Biomedical subjects

C R Hwang

Publications and source records attributed to C R Hwang.

6 recordsLinked to original sources

PubMed1999

Monte Carlo dynamics in global optimization.

Several very different optimization problems are studied by using the fixed-temperature Monte Carlo dynamics and found to share many common features. The most surprising result is that the cost function of these optimization problems itself is a very good stochastic variable to describe the complicated Monte Carlo processes. A multidimensional problem can therefore be mapped into a one-dimensional diffusion problem. This problem is either solved by direct numerical simulation or by using the Fokker-Planck equations. Above certain temperatures, the first passage time distribution functions of the original Monte Carlo processes are reproduced. At low temperatures, the first passage time has a path dependence and the single-stochastic-variable description is no longer valid. This analysis also provides a simple method to characterize the energy landscapes.

Crystallography, X-Ray↗

PubMed1996

Effects and limitations of prolonged intermittent ischaemia for hepatic resection of the cirrhotic liver.

Intermittent clamping of the hepatic pedicle during hepatectomy may reduce operative bleeding, but its limitations and long-term effects on the cirrhotic liver are unknown. Eighty-three patients with cirrhosis undergoing hepatectomy with repeated clamping for 15 min and declamping for 5 min were divided into three groups based on total clamping duration: group 1 less than 40 min (39 patients); group 2 40-80 min (28); group 3 more than 80 min (16). Larger tumours were associated with longer ischaemia times (P = 0.002), longer operating times, greater operative blood loss and increased blood transfusion requirements (P < 0.001), and resulted in higher postoperative levels of serum transaminases and lactic dehydrogenase (P < 0.001). Operative morbidity and mortality rates, and the late hepatic failure rate, were not affected. The longest total ischaemia time was 204 min but the uppermost time limit for hepatic ischaemia remains to be determined.

Alanine Transaminase↗

PubMed1995

Isolated resection of proper caudate lobe for hepatocellular carcinoma in cirrhotic liver: a case report.

The caudate lobe of the liver is located between the hepatic hilum and the inferior vena cava. Resection of the caudate lobe alone, without sacrificing other parts of the liver, is a surgical challenge. An isolated resection of proper caudate lobe was accomplished here in a 64-year-old man with hepatocellular carcinoma complicated by liver cirrhosis. The post-operative course was uneventful. The patient remains free of disease two years after operation. The technique used is described to advocate isolated caudate lobectomy for a patient with cirrhosis with a caudate lobe hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

PubMed1993

Spontaneous rupture of splenic hemangioma: a case report.

Splenic hemangioma is rare. The major problem concerning splenic hemangioma is the difficulty of preoperative diagnosis. No characteristic signs allow the specific diagnosis of this tumor. Spontaneous rupture is the main complication, occurring in up to 25% of cases reported. In cases of rupture of the tumor, splenectomy is a life-saving and mandatory procedure. A case of spontaneous rupture of splenic cavernous hemangioma is presented and the literature is reviewed.

Adult↗

PubMedDate not supplied

There is no need for nasogastric decompression after partial gastrectomy with extensive lymphadenectomy.

OBJECTIVE: To find out if routine nasogastric tube decompression is necessary after radical gastrectomy with systematic extensive lymphadenectomy in patients with gastric cancer. DESIGN: Prospective randomised trial. SETTING: Surgical Department, Taichung Veterans General Hospital, Taiwan. SUBJECTS: 74 patients with gastric cancer including 11 with gastric outlet obstruction who underwent radical distal gastrectomy. INTERVENTIONS: After operation, 37 patients were randomised to receive nasogastric intubation and 37 not to have it. MAIN OUTCOME MEASURES: Morbidity, mortality, and speed of recovery. RESULTS: No patient died after operation. The groups were comparable for the day of starting oral diet, rate of reinsertion of nasogastric tube and morbidity. Patients who were not intubated mobilised more quickly, and spent less time in hospital. Only one of seven patients with gastric outlet obstruction who had not been intubated needed to be so. CONCLUSIONS: Routine postoperative nasogastric decompression is unnecessary after radical gastrectomy even in the presence of gastric outlet obstruction.

Adult↗

PubMedDate not supplied

Treatment for dehiscence of pancreaticojejunostomy after pancreaticoduodenectomy: is resection of the residual pancreas necessary?

BACKGROUND/AIMS: Partial or total disruption of pancreaticojejunostomy (PJ) is a rare but serious complication after pancreaticoduodenectomy (PD). The recommended option of treatment is completion pancreatectomy. However, the mortality remains high as most patients were too critical to withstand the procedure. PATIENTS AND METHODS: 12 consecutive patients with dehisced PJ after PD were treated by oversewing the pancreatic stump without resection of the residual pancreas. RESULTS: Although a high morbidity rate (75%) occurred after our management, ten patients survived reoperation, without recurrent pancreatic fistula or the need for insulin injection. CONCLUSION: A complete pancreatectomy is not necessary for a dehisced PJ, if acute pancreatitis is not found in the residual pancreas.

Adult↗