 and Stage 4 CKD had decreased risk for CKD progression in this short-term cohort follow-up. CKD etiology affects disease progression. Careful monitoring and treatment of anemia and elevated blood pressure in children with CKD may slow disease progression. Copyright © 2015. Published by Elsevier B.V.
    Journal of the Formosan Medical Association 08/2015; DOI:10.1016/j.jfma.2015.07.019 · 1.97 Impact Factor
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    ABSTRACT: Complete or partial trisomy 10q involves a duplication of 10q, or the long arm of chromosome 10. Distal 10q trisomy is a well-recognized and defined but rare genetic syndrome in which duplication of distal segments of 10q results in a pattern of malformations. Although abnormal chromosome phenotypes are commonly detected by visualization of chromosomes by traditional cytogenetic techniques, this approach is marginal in both diagnostic sensitivity and potential for biological interpretation, thus making implementation of advanced techniques and analysis methods an important consideration in a health service. The present study describes the case of a Taiwanese boy from healthy parents with mental, growth, and psychomotor retardations. Additional clinical features included facial dysmorphism, microcephaly, brain atrophy, camptodactyly, and-as the first reported case-bilateral renal atrophy with chronic kidney disease stage 2 and the presence of a renal cyst in one kidney. A novel 21.8 Mb copy number variation region in chromosome region 10q23.1-10q25.1 was verified by array-comparative genomic hybridization in combination with quantitative real-time polymerase chain reaction. Subsequently, 200 protein-coding genes were identified in this copy number variation region and analyzed for their biological meaning using the database for annotation, visualization and integrated discovery. According to the result of gene functional enrichment analysis using database for annotation, visualization and integrated discovery, the Wnt signaling pathway is the most pertinent to the gene content in the copy number variation region. A change in the expression levels of some Wnt signaling pathway components and of NFKB2 and PTEN genes due to a gain in their gene copy number may be associated with the patient's clinical outcomes including brain atrophy, bilateral renal atrophy with chronic kidney disease stage 2, a renal cyst in one kidney, and growth retardation.
    BMC Research Notes 06/2015; 8(1):250. DOI:10.1186/s13104-015-1213-x
  • Yen-Ju Chen · Wen-Li Lee · Chuang-Ming Wang · Hsin-Hsu Chou
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    ABSTRACT: Nebulized hypertonic saline (HS) treatment reduced the length of hospitalization in infants with acute bronchiolitis in a previous meta-analysis. However, there was no reduction in the admission rate. We hypothesized that nebulized HS treatment might significantly decrease both the duration and the rate of hospitalization if more randomized controlled trials (RCTs) were included. We searched MEDLINE, PubMed, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL) without a language restriction. A meta-analysis was performed based on the efficacy of nebulized HS treatment in infants with acute bronchiolitis. We used weighted mean difference (WMD) and risk ratio as effect size metrics. Eleven studies were identified that enrolled 1070 infants. Nebulized HS treatment significantly decreased the duration and rate of hospitalization compared with nebulized normal saline (NS) [duration of hospitalization: WMD = -0.96, 95% confidence interval (CI) = -1.38 to -0.54, p < 0.001; rate of hospitalization: risk ratio = 0.59, 95% CI = 0.37-0.93, p = 0.02]. Furthermore, nebulized HS treatment had a beneficial effect in reducing the clinical severity (CS) score of acute bronchiolitis infants post-treatment (Day 1: WMD = -0.77, 95% CI = -1.30 to -0.24, p = 0.005; Day 2: WMD = -0.85, 95% CI = -1.30 to -0.39, p < 0.001; Day 3: WMD = -1.14, 95% CI = -1.69 to -0.58, p < 0.001). There was no decrease in the rate of readmission (risk ratio = 1.08, 95% CI = 0.68-1.73, p = 0.74). Nebulized HS treatment significantly decreased both the rate and the duration of hospitalization. Due to the efficacy and cost-effectiveness, HS should be considered for the treatment of acute bronchiolitis in infants.
    Pediatrics & Neonatology 01/2014; 55(6). DOI:10.1016/j.pedneo.2013.09.013 · 1.23 Impact Factor
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    ABSTRACT: Background/aim: The effects of ω-3 fatty acids (O3FAs) on renal function and proteinuria in immunoglobulin A nephropathy (IgAN) are not fully understood. Thus, we conducted an up-to-date meta-analysis of the currently available randomized controlled trials (RCTs) to validate the effects of O3FA in IgAN. Methods: A literature search was performed in PubMed, Medline, Embase and the Cochrane Central Registry of Controlled Trials using an extended search strategy to identify RCTs that assessed the treatment efficacy of O3FA in IgAN. The dose-effect relationships of O3FA on renal function and proteinuria were also determined. Results: Five RCTs with a total of 233 patients were included in our analysis. Our results demonstrated that while O3FA does not have any beneficial effects in preserving renal function in IgAN, proteinuria was significantly reduced. Furthermore, patients who received a high dose of O3FA (>3 g/day) did not differ from those who received a low dose of O3FA (≤3 g/day) in renal function or proteinuria. Conclusion: The currently available evidence suggests that O3FA has no benefit in preserving renal function, but can ameliorate proteinuria in IgAN. However, the effects of O3FA on proteinuria are not dose dependent.
    Nephron Clinical Practice 10/2012; 121(1):c30-c35. DOI:10.1159/000341929 · 1.40 Impact Factor
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    ABSTRACT: To determine if glucocorticoids can prevent renal scar formation after acute pyelonephritis in pediatric patients. Patients younger than 16 years diagnosed with their first episode of acute pyelonephritis with a high risk of renal scar formation (ie, inflammatory volume ≥ 4.6 mL on technetium-99m-labeled dimercaptosuccinic acid scan [DMSA] or abnormal renal ultrasonography results) were randomly assigned to receive either antibiotics plus methylprednisolone sodium phosphate (1.6 mg/kg per day for 3 days [MPD group]) or antibiotics plus placebo (placebo group) every 6 hours for 3 days. Patients were reassessed by using DMSA 6 months after treatment. The primary outcome was the development of renal scars. A total of 84 patients were enrolled: 19 in the MPD group and 65 in the placebo group. Patient characteristics were similar between the 2 groups, including the acute inflammatory parameters and the initial DMSA result. Renal scarring was found in 33.3% of children treated with MPD and in 60.0% of those who received placebo (P < .05). The median cortical defect volumes on follow-up DMSA were 0.0 mL (range: 0-4.5 mL) and 1.5 mL (range: 0-14.8 mL) for the MPD and placebo groups, respectively (P < .01). Patients in the MPD group experienced faster defervescence after treatment than the placebo group. Adjunctive oral MPD therapy reduced the occurrence and/or severity of renal scarring after acute pyelonephritis in these hospitalized children who had a high risk of renal scar formation.
    PEDIATRICS 08/2011; 128(3):e496-504. DOI:10.1542/peds.2010-0297 · 5.47 Impact Factor
  • Pediatrics International 04/2010; 52(2):e62-4. DOI:10.1111/j.1442-200X.2010.03045.x · 0.73 Impact Factor
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    ABSTRACT: We correlated abnormal findings on renal ultrasonography (US) and inflammatory volume (Volume) on technetium dimercaptosuccinic acid renal single photon emission computerized tomography (DMSA) in children with acute pyelonephritis (APN) with renal scars. A total of 31 males and 14 females (9 days to 9.8 years old) who fulfilled diagnostic criteria for APN and who underwent initial DMSA between January 1995 and July 2002 and followup DMSA at least 6 months later were enrolled in the study. APN was diagnosed by initial DMSA, and placement in the scar or scar-free group was determined by followup DMSA. Photopenic areas on initial DMSA were calculated as Volume, and were compared to US findings. Ultrasound demonstrated 35 abnormal kidneys (38.9%) among these children with APN. Significant differences in age, Volume (11.19 +/- 2.52 ml vs 3.02 +/- 0.75 ml, p <0.005), C-reactive protein (CRP) and photopenic lesion on initial DMSA were found between children with abnormal and normal US. Of 65 children with initial APN foci 33 (50.8%) recovered, and the others had development of scars. The sensitivity of US for detecting APN (identified by DMSA scan) was 49.2%, and the specificity was 88% (OR 7.1, 95% CI 2.18 to 24.41). The sensitivity of US for predicting renal scarring was 59.4%, and the specificity was 60.6% (OR 2.3, 95% CI 0.82 to 7.65). Patients with abnormal US findings and high serum CRP (greater than 70 mg/l) had a large Volume (10.96 +/- 3.05 ml) and a 76.2% chance of being in the scar group. US findings are significantly correlated to Volume in APN. Along with a high level of CRP, US is helpful in predicting development of renal scarring.
    The Journal of Urology 01/2005; 173(1):190-4; discussion 194. DOI:10.1097/01.ju.0000148315.63223.36 · 4.47 Impact Factor