Hao-Chung Ho

Taichung Veterans General Hospital, 臺中市, Taiwan, Taiwan

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Publications (43)49.61 Total impact

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    ABSTRACT: Nortriptyline (NTP), an antidepressant, has antitumour effects on some human cancer cells, but its effect on human bladder cancer cells is not known. In this study, we used a cell viability assay to demonstrate that NTP is cytotoxic to human TCCSUP and mouse MBT-2 bladder cancer cells in a concentration and time-dependent manner. We also performed cell cycle analysis, annexin V and mitochondrial membrane potential assays, and Western blot analysis to show that NTP inhibits cell growth in these cells by inducing both mitochondria-mediated and death receptor-mediated apoptosis. Specifically, NTP increases the expression of Fas, FasL, FADD, Bax, Bak, and cleaved forms of caspase-3, caspase-8, caspase-9, and poly(ADP-ribose) polymerase. In addition, NTP decreases the expression of Bcl-2, Bcl-xL, BH3 interacting domain death agonist, X-linked inhibitor of apoptosis protein, and survivin. Furthermore, NTP-induced apoptosis is associated with reactive oxygen species (ROS) production, which can be reduced by antioxidants, such as N-acetyl-l-cysteine. Finally, we showed that NTP suppresses tumour growth in mice inoculated with MBT-2 cells. Collectively, our results suggest that NTP induces both intrinsic and extrinsic apoptosis in human and mouse bladder cancer cells and that it may be a clinically useful chemotherapeutic agent for bladder cancer in humans. Copyright © 2015. Published by Elsevier B.V.
    European journal of pharmacology 06/2015; 761. DOI:10.1016/j.ejphar.2015.06.007 · 2.53 Impact Factor
  • Urological Science 06/2015; 26(2):S26. DOI:10.1016/j.urols.2015.06.002
  • Urological Science 06/2015; 26(2):S71-S72. DOI:10.1016/j.urols.2015.06.118
  • Urological Science 06/2015; 26(2):S79. DOI:10.1016/j.urols.2015.06.145
  • Urological Science 06/2015; 26(2):S7. DOI:10.1016/j.urols.2015.06.228
  • Urological Science 06/2015; 26(2):S7. DOI:10.1016/j.urols.2015.06.229
  • Urological Science 06/2015; 26(2):S63. DOI:10.1016/j.urols.2015.06.086
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    ABSTRACT: Angiomyolipoma is a benign mesenchymal tumor composed of blood vessels, smooth muscle, and mature adipose tissue. Angiomyolipomas in the kidney allografts are rare. We report a case of angiomyolipoma that was incidentally found 1 year after transplantation. Abdominal computed tomography showed a 4-cm renal tumor with contrast enhancement and an early washout pattern, resembling a renal cell carcinoma. Tumor biopsy proved a lipid-poor angiomyolipoma. Tumor diameter decreased to 2.4 cm after six months of treatment with sirolimus. Sirolimus not only reduces tumor size, but also benefits a transplant patient who needs immunosuppression. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Transplant International 03/2015; 28(9). DOI:10.1111/tri.12567 · 2.60 Impact Factor
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    ABSTRACT: Information on post-transplant malignancy and mortality risk in kidney transplant tourists remains controversial and is an important concern. The present study aimed to evaluate the incidence of post-transplant malignancy and mortality risk between tourists and domestic transplant recipients using the claims data from Taiwan's universal health insurance.A retrospective study was performed on 2394 tourists and 1956 domestic recipients. Post-transplant malignancy and mortality were defined from the catastrophic illness patient registry by using the International Classification of Diseases, 9th Revision. Cox proportional hazard regression and Kaplan-Meier curves were used for the analyses.The incidence for post-transplant de novo malignancy in the tourist group was 1.8-fold higher than that of the domestic group (21.8 vs 12.1 per 1000 person-years). The overall cancer recurrence rate was approximately 11%. The top 3 post-transplant malignancies, in decreasing order, were urinary tract, kidney, and liver cancers, regardless of the recipient type. Compared with domestic recipients, there was significant higher mortality risk in transplant tourists (adjusted hazard ratio = 1.2, 95% confidence interval: 1.0-1.5). In addition, those with either pre-transplant or post-transplant malignancies were associated with increased mortality risk.We suggest that a sufficient waiting period for patients with pre-transplant malignancies should be better emphasized to eliminate recurrence, and transplant tourists should be discouraged because of the possibility of higher post-transplant de novo malignancy occurrence and mortality.
    Medicine 12/2014; 93(29):e344. DOI:10.1097/MD.0000000000000344 · 5.72 Impact Factor
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    ABSTRACT: Background: Sequential treatments using various targeted-therapies have been recommended for metastatic renal cell carcinoma. However, regimen selection remains difficult when adapting to various clinical situations. Patients and methods: From 2006 to 2012, 29 patients who received sequential targeted-therapy at our hospital were included for analysis of the treatment regimens and outcome. Results: Patients who used sunitinib as first-line and axitinib as second-line treatment experienced a similar second-line treatment duration, as those used the same first-line and everolimus as the second-line regimen. The first-line sunitinib treatment duration was longer in the axitinib group. Conclusion: Our data showed a promising sequential treatment result using sunitinib-axitinib and sunitinib-everolimus. In patients whose first-line sunitinib treatment resulted in primary resistance, second-line everolimus was found to still contribute a fair degree of disease control. Patients who responded to first-line sunitinib could also achieved fair disease control using second-line axitinib.
    Anticancer research 10/2014; 34(10):5643-7. · 1.83 Impact Factor
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    ABSTRACT: Background The da Vinci robot system has become the mainstay of minimally invasive surgery and has been used in numerous complex reconstructive procedures. Due to the success of this innovative technology, we attempted to expand our practical model and application of the da Vinci robot system into other urologic surgeries, beginning with robotic-assisted laparoscopic radical prostatectomy (RALRP). Methods We retrospectively reviewed a total of 683 patients who underwent robotic-assisted urologic surgery between December 2005 and December 2012. We divided this 8-year course of device use into three periods, and analyzed the surgical capability of operations in 1 day over different periods through a retrospective analysis. Results In the first period (2005–2008), 159 cases of robotic-assisted urologic surgeries were performed. A total of 195 cases were performed in the second group (2009–2010), and 329 cases in the third (2011–2012). Starting with radical prostatectomy in December 2005, we performed various types of procedures such as partial nephrectomy, pyeloplasty, nephroureterectomy with cystoprostatectomy, nephroureterectomy with bladder cuff, radical cystoprostatectomy/cystectomy with ileal conduit reconstruction, partial cystectomy, adrenalectomy, nephropexy, simple prostatectomy, ureteral reconstruction, and pyelolithotomy/ureterolithotomy. The mean operation times of prostatectomy, partial nephrectomy, nephroureterectomy with radical cystectomy/cystectoprostatectomy, and nephroureterectomy were 154, 140, 295, and 129 minutes, respectively. Conclusion Based on our experience, a robotic system can be applied to many different types of urologic surgeries both safely and efficiently.
    Journal of the Chinese Medical Association 05/2014; 77(5). DOI:10.1016/j.jcma.2014.02.012 · 0.85 Impact Factor
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    ABSTRACT: The prognosis of renal cell carcinoma with brain metastasis is generally poor. Here we report a case of a 56-year-old man with metastatic renal cell carcinoma to the brain who underwent metastasectomy, cytoreductive nephrectomy, and whole brain radiotherapy. Thereafter, he received sunitinib, everolimus, and sorafenib sequentially for 11 months, 2 months, and 2 months, respectively. No tumor recurrence or progression of brain lesions has been reported in this patient for the past 16 months.
    Urological Science 04/2014; 25(4). DOI:10.1016/j.urols.2012.05.001
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    ABSTRACT: Background Doubling of serum creatinine (DSC) in transplantation has been seen as the end-point of renal function without pathological evidence. We conducted this study to elucidate the relationship between DSC and pathological findings. Material and Methods We conducted a retrospective cohort study to illustrate pathologic changes in patients receiving a kidney biopsy in the previous 5 years with clinicopathological correlations to DSC and proteinuria. Results Of a total of 99 kidney recipients (146 biopsies), results of graft biopsy were as follows: calcineurin inhibitor toxicity (CNI) (38.7%) and rejection (36.9%). Compared to males, females had higher proportions of class I (p=0.003) and class II PRA (p<0.001), and a higher rejection rate (p=0.042), but had the same clinical outcomes as males, like eGFR at follow-up (p=0.882), DSC (p=0.703), and proteinuria (p=0.745). Pathological diagnoses and findings were related to proteinuria: glomerulopathy (HR=4.9, p=0.01), AMR (HR=2.5, p=0.025), especially acute AMR (HR=2.9, p=0.008), chronic glomerular change (HR=10.2, p=0.002), arteriolar hyaline (HR=2.3, p=0.026), and mesangial matrix change (HR=6.3, p=0.002). BK nephropathy and rejection were the only 2 risk factors. Pathological findings favoring AMR (PTC infiltration and glomerulitis) showed a greater risk of DSC compared with those favoring CMR (interstitial inflammation, intimal arteritis, and tubulitis). DSC was correlated with clinical manifestation (rejection) and provided strong pathological evidence. Conclusions There was more acute rejection and chronic pathological change in women, but outcomes were the same due to less activity of renin-angiotensin-aldosterone and hyperfiltration in females. DSC as an end-point of graft function can be used to identify recipients, especially AMR or mixed AMR and CMR. 1. All forms of support received by each author: None of the authors received support. 2. Any potential conflict of interest for each author: No conflict of interest for any of the authors.
    09/2013; 18:471-81. DOI:10.12659/AOT.889098
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    ABSTRACT: Renal transplant is the preferred treatment for patients with uremia. The renal transplant procedure is well established with a high success rate, but surgical complications are encountered occasionally. We report a case of sudden onset of anuria of the graft kidney owing to acute external iliac artery dissection diagnosed by Doppler sonography. Urgent endarterectomy with thrombus removal of false lumen prevented ischemia and occlusion of the right femoral artery. Without accurate diagnosis and management, this complication could have caused graft loss and death. We believe that renal transplant requires attentive teamwork to keep the graft functioning well.
    06/2013; 11(3):274-7. DOI:10.6002/ect.2012.0152
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    ABSTRACT: Background: The risk of developing chronic kidney disease (CKD) among living kidney donors (LKDs) is seldom included in evaluations of patients' outcomes. Potential risk factors and new criteria for estimating the glomerular filtration rate (eGFR) indexed for body surface area (BSA) were investigated with a view to prevent the development of CKD in LKDs. Methods: We conducted a retrospective study of LKDs from May 1983 to March 2011. The Mann-Whitney U test and χ(2) test were used to analyze the male versus female groups. Survival analysis was plotted as CKD-free survival and analyzed separately by different eGFR index classifications. The Cox regression model was used to identify potential risk factors for development of CKD. Results: A total of 105 LKDs with a mean age of 46.3 ± 12.5 years had a mean eGFR indexed for BSA of 88.9 ± 21.5 ml/min per 1.73 m(2). After a mean duration of 5.4 ± 4.9 years' follow-up, eGFR dropped to 61.4 ± 16.4 ml/min per 1.73 m(2) (p = 0.002). Median CKD-free survival was only 5.7 years. The difference between eGFR ≥ 80 ml/min per 1.73 m(2) and <80 ml/min per 1.73 m(2) was not statistically significant (p = 0.980). Multivariate Cox regression analysis showed that higher eGFR at donation (HR = 0.952, p = 0.0199) could be a protective factor. The receiver operating characteristic (ROC) curve for initial eGFR with best sensitivity of 52.78 % and specificity of 81.40 % was obtained with a cutoff value of 90.2 ml/min per 1.73 m(2) for preoperative eGFR. An eGFR of 90 ml/min per 1.73 m(2) yielded a significant survival curve (p = 0.0199) after 21 years of follow-up. Further classifications of eGFR >90 ml/min per 1.73 m(2) into 90-99 ml/min per 1.73 m(2), 100-109 ml/min per 1.73 m(2), and ≥110 ml/min per 1.73 m(2) were examined, but this survival curve was not statistically significant (p = 0.1247). Conclusions: Living kidney donors will develop CKD after a long duration of follow-up if there is insufficiently high eGFR at donation. An eGFR above 90 ml/min per 1.73 m(2) before donation is the only factor that predicts prevention of CKD. Larger studies with longer duration of follow-up are necessary to clarify the clinical outcome of this postoperative CKD group, especially for patients with eGFR between 80 and 90 ml/min per 1.73 m(2).
    World Journal of Surgery 01/2013; 37(4). DOI:10.1007/s00268-013-1906-z · 2.64 Impact Factor
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    ABSTRACT: Suprapubic cystostomy is commonly performed in patients with neurogenic bladder or bladder outlet obstruction. The most serious complication is bowel injury, which usually occurs during catheter insertion. Bowel perforation during suprapubic catheter exchange is rare. We herein report an extremely rare case of terminal ileal perforation resulting from a change of suprapubic catheter. After insertion of the suprapubic catheter, a feculent material was noted in the terminal ileum. A cystography revealed that the contrast medium passed directly into the terminal ileum and colon. A computed tomographic scan confirmed the presence of a balloon tip in the terminal ileum. Terminal ileum perforation was diagnosed. Emergent laparotomy and loop ileostomy were performed. The patient's recovery was uneventful.
    Urological Science 01/2013; 25(2). DOI:10.1016/j.urols.2012.07.012
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    ABSTRACT: Purpose: The purpose of this study is to evaluate the efficacy of a protocol including topical heparin therapy for hand-foot skin reactions (HFSR) during multikinase (MKI) treatment. Methods: We prospectively collected 26 patients who had HFSRs during treatment with the MKIs, sunitinib, sorafenib, or axitinib. The age distribution ranged from 46 to 87 years, with a mean of 66 years. The distribution of HFSR severity was 12 patients with grade 1, 12 with grade 2, and 2 with grade 3. A heparin-containing topical ointment treatment, combined with hand-foot shock absorbers and skin moisturizers, was used at the lesion sites. Changes in the grade of HFSR, MKI dosage, and interruptions of MKI therapy were recorded. Results: The results showed that 66.7% of grade 1 patients were cured of disease, 83.3% of grade 2 patients had improved symptoms, and both grade 3 patients (100%) had improved symptoms and were downgraded to grade 2. Four (15.4%) patients required reduction of MKI dosage, but there were no treatment interruptions or dropouts. Conclusion: Our protocol is beneficial in promoting resolution of HFSRs induced by MKIs. Further validation in large control studies should be investigated.
    Supportive Care in Cancer 12/2012; 21(3). DOI:10.1007/s00520-012-1693-3 · 2.36 Impact Factor
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    ABSTRACT: Background: Catheter malfunction is a common and significant complication during peritoneal dialysis (PD). We developed a minilaparotomy procedure to rescue malfunctioning catheters and to prevent recurrence of malfunction. Methods: From 2006 to 2011, 11 patients receiving PD had a malfunctioning catheter. In all patients, a 2-cm incision, 5 cm caudally to the previous peritoneal entry site was used to correct the malfunctioning catheter, with concomitant fixation of the catheter to the peritoneum. Results: Catheter tip migration occurred in 7 patients, omental wrapping in 3, and blood clot obstruction in 1. The mean onset time to catheter malfunction was 197.5 days (range: 4 - 1270 days), and the mean operating time was 41 minutes (range: 35 - 56 minutes). There was no recurrence of catheter malfunction and no surgery-related peritonitis. Conclusions: Our minilaparotomy procedure is safe and feasible for the salvage of malfunctioning PD catheters.
    09/2012; 33(1). DOI:10.3747/pdi.2011.00237
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    ABSTRACT: Peritoneal dialysis (PD) is a widely used renal replacement therapy for end-stage renal disease (ESRD) patients. Using laparoscopic guidance for PD catheter placement, we have designed a safe method that resulted in a reduction in catheter migration. We retrospectively reviewed 250 consecutive patients who underwent PD catheter placement from January 2005 to December 2009. The patients were divided into two groups: the conventional open surgery group and the laparoscopic group. All patients received Tenckhoff straight catheters. In the laparoscopic group, the catheter was additionally fixed to the ventral abdominal wall. Data were collected and a statistical analysis was performed to compare patient characteristics, surgical complications and catheter removal between the groups. Overall surgical complications in the laparoscopic group were lower than those in the conventional group (3.8% vs. 19.4%, p < 0.001), and the majority of catheter migrations and omental wraps occurred in the conventional group. Patients in the conventional group had higher American Society of Anesthesiologists scores than those in the laparoscopic group. There was no difference in the incidence of previous abdominal operation or follow-up periods in the groups. Our laparoscopy-assisted PD catheter insertion method using an intraperitoneal fixation loop is safeand can be a valuable tool in prevention of catheter migration and omental wraps.
    Journal of the Chinese Medical Association 07/2012; 75(7):309-13. DOI:10.1016/j.jcma.2012.06.001 · 0.85 Impact Factor
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    ABSTRACT: Induction therapy with interleukin-2 receptor antagonist (IL2RA) is widely used for renal transplant recipients and this study aimed to examine the impact of IL2RA among Chinese renal transplant recipients. Two hundred and thirty-eight Chinese renal transplant recipients aged 18-65 years at the Taichung Veterans General Hospital from January 2004 to July 2009 were retrospectively studied to assess the influence of IL2RA on biopsy-proven acute rejection (BPAR) within 1 year. Secondary outcomes included acute rejection rate in the first 3 months, delayed graft function, post-transplant diabetes mellitus, and malignancy. Cox proportional hazard analysis was used for multivariate analysis. Of all the patients, 116 received IL2RA (basiliximab, n = 44; daclizumab, n = 72) and 122 had no induction therapy. The mean follow-up duration was 43.3 months (range, 1-79 months). Overall, 227 (95.4%) patients completed the 12-month follow-up period with a functioning graft. No difference of BPAR was observed between the two groups and the secondary outcomes were also similar. After adjusting potential covariates with Cox regression, IL2RA use still provided no benefit on BPAR. In conclusion, there is no benefit of IL2RA in decreasing BPAR was observed in our study. Routine use of IL2RA for adult Chinese kidney transplant recipients may not be as effective as we thought before. More research is still needed to elucidate the effect of IL2RA among Chinese kidney transplant recipients.
    Renal Failure 05/2012; 34(7):856-61. DOI:10.3109/0886022X.2012.684032 · 0.94 Impact Factor

Publication Stats

172 Citations
49.61 Total Impact Points


  • 2005–2015
    • Taichung Veterans General Hospital
      • Department of Internal Medicine
      臺中市, Taiwan, Taiwan
  • 2014
    • Taichung Hospital
      臺中市, Taiwan, Taiwan
  • 2009–2010
    • National Chung Hsing University
      臺中市, Taiwan, Taiwan
  • 2003
    • Chung Shan Medical University
      • Institute of Medicine
      臺中市, Taiwan, Taiwan