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Biomedical subjects

C H Tseng

Publications and source records attributed to C H Tseng.

At least 37 records · Page 2Linked to original sources
PubMed1998

Improved sentinel lymph node localization in patients with primary melanoma with the use of radiolabeled colloid.

BACKGROUND: The purpose of this study was to determine whether the sentinel lymph node (SLN) localization technique, which uses blue dye and 99mTc-labeled sulfur colloid, provides advantages over blue dye alone in the management of patients with stages I and II cutaneous melanoma. METHODS: The records of 626 consecutive patients with melanoma who underwent lymphatic mapping and SLN biopsy between 1991 and 1997 at the M.D. Anderson Cancer Center were reviewed. Lymphatic mapping was performed with isosulfan blue dye alone (n = 252) or in combination with 99mTc-labeled sulfur colloid accompanied by a hand-held gamma probe (n = 374). SLNs were defined as those that stained blue or demonstrated increased focal radiotracer uptake. RESULTS: SLN identification rates improved from 87% (dye alone) to 99% (dye and colloid) (P < .0001) with the combined technique in all anatomic sites examined. The mean number of SLNs harvested from each basin was significantly greater in the patients mapped with dye and colloid (1.74 vs 1.31; P < .0001). Occult metastatic disease was identified in 17.5% of all patients and did not significantly differ between groups. In 92% of patients who had at least one positive SLN and were mapped with both agents, lymphatic metastases were identified in the SLN that contained the greatest radiotracer uptake. CONCLUSIONS: SLN identification is enhanced by the addition of radiolabeled sulfur colloid and intraoperative use of the hand-held gamma probe and may identify SLNs missed by the blue dye alone. These data support the combined use of radiolabeled sulfur colloid and blue dye in lymphatic mapping procedures to improve the nodal staging of stages I and II melanoma.

Adolescent↗
PubMed1997

NMR of laser-polarized 129Xe in blood foam.

Laser-polarized 129Xe dissolved in a foam preparation of fresh human blood was investigated. The NMR signal of 129Xe dissolved in blood was enhanced by creating a foam in which the dissolved 129Xe exchanged with a large reservoir of gaseous laser-polarized 129Xe. The dissolved 129Xe T1 in this system was found to be significantly shorter in oxygenated blood than in deoxygenated blood. The T1 of 129Xe dissolved in oxygenated blood foam was found to be approximately 21 (+/-5) s, and in deoxygenated blood foam to be greater than 40 s. To understand the oxygenation trend, T1 measurements were also made on plasma and hemoglobin foam preparations. The measurement technique using a foam gas-liquid exchange interface may also be useful for studying foam coarsening and other liquid physical properties.

Animals↗
PubMed1997

Lipid profile and peripheral vascular disease in arseniasis-hyperendemic villages in Taiwan.

To examine whether lipid abnormalities contributed to the endemic peripheral vascular disease (PVD) in villages where arseniasis was hyperendemic in Taiwan, the authors studied 533 adults with Doppler ultrasound and lipid profiles including total cholesterol, triglyceride, high- and low-density lipoprotein cholesterol, apolipoprotein AI, and apolipoprotein B. Among them, 63 had PVD based on an ankle-brachial index < 0.90. Long-term arsenic exposure indices including cumulative arsenic exposure in mg/L-years, duration of drinking artesian well water in years, and duration of living in arseniasis-hyperendemic villages in years were calculated from detailed history obtained through standardized interviews based on a structured questionnaire and arsenic concentration in well water. Possible confounders including age, sex, body mass index, cigarette smoking, and disease status of diabetes mellitus and hypertension were considered in the analyses. None of the lipid profiles differed significantly between the presence and absence of PVD. The odds ratios for PVD did not differ among different quintiles of lipid profiles with the lowest quintile as the referent. However, a significant dose-response relation was found for the long-term arsenic exposure indices. The multivariate-adjusted odds ratios for cumulative arsenic exposure of 0.1 approximately 19.9 and > or = 20 mg/L-years were 2.77 and 4.68, respectively, compared with the unexposed. These results suggest that the PVD in arseniasis-hyperendemic villages is correlated with ingested inorganic arsenic and not with the lipid profiles.

Adult↗
PubMed1996

Determinants of tissue delivery for 129Xe magnetic resonance in humans.

Magnetic resonance imaging using laser-polarized 129Xe is a new technique first demonstrated by Albert et. al. (Nature 370, 1994) who obtained a 129Xe image of an excised mouse lung. This paper describes the factors influencing the accumulation of inhaled, polarized 129Xe in human tissue. The resulting model predicts the 129Xe magnetization in different tissues as a function of the time from the start of inhalation, the tissue perfusion rate and partition coefficient for xenon, and the relevant T1 decay times. The relaxation times of 129Xe in biological tissues are not yet known precisely. Substitution of estimated values for these parameters results in an expected signal-to-noise ratio (SNR) from polarized 129Xe MR in the brain of approximately 2% of the equivalent SNR from proton MR.

Brain↗
PubMed1996

Dose-response relationship between peripheral vascular disease and ingested inorganic arsenic among residents in blackfoot disease endemic villages in Taiwan.

The purpose of this study was to examine the correlation between previous arsenic exposure and peripheral vascular disease after stopping consumption of high-arsenic artesian well water for more than two decades in blackfoot disease endemic villages in Taiwan. A total of 582 adults (263 men and 319 women, aged 52.6 +/- 10.6 years) living in these villages underwent Doppler ultrasound measurement of systolic pressures on bilateral ankle (posterior tibial and dorsal pedal) and brachial arteries and estimation for long-term arsenic exposure. The diagnosis of peripheral vascular disease was based on an ankle-brachial index (the ratio between ankle and brachial systolic pressures) <0.90 on either side. Three indices of arsenic exposure were estimated: (1) duration of living in blackfoot disease endemic villages; (2) duration of artesian well water consumption; and (3) cumulative arsenic exposure in mg/l-years based on the detailed history of residential addresses and artesian well water consumption and the arsenic concentration in artesian well water. Multiple logistic regression analysis was used to assess the association between peripheral vascular disease and arsenic exposure. A dose-response relation was observed between the prevalence of peripheral vascular disease and the long-term arsenic exposure. The odds ratios (95% confidence intervals) after adjustment for age, sex, body mass index, cigarette smoking, serum cholesterol and triglyceride levels, diabetes mellitus and hypertension were 2.77 (0.84-9.14), and 4.28 (1.26-14.54) for those who had cumulative arsenic exposure of 0.1-19.9 and > or = 20.0 mg/l-years, respectively, compared with those who were not exposed. This study suggests a close relation between long-term arsenic exposure and peripheral vascular disease in blackfoot disease endemic villages in Taiwan after stopping consumption of artesian well water.

Adult↗
PubMed1996

Color-Doppler Ultrasound-assisted endoscopic neurosurgery for intracerebral hemorrhage.

BACKGROUND: Over the past few years, the use of endoscopy in neurosurgery has gradually gained importance. In this study we described the performance of Color Doppler Ultrasound (CDU)-guided endoscopic neurosurgery in ten patients with intracerebral hemorrhage. The completeness of hematoma evacuation was also evaluated. METHODS: CDU, resectoscope, cutting loops, biopsy forcep, and the irrigation and suction device were the main instruments used in treating intracerebral hematoma. The CDU probe was utilized to locate the exact position of the hematoma and to provide direct visual control of the operation. The cutting loops and biopsy forcep were applied to morcellate and fragment the hematoma. Next, the fragmented hematoma was aspirated by a suction and irrigation device. CDU was then re-used to verify the completeness of hematoma resection and hemostasis as well as evaluate the position of midline shifting. RESULTS: The completeness of hematoma evacuation in our patient series was over 90% in three patients, over 50% in five patients, and less than 50% in two patients. One patient showed signs of rebleeding two days post-operatively and underwent conventional craniotomy. CONCLUSIONS: This endoscopic neurosurgical procedure caused less trauma around and along the route to the hematoma, and inflicted less damage to healthy brain tissue. Sonography, especially CDU, is quite helpful in the localization of hematoma and evaluation of intra- or post-operative bleeding. The operation time was also significantly shortened as compared to conventional craniotomy, thereby reducing the risk of operation.

Aged↗
PubMed1995

Changes in pulmonary mechanics and gas exchange after thoracentesis on patients with inversion of a hemidiaphragm secondary to large pleural effusion.

The present study was designed to test whether there was a significant improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracentesis on patients with inversion of a hemidiaphragm due to pleural effusion. In 21 patients with inversion of a hemidiaphragm because of a pleural effusion, we studied the changes in pulmonary mechanics and gas exchange that occurred in 24 h after removal of 600 to 2,700 mL of fluid by thoracentesis. There was a small but significant increase in the forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) (p < 0.001). The alveolar-arterial oxygen gradient (P[A-a]O2) and partial pressure of arterial oxygen (PaO2) showed a significant increase (p < 0.001), but there was no change in partial pressure of arterial carbon dioxide (PaCO2). In the present study, all patients with a large pleural effusion had inversion of a hemidiaphragm documented by chest sonography, and that was an important factor to observe significant improvement in pulmonary mechanics and gas exchange.

Adult↗
PubMed1995

Body composition and its relationship with physical activity and anthropometric factors in Chinese adults.

To evaluate the relationship of body composition with physical activity and other anthropometric factors, a group of 437 healthy Chinese men and women were recruited. Body composition was measured using the bioelectric impedance technique. Levels of physical activity (LPA) were classified as light, moderate and heavy. Anthropometric factors evaluated included body mass index (BMI), ponderal index (PI), waist-to-hip ratio (WHR), triceps skinfold thickness (TSF), mid-arm circumference, mid-forearm circumference, arm muscle circumference (AMC) and arm muscle area (AMA). Sex was found to be highly associated with body composition, with females having a higher percentage of body fat and males having a higher percentage of body lean mass. This gender difference was independent of age, physical activity or other anthropometric factors. An increased level of physical activity was associated with higher body lean mass and lower body fat. Sex, LPA, TSF, PI and WHR were all entered into the regression equations to estimate body composition. Sex and physical activity have an independent effect on body composition and the commonly used estimators for adiposity and fat distribution such as BMI, PI, TSF and WHR are closely correlated with body composition.

Adult↗
PubMed1995

Fibrolamellar variant of hepatocellular carcinoma--report of a Chinese patient.

Fibrolamellar hepatocellular carcinoma is rare. By chance, a Chinese woman detected a mass in the right upper quadrant of the abdomen. Ultrasonography, computed tomography and magnetic resonance imaging revealed a solid tumor with a central fibrous scar locating at the posterior inferior subsegment of the right hepatic lobe. The tumor was successfully resected and histopathological examination revealed a fibrolamellar hepatocellular carcinoma. Our case shows that fibrolamellar hepatocellular carcinoma may also occur in Chinese as well as in Japanese and Westerners.

Adult↗
PubMed1995

Prior epidural injection of 10 ml normal saline reduces the incidence of inadvertant venous puncture in epidural catheterization.

BACKGROUND: Anesthetically, epidural neural blockade is widely used in the fields of surgery and obstetrics as well as in diagnosis and management of acute and chronic pain. However, inadvertent epidural venous puncture might be a serious problem, or even life-threatening particularly when drug is erronaneously injected and prompt diagnosis is not made correct and treatment is not instituted. Although many anesthesiologists suggested that injection of fluid into the epidural space before catheter insertion could prevent an epidural venous puncture, some others did not agree to it. This study aimed a assess the effect of injection of different volumes of saline into the epidural space before catheter insertion on the incidence of epidural venous puncture. METHODS: Three hundred ASA I or II patients receiving Extracorporeal Shock Wave Lithotripsy (ESWL) were randomly divided into three groups: group A (no saline), group B (5 ml of saline) and group C (10 ml of saline). After the injection of different volume of saline into the epidural space, an epidural catheter was inserted into the epidural space via a Touhy needle. The incidence of epidural venous puncture in each group was compared. RESULTS: The incidence of epidural venous puncture in group A and B was 14% and 11%, respectively. However, the incidence in group C (1%) was significantly lower than the other two groups. CONCLUSIONS: Our results suggest that injection of 10 ml saline into the epidural space before catheter insertion could significantly diminish the incidence of epidural venous puncture.

Adult↗
PubMed1994

Mortality in diabetic patients after lower extremity amputations.

This study evaluates the prognostic factors and causes associated with mortality in Chinese diabetic patients after lower extremity amputations. Medical records of all diabetic patients admitted to the National Taiwan University Hospital for leg amputations from 1982 to 1991 were reviewed. Demographic data, medical history, amputation levels and admission routines, including fasting plasma glucose, cholesterol, triglycerides, blood urea nitrogen, creatinine, urine protein and electrocardiograms, and bacterial culture done during the admission period were recorded. The vital status of the patients was followed by personal contact and mortality was ascertained from government computer records. The causes of death were recorded according to the death certificates. Univariate analysis and multivariate Cox's proportional hazards model were used to identify the prognostic factors associated with mortality. A total of 87 diabetic amputees, of whom 34 died, were found within this 10-year period. Cerebral infarction, infection and diabetes mellitus were the most commonly reported causes of death. Their calculated mortality was 5.95 times higher than the mortality rate of the age-comparable population in Taiwan. A history of hypertension and coronary heart disease were found to be the best indicators for predicting a fatal outcome with rate ratios of over two-fold. This study shows that post-amputational mortality is high in diabetic patients and that the major cause of death is cerebral infarction. The major cause of death in this study differs from that reported for Caucasians, for whom cardiovascular disease is the most important cause of death.

Adult↗
PubMed1994

Atherosclerotic risk factors for peripheral vascular disease in non-insulin-dependent diabetic patients.

The purpose of this study was to evaluate risk factors associated with peripheral vascular disease (PVD) in patients with non-insulin-dependent diabetes mellitus (NIDDM). A group of 100 patients (50 men and 50 women) aged 50 years or over with PVD and another group of 200 age-sex-matched patients (100 men and 100 women) without PVD were studied. The mean +/- standard error of ages for subjects with and without PVD were 60.8 +/- 0.6 years and 59.7 +/- 0.3 years, respectively. Doppler ultrasound was used to measure the systolic pressures of the brachial, posterior tibial and dorsal pedal arteries bilaterally. The diagnosis of PVD was made by an ankle-brachial index (ABI) < 0.90 and the diagnosis of non-PVD by an ABI > 1.00. The association of PVD with diabetic duration, body mass index (BMI), cerebral infarction (CI), coronary heart disease (CHD), proteinuria, diabetic retinopathy, neuropathy, hypertension, and cigarette smoking was evaluated. In addition, biochemical data including fasting plasma glucose, hemoglobin (HD)Alc, cholesterol, triacylglycerol, high- and low-density lipoprotein cholesterol, uric acid, blood urea nitrogen (BUN) and creatinine (Cr) were studied. In univariate analysis, PVD was associated with an increased level of systolic blood pressure (SBP), BUN and Cr, cigarette smoking, CI, CHD, proteinuria and retinopathy. In stepwise logistic regression analysis, the level of SBP, cigarette smoking and CI remained statistically significant. The log odds of PVD could be expressed as: -2.834 + 0.013 (SBP in mmHg) + 0.577 (cigarette smoking) + 1.320 (CI). PVD is the result of aggregation of atherosclerotic risk factors; among those factors noted in this study, SBP, cigarette smoking and CI are important.

Arteriosclerosis↗
PubMed1994

Dupuytren's contracture: report of a Taiwanese case.

This case of Dupuytren's contracture was seen in a 65-year-old Taiwanese male farmer patient. The patient complained of a progressive inability to fully extend the ring and middle fingers of his dominant hand over the last three years. Clinically, a longitudinal cord-like mass surrounded the distal palmar crease of the hand and digital flexion contraction of the ring finger was more affected than the middle finger. Histopathologically, the excised tissue was of a mixed, moderate and scantily cellular type. After surgical treatment by limited fasciectomy, the patient's hand recovered fully. No recurrent contracture was noted after three years of follow-up.

Aged↗
PubMed1994

Grip and pinch strength in Chinese adults and their relationship with anthropometric factors.

In this study, we evaluated the correlation of four types of hand strength (hand grip, tip pinch, palmar pinch and key pinch) with age, sex, body weight, body height, body mass index, triceps skinfold thickness, mid-arm circumference and mid-forearm circumference in a group of 437 Chinese adults (195 men and 242 women) who ranged in age from 28 to 78 years. All of the hand strengths studied correlated positively with gender, body weight, body height, mid-arm and mid-forearm circumference and negatively with age and triceps skinfold thickness in the analyses of simple correlation coefficients. Men were found to be more powerful than women in all hand strength types in different age groups. The magnitude of strength decline with age was more prominent in grip strength than pinch strength including palmar, tip and key. Stepwise multiple regression analyses showed that sex, age and mid-forearm circumference were most predictive of all types of hand strength. Body height was an additional independent predictor of grip and palmar pinch. Body mass index, body weight, mid-arm circumference and triceps skinfold thickness were not independent predictors associated with hand strength.

Adult↗
PubMed1994

Ten-year clinical analysis of diabetic leg amputees.

The clinical characteristics of 234 amputees admitted to the National Taiwan University Hospital during a 10-year period were analyzed. Diabetes mellitus accounted for 37.2% (87 cases) of the amputations and was the most commonly associated disease. Malignancy was the second cause of amputation (16.2%). Traffic accidents and atherosclerosis (without diabetes mellitus) each accounted for about 13% of the amputations. Below-knee amputation was the most commonly performed procedure among the diabetics, while above-knee, below-knee and ray amputations were roughly equally performed among non-diabetic patients. Reamputations were done in 16 diabetic and 12 non-diabetic patients, mostly within a short period of time after the first amputation. Four of the diabetic reamputations and nine of the non-diabetic reamputations were performed on the same side as the first amputation. The mean +/- standard error of admission days and total expenses for each episode of amputation were 36.2 +/- 2.7 days and 116.5 +/- 1.7 thousand New Taiwan dollars for the non-diabetics and 41.3 +/- 4.0 days and 134.0 +/- 16.0 thousand New Taiwan dollars for the diabetics, respectively. We concluded that: 1) diabetes mellitus was the main cause of amputation; 2) diabetes mellitus was associated with a higher rate of reamputations of the contralateral legs; and 3) a multidisciplinary foot-care team is essential for the management of lower leg amputations.

Adult↗