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Biomedical subjects

C J Wang

Publications and source records attributed to C J Wang.

At least 127 records · Page 7Linked to original sources
PubMed1998

Bilateral pathological femoral neck fractures secondary to ectopic parathyroid adenoma.

A rare case of bilateral pathological femoral neck fractures secondary to ectopic parathyroid adenoma is reported. Both hip fractures were treated with closed reduction and internal fixation. The right hip fracture healed uneventfully, whereas the left hip fracture developed non-union that required subtrochanteric osteotomy and internal fixation and eventually healed. Neither hip developed avascular necrosis.

Adenoma↗
PubMed1998

Promotional effect of N-nitroso-N-(3-keto-1,2-butanediol)-3'-nitrotyramine (a nitrosated Maillard reaction product) in mouse fibroblast cells.

N-Nitroso-N-(3-keto-1,2-butanediol)-3'-nitrotyramine (NO-NTA) is a product of model browning system generated in the presence of sodium nitrite. The chemical structure of this compound has been confirmed by UV, mass and nuclear magnetic resonance, and infrared spectroscopy in our previous study. A two-stage transformation protocol was used to chemically transform the mouse embryo fibroblasts C3H10T1/2 cells. To initiate transformation, the cells were treated with benzo[a]pyrene (BaP) (0.1 mg/ml), and NO-NTA (0.01, 0.1 and 1 mg/ml) was employed subsequently to complete the transformation process. Malignant transformed foci were formed in BaP-initiated and NO-NTA promoted C3H10T1/2 cells after 8 wk. Cells treated with NO-NTA alone failed to induce transformation. However, cells initiated with BaP and promoted by cells initiated with BaP and promoted by NO-NTA demonstrated oncogenic properties. Cell lines transformed with NO-NTA-transformed colonies exhibited enhanced growth rate, anchorage independence and tumorigenicity in animals relative to parent cells. These results indicate that NO-NTA is a new tumour promoter and may induce tumour promotion by two-stage oncogenesis. Further studies on the mechanism of action of NO-NTA are now in progress.

Animals↗
PubMed1998

The prognostic factors of lung cancer patients with brain metastases treated with radiotherapy.

PURPOSE: To analyze the prognostic factors of lung cancer with brain metastases (BM) and evaluate the role of cranial irradiation on survival. METHODS AND MATERIALS: From 1987 to 1994, 159 lung cancer patients with CT scan documented BM were reviewed. All of them underwent cranial irradiation (median radiation dose: 30 Gy). Chemotherapy and surgery of BM were performed in 21 and 10 cases, respectively. RESULTS: Overall median survival was 3.5 months and one year survival rate was 10.69%. Univariate analysis showed that the significant factors were performance status, age, total radiation dose to brain, BM as the first metastasis, neurosurgery, symptoms of urine/stool incontinence, and synchronous BM. Multivariate analysis indicated that (1) performance status (p = 0.0002), (2) total radiation dose (p = 0.0032), (3) BM as the first metastasis (p = 0.0449), (4) neurosurgery (p = 0.0233), (5) symptoms of urine/stool incontinence (p = 0.0002), and (6) the presence of a midline shift on cranial CT scans (p = 0.0063) were significant prognostic factors. CONCLUSION: The prognosis of BM in lung cancer patients is extremely poor. Radiotherapy appears as an effective means of palliation with 75% overall symptomatic response rate. Higher radiation dose (> or = 30 Gy) and neurosurgery are associated with longer survival. Good performance status, BM as the first metastasis, absence of sphincter dysfunction, and midline shift on CT scans are favorable prognostic predictors. The role of midline shift is very interesting and needs to be explored further.

Adult↗
PubMed1998

Postoperative analgesia by intra-articular neostigmine in patients undergoing knee arthroscopy.

BACKGROUND: Recently, the spinal administration of neostigmine was shown to produce a dose-dependent analgesia. However, this analgesia is limited by adverse effects. The purpose of this study was to examine the analgesic action of peripheral muscarinic receptors by administering intra-articular neostigmine after operation in patients undergoing knee arthroscopy. METHODS: Sixty patients (classified as American Society of Anesthesiologists status I or II) having arthroscopic meniscus repair during general anesthesia were randomized to receive, in a double-blind manner, after operation 125, 250, or 500 microg intra-articular neostigmine; 2 mg intra-articular morphine; or as control groups intra-articular saline or 500 microg neostigmine given subcutaneously (s.c.). Visual analog pain scores (VAS), duration of analgesia as defined by first demand for patient-controlled analgesia by morphine, and subsequent 48-h consumption of morphine were evaluated. RESULTS: Intra-articular (500 microg) neostigmine resulted in significant VAS reduction 1 h after injection compared with patients given intra-articular saline and with those given intra-articular morphine. Analgesia lasted longer after 500 microg intra-articular neostigmine (350 +/- 126 min) compared with intra-articular morphine (196 +/- 138 min; P < 0.05) or with the control groups (intra-articular saline, 51 +/- 11 min; s.c. neostigmine, 46 +/- 8 min; P < 0.05). The need for supplementary analgesia was significantly higher in control groups than for patients given intra-articular morphine or 500 microg intra-articular neostigmine. No significant analgesic effects were observed for the two lower doses of intra-articular neostigmine. Among all study groups, no adverse effects were observed. CONCLUSIONS: Intra-articular injection of the acetylcholinesterase inhibitor neostigmine produced a moderate but significant analgesic effect. Several mechanisms such as the hyperpolarization of neurons, reduction in the release of pronociceptive neurotransmitters, or activation of the nitric oxide-cyclic guanosine monophosphate pathway might mediate this peripheral cholinergic antinociception by elevating endogenous acetylcholine.

Adult↗
PubMed1998

Management of small infected tibial defects with antibiotic-impregnated autogenic cancellous bone grafting.

Between January of 1991 and December of 1993, 36 patients who had tibia fractures complicated by small infected tibia defects were treated at the authors' service. The group included 30 men and 6 women whose average age was 36.5 years (range, 18-72 years). The average follow-up period was 3.7 years. By using the Cierney-Mader staging classification of chronic osteomyelitis, 26 of 36 patients (72%) were stage 4A and 10 of 36 patients (28%) were stage 4B. Ten patients required muscle transfer. All patients were treated with a two-stage protocol. In the first stage, antibiotic-impregnated polymethylmethacrylate bead chains were used to obliterate the debrided osseous defect. In the second stage, the beads were removed, and the defects were reconstructed with antibiotic-impregnated autogenic cancellous bone graft. The time between the first and second stage was 2 to 8 weeks for patients without muscle transfer and 8 to 12 weeks for the patients with muscle transfer. The bone defects ranged from 2 to 4 cm. Wound healing and bony union were achieved in all patients. Only two patients had recurrent infections. The infection arrest rate was 94.4%. Minor pin tract infection of the external skeletal fixation was seen in two patients. Two patients developed skin rashes secondary to antibiotic therapy. Radiographs at an average follow-up of 3.7 years showed good consolidation and hypertrophy of grafted bones in all patients. After 3 to 5 years of follow-up, our results suggest that the use of impregnating antibiotics have no adverse effects on autogenic cancellous bone graft incorporation and may help to eliminate infection. This treatment protocol provided rapid recovery from osteomyelitis. The use of antibiotic-impregnated autogenic bone graft seems to be an effective and safe method for the management of small infected tibial defects.

Adolescent↗
PubMed1998

In vivo and in vitro studies on the antitumor activities of MCP (Malva crispa L. Powder).

Four short-term in vivo and in vitro tests were used to further confirm the antitumor activities of MCP, a vegetable powder, prepared from Malva crispa L. (i) In the H22 hepatoma-transplanting test, MCP had antitumor action, but MCP residue did not show such action; 5-FU appeared to have more potent antitumor activities and more harmful effects than MCP. (ii) In the micronucleus (MN) test, MCP significantly decreased MN frequency. (iii) In the cancer cell culture systems, the MCP fat-soluble extract revealed inhibitory effects on the growth and proliferation of the human hepatoma and the gastric cancer cells in a dose-response manner. (iv) In the colony formation test, MCP also altered the morphology of human gastric cancer cells. It was suggested that MCP could be consumed not only by healthy subjects for cancer prevention but also by patients with cancer as supplementary treatment in combination with anticarcinogenic drug such as 5-FU, cyclophosphamide (CP).

Animals↗
PubMed1998

Pituitary adenomas in the old-aged.

From 1986 to 1996, 187 patients with pituitary adenoma were diagnosed and received surgery at Kaohsiung Medical College Hospital. Of which, 29 patients older than 60 years were retrospectively studied. Their initial clinical symptoms, pathological findings, immunoperoxidase staining, electronic microscopic findings and hormone levels were retrospectively recorded. We found that the old patients more often suffered from the neurological deficit such as headache and visual problems rather than endocrine of the tumors cells are compared, and fewer cells and nuclei are found in the older group than that in the younger group. The secretary granules in functioning tumors especially prolactinomas in old-aged patients are larger than those in the young patients. The tumor cells in the old-aged patients have fewer subcellular organelles and secretary granules but have large secretary granules. It is concluded that: (1) transsphenoidal surgery is feasible and safe in this age group; (2) plurihormonal tumors occur more frequently in old-age than young patients; (3) clinically endocrine-inactive pituitary adenomas occur more often in old-aged; (4) pituitary adenomas in old-aged cause neurological deficit more frequently than endocrine disturbance.

Adenoma↗
PubMed1998

Successful resection of a teratoma of the third ventricle in a 3-year-old boy.

Few cases of teratoma in the third ventricle have been reported in detail. We describe a 3-year-old Chinese boy presenting with increased intracranial pressure, headache, and vomiting. Preoperative computed tomography and magnetic resonance imaging demonstrated a teratoma in the third ventricle. Complete excision of the tumor was achieved through the interhemispheric transcallosal approach. The patient did well and was without neurologic deficits postoperatively. Although the majority of tumors located in the third ventricle are malignant and can penetrate the brain tissues that constitute the wall of the third ventricle, mature teratomas are an exception and total removal may be possible.

Cerebral Ventricle Neoplasms↗
PubMed1998

Hypertrophic osteoarthropathy in nasopharyngeal carcinoma patients: two cases report.

Hypertrophic osteoarthropathy (HOA) is a rheumatic disorder characterized by digital clubbing, bone pain, and arthralgia. HOA can be idiopathic or secondary to a variety of pulmonary, cardiogenic, or malignant disorders. We present 2 male patients, aged 46 and 42, with advanced nasopharyngeal carcinoma (NPC) who developed HOA 1-4 years after radiotherapy. Differential diagnosis between HOA and coexisting bone metastasis must be made with caution. We found bone scintigraphy to be the most sensitive tool to distinguish between these 2 disease. Intense symmetrical uptake of radioisotope along the cortex of long bones, so-called parallel tract sign, is typical. Plain radiographs demonstrating prominent periosteal reaction were also effective for this. The rheumatic manifestation of HOA was paraneoplastic and related to pulmonary metastasis. The clinical manifestation of the 2 patients suggested that pulmonary metastasis should be suspected in NPC patients when HOA appears.

Adult↗
PubMed1998

Anesthesia for pediatric herniorrhaphy or hydrocelectomy: comparison of propofol/ketamine and thiopentone/halothane.

Total intravenous anesthesia has recently become available for ambulatory surgery. It has the advantages of decreased air contamination from volatile anesthetics and decreased exposure of operating room personnel to volatile anesthetics. The purpose of this study was to compare the anesthetic properties of propofol/ketamine (total intravenous) anesthesia and thiopentone/halothane (intravenous and gaseous) anesthesia for herniorrhaphy or hydrocelectomy in children. Sixty children aged 2 to 7 years scheduled for herniorrhaphy or hydrocelectomy were allocated to two groups. The propofol/ketamine group (group 1) received a loading dose of intravenous propofol 3 mg/kg followed by propofol infusion 200 micrograms/kg/minute; additional bolus doses of propofol 1 mg/kg were given as needed or the infusion dose was increased or decreased by 33 micrograms/kg/minute as needed. Ketamine 1 mg/kg was administered intravenously 2 to 3 minutes before herniorrhaphy or hydrocelectomy to reinforce the analgesic and anesthetic effects of propofol. The thiopentone/halothane group (group 2) received intravenous thiopentone 6 mg/kg followed by halothane with 40% oxygen using a mask. Group 2 patients maintained spontaneous breathing with intermittent assistance and group 1 patients maintained spontaneous natural airway breathing during anesthesia. The scores on the postoperative assessment scale were higher in group 2 patients, indicating poorer anesthesia recovery characteristics, but the differences were not significant. Pain on injection was more frequent in group 1 (12/32) than in group 2 (2/28). The incidence of vomiting in group 2 (6/28) was significantly higher than in group 1 (0/32). We conclude that propofol/ketamine allows patients to maintain spontaneous natural airway breathing during anesthesia, and its analgesic and anesthetic effects are comparable to those of thiopentone/halothane. Propofol/ketamine is appropriate for pediatric herniorrhaphy and hydrocelectomy. It can be recommended for pediatric ambulatory surgery.

Anesthesia↗
PubMed1998

Injection pain with propofol: the effectiveness of thiopentone on induction.

One hundred and twenty-seven children aged 3-6 years were allocated to four groups. All of them received venous cannulation on the dorsum of the hand. On induction, the group L1, L2 and L3 patients received propofol 3 mg/kg mixed with lignocaine 0.15 mg/kg, 0.3 mg/kg, 0.6 mg/kg, respectively. The group T patients received thiopentone 3 mg/kg, then propofol 1.5 mg/kg mixed with lignocaine 0.075 mg/kg. Pain on injection was categorized into two-assessment items (facial expression and limbs withdrawal). The facial expression category were subdivided into none, mild (knit of brows), moderate (grimace), and severe (crying). The withdrawal of limbs was categorized into none, mild (withdrawal of hand), moderate (withdrawal of fore-arm and arm), severe (withdrawal of arm and twisting of body). Patients were monitored using an electrocardiogram, pulse oximeter, autonomic noninvasive blood pressure measuring device and capnography. The patient characteristics did not differ significantly among the four groups. Pain on injection was significantly more frequent in the group L1 patients (81%) compared with the group T (27%) patients. Increasing lignocaine dose reduced the incidence of pain graded as "moderate" or "severe" though there was no significant difference. The incidences of excitatory effect on propofol injection were reduced with increasing lignocaine dose and prior administration of thiopentone but there were no obviously differences among groups. We concluded that thiopentone reduced injection pain on propofol and should be recommended.

Anesthetics, Intravenous↗
PubMed1998

Neurodevelopment of surviving infants at age two years, with a birthweight less than 2000 g and cared for in neonatal intensive care units (NICU)--results from a population based longitudinal study in Taiwan.

All surviving infants from nine neonatal intensive care units (NICU) in a southern city and county of Taiwan were followed up and assessed at 2 y of age if they had a birthweight of less than 2000 g and were born between February 1, 1993 and January 31, 1994. The assessments included: neurological, growth and general health. A comparison group of normal birthweight and full-term infants without congenital anomalies, matched by birth month and sex to the NICU survivors was also studied with respect to the same outcome measures. A developmental delay (either a severe neurological deficit or Mental Development Index < 68 or Psychomotor Development Index < 68) was present in 21 (15.4%) of the cases, compared to 3 (2.5%) of the controls (P < 0.0004). Significant correlates of developmental outcome for the cases were birthweight, gestational age, and maternal education. The very low birthweight (VLBW) children (< 1500 g) in our study cohort had a comparatively higher incidence of severe neurological deficits (and cerebral palsy) than that reported by other similar studies in developed countries. The incidence of abnormal neurodevelopmental outcome remained high in the graduates of NICU at 2 y of age, compared to that in normal controls. The findings have important implications in future health policy making regarding postnatal management of the surviving infants of NICU in developing countries such as Taiwan.

Case-Control Studies↗
PubMed1998

Pregnancy in a previous cesarean section scar: case report.

An ectopic pregnancy developing in a previous cesarean section scar is an extreme rarity among all ectopic pregnancies. Due to the difficulty of making an accurate diagnosis, this kind of ectopic pregnancy is the most dangerous and life-threatening type. A 30-year-old woman, who was gravida 4, para 3, was admitted to our emergency room with massive vaginal bleeding. She had undergone a cesarean section due to a breech birth 3 months prior to this admission. Ultrasound examination showed a pregnancy located in the low corpus uterus. The possibility of a spontaneous abortion in progress or a cervico-isthmic pregnancy were considered. Due to the massive vaginal bleeding and unstable vital signs of the patient, surgical intervention was decided upon to save the woman's life. We first performed dilatation and curettage. There was no gestational villi and severe vaginal bleeding was noted during this procedure. An emergent exploratory laparotomy was then performed, followed finally by a hysterectomy. Pathologic findings confirmed the diagnosis of a pregnancy in the previous cesarean section scar. Diagnosis, prevention, clinical evaluation and management of these conditions are discussed.

Adult↗
PubMed1997

Potential effect of sodium nitrite on the expression of nuclear proto-oncogenes during 2-acetyl aminofluorene-induced hepatocarcinogenesis in rats.

2-acetyl aminofluorene (AAF) reacts in acidic conditions with nitrous fume yielding N-nitroso-AAF (N-NO-AAF), as previously described, that exerts more toxic and mutagenic effects than its parental compound. In this study, the effect of sodium nitrite (NaNO2) on the tumorigenicity of AAF in rats fed with AAF and NaNO2 was observed. Wistar rats were divided into five groups: group I served as control; group II were treated with NaNO2 (0.3%); group III was given 0.02% AAF alone; groups IV and V received both AAF and NaNO2 (0.2 and 0.3% respectively) in their diet for 12 weeks. At the end of the experiment, all rats in groups III, IV and V developed early stage phenomena of hepatocellular carcinoma, including hepatomegaly with variable-sized foci and neoplastic nodules. Severe damage was observed in the rats treated with AAF and NaNO2. Feeding of AAF (0.02%) for 3 months elevated the levels of c-Fos, c-Jun and c-Myc proteins in the rat livers. The AAF-induced c-Jun, c-Fos and c-Myc expressions were significantly magnified (P < 0.001) by NaNO2. These data confirmed that the strengthening of AAF-induced hepatocarcinogenesis by NaNO2 should be associated with its enhancing effect on the AAF-induced increases in the expressions of c-Jun, c-Fos and c-Myc.

2-Acetylaminofluorene↗
PubMed1997

The role of nitric oxide in the control of plasma glucose concentration in spontaneously hypertensive rats.

Glucose homeostasis was studied in the spontaneously hypertensive rat (SHR). The fasting plasma glucose levels were similar in the SHR and normotensive Wistar-Kyoto (WKY) rat (102.7+/-2.4 vs. 107.4+/-4.2 mg/dl, P > 0.01). One hour after glucose challenge, the plasma glucose level was slightly but insignificantly increased in both SHR and WKY rat (117+/-2.5 vs. 114.3+/-3.2 mg/dl, P > 0.01). After N(G)nitro-L-arginine methyl ester (L-NAME) 20 mg/kg per day was administered intraperitoneally (i.p.) for 4 days, the plasma glucose level was significantly increased in the rats (SHR 167.3+/-4.9; WKY rat 136.0+/-4.8 mg/dl); the increase was significantly more pronounced in the SHR. The fasting insulin levels were similar in the SHR and WKY rats (2.3+/-0.4 vs. 2.0+/-0.3 ng/ml, P > 0.01). One hour after glucose challenge, the insulin level was significantly increased in the WKY rat (4.8+/-0.7 ng/ml) but not in the SHR (2.2+/-0.4 ng/ml). With L-NAME treatment, plasma insulin increase was noted in the WKY rat but not SHR (4.6+/-0.6 vs. 2.6+/-0.4 ng/ml, n = 8, P < 0.01). One hour after insulin 1 IU/kg was injected intramuscularly (i.m.), the plasma glucose level was significantly decreased in both the SHR (from 115.0+/-6.5 to 48.6+/-3.6 mg/dl, n = 8) and WKY rat (from 108.3+/-3.8 to 52.6+/-4.2 mg/dl, n = 8). No significant difference was noted between the decrease of the two groups (P > 0.01). The present findings suggested that NO plays a role in the glucose homeostasis of rats. NO-synthase blockade resulted in an increase of plasma glucose level. The SHR maintains normal glucose level and tolerance in spite of a defective insulin release response. This is probably due the compensatory effect of a more prominent NO-dependent glucose homeostatic function.

Animals↗
PubMed1997

Lying-on position of total skin electron therapy.

PURPOSE: A technique for whole-body electron therapy with the patient in a lying position has been developed. This technique allows Total Skin Electron Therapy (TSET) for those patients who were previously unable to be treated in a conventional standing position. METHODS AND MATERIALS: This study was carried out on a Varian 2100C linear accelerator with a 6 MeV high dose rate electron beam. The collimator was open to a width of 36 x 36 cm. There were two main procedures, with six dual-field techniques: 1) two static AP/PA vertical dual fields (VDF): the patient laid on the floor transversely under the collimator when the gantry was in a vertical position. A 0.6 cm acrylic board was placed 15 cm away from the patient, then the gantry was rotated 25 degrees clockwise and counterclockwise to treat the patient in the supine and prone positions, respectively. 2) Four oblique junction fields (OJF): the patient laid on the floor in a prone and supine position parallel to the wave guide at (227 - body thickness x tan 60 degrees) cm away from the vertical axis of the gantry, then the gantry was rotated 60 degrees toward the patient. A 0.6 cm acrylic board was placed 15 cm away from the patient perpendicular to the beam. The patient was move along the field central axis. It allowed the patient's body to be within the 160 cm effective treatment profile. When the patient's body axis move 5 degrees toward the lateral side of the field central axis, we could obtain a better dose distribution in the vertex of the scalp and the soles of the feet. The angle of the VDF was measured by chamber detectors to obtain the effective treatment profile. Likewise, the optimal profile for the OJF was determined by the same procedures. The Rando phantom was used to measure the superficial dose of the body. RESULTS: The dimension of effective treatment profile for the VDF was 188 x 72 cm at 87% dose level For the OJF, we had to move the patient along the field central axis to obtain the effective treatment profile in a 180 x 85 cm dimension at a 87% dose level. The vertex and sole dose measured in this setup was in the range of 80-88%. CONCLUSIONS: The empirical data showed that the lying-on position for TSET was technically feasible. The dose distribution in the body surface was also compatible with the Stanford standing technique. The nonambulatory skin malignancy patient can be treated in a comfortable and reproducible position.

Electrons↗