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Biomedical subjects

F M Wang

Publications and source records attributed to F M Wang.

At least 19 recordsLinked to original sources

Borrelia burgdorferi infection may be the cause of sarcoidosis.

Serum antibody to Borrelia burgdorferi was measured in 33 patients with sarcoidosis which was confirmed clinically and pathologically. The results showed that 81.8% of the patients were positive for anti-B. burgdorferi antibody. In addition, a strain of B. burgdorferi was isolated from a patient's blood. Fifteen patients received ceftriaxone 2g per day or penicillin 12 million U per day. The antibody titers of the patients decreased to nearly normal levels rapidly. Serum angiotensin converting enzyme (SACE) turned to normal range after the treatment. According to the findings mentioned above, we consider that B. burgdorferi infection may be the cause of sarcoidosis and sarcoidosis might be a specific type of Lyme disease.

Adult

Types of dementia in Taiwan--a prospective study.

We prospectively investigated 100 consecutive inpatients with suspected dementia to evaluate the relative frequency of various types of dementia in a general hospital of Taiwan. Dementia was confirmed in 86 cases (86%) according to the dementia criteria of the third revised edition of the Diagnostic and Statistical Manual of Mental Disorders and Clinical Dementia Rating Scale (greater than or equal to 1). In contrast to the western developed countries, vascular dementia (VD) (35%) was the leading type of dementia, followed by Alzheimer's disease (AD) (27%), mixed VD and AD (MIX) (14%), and other degenerative diseases (10%). Ten cases (11.6%) of potentially treatable dementia were identified and 8 of 10 had good improvement after appropriate treatment. There were significant age differences among patients with MIX, AD and VD (p less than 0.01). Those with MIX were the oldest (72.12 +/- 9.4) followed by AD (69.70 +/- 8.52) and VD (64.81 +/- 9.12). Males were slightly predominant in this series (male:female = 50:36). A comprehensive clinical investigation including laboratory tests, electroencephalography and CT are necessary in the assessment of demented patients in order to make correct etiological diagnoses which lead to appropriate treatment or management of this terrifying syndrome.

Adult

[Borrelia burgdorferi may be the causal agent of sarcoidosis].

Serum antibody to Borrelia burgdorferi was measured in 33 patients with sarcoidosis who were confirmed clinically and pathologically. The results showed that 81.8% of the patients were positive. In addition, a strain of Borrelia burgdorferi was isolated from a patient's blood. Fourteen patients received ceftriaxone 2 g per day and/or penicillin 12 million per day and a patient received lincomycin 1.2 g per day. The antibody titer of the patients turned to normal level, their SACE turned to normal range, and chest X-ray findings were markedly improved in 3 cases after the treatment. According to the facts mentioned above, we consider that Borrelia burgdorferi may be the causal agent of sarcoidosis and sarcoidosis might be a special type of Lyme disease.

Adult

Congenital dacryocele. A collaborative review.

Fifty-four cases of congenital dacryocele from several medical centers were reviewed retrospectively. There was strong female preponderance (73%) and unilateral involvement (88%). Lacrimal sac contents could be expressed by local massage through the puncta in 21% of cases. Probing and irrigation were done under general (27.8%) or local (55.6%) anesthesia, while in other cases (16.7%), the cyst resolved before intervention. Recurrence of the dacryocele occurred in 10 patients (22%) after probing. Nasal cysts were visualized in six cases. Marsupialization of nasal cysts was necessary in four cases. In one center, after conservative therapy, 80% of cysts resolved spontaneously and 20% developed dacryocystitis. Surgical intervention is indicated in cases of dacryocystitis, cellulitis, breathing difficulty from large nasal cysts, recurrent dacryocele, and lack of its resolution after a short trial of digital massage.

Child, Preschool

Ocular findings in Treacher Collins syndrome.

We examined 14 patients from nine families referred with the diagnosis of Treacher Collins syndrome. We noted seven significant ocular findings including the following: a subnormal horizontal palpebral fissure length and inferomedial displacement of the lateral canthus in primary gaze; further medial displacement (4.0 mm or more) of the lateral canthus with resultant shortening of the horizontal fissure length on forced eyelid closure (fissure narrowing sign); partial-thickness eyelid colobomata localized to the nasal one half to two thirds of the lower eyelids; bilateral absence of the inferior lacrimal puncta; bilateral blepharoptosis; inferior displacement of the palpebral fissures; and regular astigmatism without any consistent orientation of the axis of astigmatism relative to the lower eyelid defects, blepharoptosis, or lateral canthus. The fissure narrowing sign correlates with known anatomic deficiencies in the Treacher Collins syndrome and may prove valuable in confirming the diagnosis in patients who lack certain typical features.

Adolescent

Sialomucin at the resection margins and likelihood of local recurrence of carcinoma of the rectum after anterior resection.

The histochemical changes in mucin at the postoperative resection margins in carcinoma of the upper and middle third of the rectum after anterior resection were studied retrospectively in 52 patients. The sialomucinous change was most likely to occur at the intestinal margins of those patients who had tumour recurrence (P less than 0.001). The histological types of tumour, degree of differentiation, Dukes' stages and their distance from the anal verge were virtually the same in patients with and without tumour recurrence. By using high iron diamine-alcian blue staining technique we identified patients with higher risk conditions of tumour recurrence after anterior resection. This technique should increase the likelihood of a cure for patients with recurrent carcinoma of the rectum after anterior resection.

Carcinoma

Anorectal abnormalities in progressive systemic sclerosis.

Seventeen patients with progressive systemic sclerosis (PSS) were evaluated with manometry for anorectal function, and an additional 36 age-matched normal subjects were collected as a control group. The study group had a significant decrement of maximum basal pressure (MBP), 42.6 +/- 27.0 mm Hg, in PSS as compared with the control group, 71.2 +/- 24.9 mm Hg (P = .0004). The difference in the functional length (FL) of the anal canal, PSS:control = 2.4 +/- 1.0 cm:3.7 +/- 0.5 cm (P = .0001); the volume of first defecating sensation, PSS:control = 66.3 +/- 35.2 ml:125.1 +/- 43.8 ml; the voluntary component, the difference between maximum squeeze pressure (MSP) and MBP, PSS:control = 116.6 +/- 73.6 mm Hg:61.8 +/- 35.9 mm Hg (P = .0087), were also found to be statistically significant. Nevertheless, the MSP and maximal tolerable capacity (Vmax) showed no difference in these two groups (MSP, PSS:control = 159.3 +/- 88.1 mm Hg:132.9 +/- 44.9 mm Hg, P = .259), (Vmax, PSS:control = 193.1 +/- 67.7 ml:230.0 +/- 60.9 ml, P = .0526). Twelve (71 percent) of 17 patients did not have rectoanal inhibitory reflex, and paradoxical contraction during rectal balloon inflation was noted in ten patients. Nine patients had different degrees of anal incontinence and abnormal anometric profiles were found in six of eight asymptomatic patients. Therefore, only two patients (12 percent) had neither symptoms nor anometric evidence of anorectal involvement in PSS. Two patients with long-standing disease received posterior anal repair for stool incontinence, the postoperative results were satisfactory both subjectively and objectively. The average MBP increased from 0 to 20 mm Hg, average FL from 0 to 1.5 cm. Patients complained less frequently about stool incontinence or soiling, and their daily life is now more comfortable. The analysis indicates that anorectal function in PSS is affected much more frequently and earlier than thought. Anorectal manometry can be used as an adjuvant in diagnosing controversial cases. Once anal incontinence occurs, posterior anal repair can achieve good results after six months of follow-up.

Adult

Anal manometric studies in hemorrhoids and anal fissures.

Manometry study with the use of continuous water perfusion system was performed for 50 patients with Grade III or IV hemorrhoids and for 29 patients with chronic anal fissure. Another 36 patients who did not have any anorectal symptom or pathology were chosen as the control group. The maximal basal pressures for the control, the hemorrhoid, and the chronic anal fissure groups were 71.2 +/- 24.9, 85.3 +/- 27.7 and 87.4 +/- 38.8 mmHg respectively; the maximal contraction pressures for the control, the hemorrhoid and the fissure groups were 132.9 +/- 44.9, 158.8 +/- 58.0 and 162.1 +/- 64.5 mmHg; while the lengths of the functional sphincter of the three groups were 3.7 +/- 0.5, 3.8 +/- 0.8 and 3.9 +/- 0.6 cm respectively. The maximal basal pressures and the maximal contraction pressures of the hemorrhoid and fissure patients were significantly greater than those of the control group; whereas the functional sphincter lengths of the three groups did not show significant difference.

Adult

The roles of hemorrhoidectomy and lateral internal sphincterotomy in the treatment of hemorrhoids--clinical and manometric study.

To compare the clinical effect of lateral internal sphincterotomy with hemorrhoidectomy and to examine the change of anal pressure before and after these two treatments, manometric study and clinical symptoms were assessed in 56 patients with hemorrhoids. These patients were randomly allocated to one of the two treatment groups. Another twenty-seven persons with sex and age match were also studied as the normal control. There was no significant difference between the mean resting anal pressure (RAP) of the controls (72.56 +/- 11.93 mmHg) and the hemorrhoid group (75.82 +/- 8.38 mmHg). Thirty-one patients received hemorrhoidectomy and there was no significant reduction of RAP postoperatively. The mean resting anal pressure of the 25 patients receiving lateral internal sphincterotomy was reduced postoperatively (75.1 +/- 9.85 mmHg VS. 70.24 +/- 7.77 mmHg). Although lateral internal sphincterotomy did reduce the anal pressure, the clinical outcome was better in hemorrhoid group. We consider hemorrhoidectomy as the optimal choice in these two kinds of treatment. Change of anal pressure may not play such an important role in the pathogenesis of hemorrhoids.

Adult

Monocular eye closure in intermittent exotropia.

Monocular eye closure in bright illumination is a common occurrence in intermittent exotropia. In a series of patients with intermittent exotropia with normal retinal correspondence and stereopsis while the eyes were in the straight position, monocular eye closure occurred in 90% of patients with normal retinal correspondence while exotropic and in only 35% of patients with abnormal retinal correspondence while exotropic. Monocular eye closure occurs in people with intermittent exotropia to avoid diplopia and visual confusion even though these are not usual complaints. The cortical adaptation of anomalous retinal correspondence prevents diplopia and visual confusion and obviates the need to close one eye in bright sunlight.

Exotropia

Successful treatment of advanced retinopathy of prematurity.

Thirty-nine eyes of 20 premature infants, mean birthweight 922 g, mean gestational age 27 weeks, with active retinopathy of prematurity (ROP), were treated. Thirty-one eyes with stage 3+ ROP and 180 degrees to 360 degrees of preretinal neovascularization received cryotherapy to ablate the zone of peripheral avascular retina. All underwent complete regression of active disease. Eight of these eyes subsequently developed retinal detachments due to ongoing vitreous traction. One detachment was inoperable. Six eyes were successfully reattached following scleral buckling surgery. One of these six redetached and became inoperable after 20 months. Pars plicata vitrectomy was not successful in reattaching the eighth case. Twenty-eight of these 31 eyes retain useful visual acuity with follow-up of 15 to 70 months (mean 41 months). There have been no complications resulting from cryotherapy. Eight other eyes with stage 4 ROP (traction retinal detachment) were treated with cryotherapy and scleral buckling surgery. All were initially reattached, but ongoing vitreoretinal traction caused redetachment in five. One was inoperable. "Open sky" vitrectomy was successful in reattaching three of the other four. Of the six cases that remained reattached with follow-up of 6 to 51 months, only two retain useful vision.

Cryosurgery

Immunohistochemical studies of colorectal carcinoma with a monoclonal antibody against carcinoembryonic antigen.

Immunoperoxidase localization of carcinoembryonic antigen (CEA) was performed on tissue sections of colorectal carcinoma using a monoclonal antibody (MAb) against CEA. CEA has been demonstrated in 20 out of 22 rectum carcinomas (90.9%), in all of 23 colonic carcinomas, in none of 4 hyperplastic polyps and in 2 out of 6 adenomatous polyps (33.3%). CEA was found more often, and the intensity of the staining was stronger in well-differentiated carcinomas than in moderately and poorly differentiated carcinomas. No correlation was found between the presence of CEA in colorectal carcinoma and the stages of the disease. The mean values of serum CEA in patients with colorectal carcinoma and polyps with negative, weakly and strongly positive staining were 5.4 +/- 3.9 ng/ml, 28.3 +/- 23.8 ng/ml and 99.8 +/- 145.3 ng/ml respectively. Elevation of serum CEA occurred in 30 out of 39 (78.9%) cases with strongly positive CEA staining, in 4 out of 6 (66.7%) with weakly positive and in 1 out 9 (11.1%) with negative staining. A significant difference was found in serum CEA activity between the group with negative CEA staining and positive CEA staining (P less than 0.01). Our results suggest that the monoclonal antibody (MAb C27) can be used for the localization of CEA in conventionally prepared tissues of colorectal carcinomas by immunoperoxidase techniques for routine immunopathological diagnosis.

Adenocarcinoma

The treatment of advanced retinopathy of prematurity by cryotherapy and scleral buckling surgery.

Seventeen eyes of nine extremely premature infants with severe acute proliferative retinopathy of prematurity (ROP, Grades III-V) were treated. Cryotherapy alone was used in ten eyes to ablate extensive areas of avascular retina to thereby induce involution of widespread intravitreous neovascularization. No attempt was made to directly treat the arteriovenous shunt or neovascularization itself. Scleral buckling surgery was used in combination with cryotherapy in seven additional eyes to relieve diffuse vitreous traction to intravitreous neovascularization which had caused extensive traction retinal detachment. Cryotherapy was uniformly successful in causing involution of widespread intravitreous neovascularization in all patients treated. Scleral buckling surgery was initially effective in reattaching the retina in all cases but late manifestations of severe ongoing vitreoretinal traction required additional open-sky vitrectomy in two eyes and resulted in inoperable recurrent total traction retinal detachment in one eye and extensive macular scarring in another. A comparison is made between the proliferative retinopathies seen in ROP and diabetes mellitus and a rationale for effective cryotherapy in ROP is presented. In our clinical experience, the single most important prognostic factor determining the potential severity of ROP is the width and extent of the retinal avascular zone. The wider the zone, the greater the probability of rapid progression from early to advanced grades of disease.

Cryosurgery

Immunological characteristics of monoclonal antibodies against human carcinoembryonic antigen (CEA).

Four hybridomas secreting monoclonal antibodies (MAbs) of the IgG1 subclass against human carcinoembryonic antigen (CEA) were obtained from fusion of P3-NS1/1-Ag4 myeloma cells with splenic cells from mice immunized with purified CEA. None of the MAbs showed cross-reactivity to perchloric acid extractable antigens from the normal human colon by an inhibition radioimmunoassay. However, MAb C27 showed the highest affinity to CEA. The intensity of immunofluorescence staining of human colorectal cancer cells with MAb C27 correlates well to the cellular CEA content of cancer cells. LS174T showed the highest intensity of fluorescence (95%) while COLO320DM and COLO320HRS were the lowest (0.5%). None of the normal human organs - colon, lungs, liver, spleen or kidneys-showed positive staining by immunoperoxidase anti-peroxidase (PA) techniques, while tissues from colorectal carcinoma (CRC), gastric carcinoma, hepatoma and lung cancer gave a positive rate of 100% (30/30), 96.6% (28/29), 32.1% (9/28) and 82.1% (69/84) respectively. Results suggest that MAb C27 can be used in immunodetection and radiolocalization of colorectal carcinoma.

Adenocarcinoma