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Biomedical subjects

H H Hu

Publications and source records attributed to H H Hu.

At least 19 recordsLinked to original sources
PubMed1995

Prevalence and subtypes of dementia in Taiwan: a community survey of 5297 individuals.

OBJECTIVE: To study the prevalence rate of dementia in Taiwan, the relative frequencies of its subtypes, and its associations with age, education, gender, and residence location. PARTICIPANTS: A total of 2753 men and 2544 women from four urban and four rural communities participated. Their age ranged from 41 to 88 years; 28% of them were at least 65 years old. Their education ranged from 0 to 20 years; 27% of them had less than 1 year of formal schooling. DESIGN: Phase I was a screening survey by trained nurses who administered a Chinese version of the Mini-Mental State Examination, the MMSE-T1, to all participants. Phase II involved the assessment for dementia by neurologists on the 1521 individuals who had scored less than 24 on the 30-point MMSE-T1. MAIN RESULTS: Thirty-one cases of dementia were identified by the DSM-III-R criteria, including 18 cases of Alzheimer's disease, 10 cases of vascular dementia, and three cases of other dementias. The prevalence rate in individuals aged 65 and over was 2.0%. Aging and illiteracy were associated with higher rates of dementia; gender and residence location made no difference. CONCLUSIONS: The prevalence rate of dementia was low in this Chinese population. Consistent with common findings from other parts of the world, a high rate of dementia was associated with older age and illiteracy, and Alzheimer's disease was the most frequent cause.

Adult↗
PubMed1995

Clinical significance of the ophthalmic artery in carotid artery disease.

A total of 141 subjects with tight stenosis (> or = 75%) or occlusion of internal carotid artery were followed up at intervals 3-6 months regularly for 40 +/- 16 months. The direction of ophthalmic artery flow was used as a parameter of risk indicator on cerebral ischemic events. Eleven patients with bilateral carotid tight stenosis/occlusion were excluded in the analysis. Thus, the 130 carotid arteries were divided into three groups: (1) carotid artery with ipsilateral hemispheric TIA or stroke (85 patients), (2) carotid arteries with contralateral hemispheric TIA/stroke or VBI (15 patients), and (3) carotid arteries of asymptomatic patients (30 patients). The symptomatic carotid artery group (group 1) had significantly more often reversed ophthalmic flow than the other two groups (group 2 and 3, p < 0.001). During follow-up prospectively for four years, 41 patients had cerebral ischemic events, three had cardiac ischemic events and six died of malignancy. Patients with reversed OA flow had more often subsequent cerebral ischemic events than those with forward flow (27 vs 14, p = 0.010). However, the difference remained significant only in the asymptomatic patients (group 3, 4 vs 0, P < 0.001), not for groups 1 and 2, after further analysis. Our work supported that the clinical role of ophthalmic artery collateral varied between asymptomatic and symptomatic patients.

Aged↗
PubMed1995

Transorbital color Doppler flow imaging of the carotid siphon and major arteries at the base of the brain.

PURPOSE: To describe and evaluate an application of sonography, transorbital color Doppler flow imaging of the carotid siphon and major intracranial arteries, and to compare it with transtemporal color Doppler flow imaging. METHODS: The carotid siphon and major arteries at the base of the brain of 50 healthy volunteers were screened using the transorbital color Doppler flow sonography. These arteries were also studied by a transtemporal approach for comparison. In 5 volunteers, MR images in special inclination planes were obtained and compared with the transorbital color-coded Doppler flow images. RESULTS: The B-mode image of the orbit and intracranial anatomic structures, in addition to the color-coded flow images, provided an unambiguous identification of the carotid siphon and major intracranial arteries. The failure rate was lower when using the transorbital approach than when using the transtemporal approach in identifying the anterior cerebral artery (17% versus 32%). Color Doppler flow imaging using the transtemporal approach was better for the middle cerebral artery, whereas color Doppler flow imaging using the transorbital approach was better for the anterior cerebral artery (contralateral). The Doppler incident angles using the transorbital approach were better for the carotid siphon and anterior cerebral artery (contralateral). CONCLUSION: Transorbital color Doppler flow imaging, when used in conjunction with the transtemporal examination, can add information concerning the major arteries at the base of the brain.

Adult↗
PubMed1994

Performance on a dementia screening test in relation to demographic variables. Study of 5297 community residents in Taiwan.

OBJECTIVE: To examine the relation between performance on a dementia screening test and the demographic variables of age, education, gender, and urban vs rural residency. DESIGN: Community survey with cluster sampling. SETTING: One urban and one rural community from each of four geographic regions in Taiwan, Republic of China. PARTICIPANTS: A total of 5265 nondemented individuals approximately equally divided between men and women and between urban and rural residency with a range in age from 41 to 88 years and in education from 0 to 20 years. MAIN OUTCOME MEASURE: Score on a Chinese adaptation of the Mini-Mental State Examination. RESULTS: Lower test scores were associated with older age and less education. The decrease in score with age was faster among participants who had never attended school. Better performance by men and by urban residents was found only among participants with fewer than 6 years of schooling. In this group, the magnitudes of sex and residency differences were comparable among those subjects aged 41 to 64 years and those aged 65 to 88 years. Women who had never worked outside of the home performed poorer than those who had worked outside of the home. CONCLUSIONS: The influence of educational background on test performance is most evident in individuals with less education. Commonly used dementia screening tests may be unfair to poorly educated individuals, especially women and rural residents. Efforts should be made to develop ecologically relevant cognitive tests for the intended study populations. To help distinguish test bias from different rates of cognitive decline, the study populations should include individuals in predementia age ranges.

Adult↗
PubMed1994

Frequency and characteristics of early seizures in Chinese acute stroke.

We retrospectively studied 1200 hospitalized acute strokes of all etiologies between July 1990 and August 1992. Ninety-six % of all strokes underwent computed tomography of the head. Fifty-eight percent of the 1200 strokes were brain infarction, 32% brain hemorrhage, 6% subarachnoid hemorrhage and 4% were other stroke subtypes. Thirty (2.5%) of all strokes suffered from early seizures. The incidences of early seizures were 2.8% in brain hemorrhage, 2.3% in brain infarction, 2.7% in subarachnoid hemorrhage and 2% in other stroke subtypes. Early seizures were documented in 6% of the patients with carotid territory cortical infarctions and 12% of the patients with lobar hemorrhage, whereas only 0.6% of the patients without carotid territory cortical infarctions and 0.6% of the patients without lobar hemorrhage were affected. Sixty-six percent of 30 early seizures were partial seizures, 24% generalized and status epilepticus were seen only in 10%. In conclusion, we found the early seizure incidence was 2.5% in Chinese patients hospitalized with acute strokes. There was no correlation between seizure occurrence and stroke subtypes. Early seizure developed significantly higher in acute stroke patients with lesions of the cortex than those patients without cortical involvement. The partial seizures were the most frequent type occurring in 66% of all acute stroke patients with early seizures.

Acute Disease↗
PubMed1994

Further analysis of a pilot study for planning an extensive clinical trial in traditional medicine--with an example of acupuncture treatment for stroke.

Statistical methods for evaluating the effects of treatments and prognostic factors in clinical trials are discussed. Exploratory data analysis, nonparametric methods, regression modeling, and regression diagnostics of influential cases are applied to the analysis of a pilot 'randomized' controlled trial on the treatment of acute stroke with acupuncture. The utility of this analysis for modifying patient eligibility criteria, determining required sample size and utilizing stratified randomization in a future extensive stroke trial is discussed.

Acupuncture Therapy↗
PubMed1994

Stroke associated with methamphetamine inhalation.

Seven patients (all men, mean age 32 years, range 17-47) with stroke following methamphetamine inhalation were collected during the last 2 years. Like oral or intravenous abusers, our patients had more hemorrhagic (n = 5) than ischemic strokes (n = 2). Cases of intracerebral hemorrhage (ICH) were lobar (n = 3), caudate (n = 1) or putaminal (n = 1), whereas the infarctions were both in the middle cerebral artery region. Each stroke event occurred within 3 days after drug use. Three patients had hypertension on admission. Though young in age, most patients had multiple stroke risk factors. In 3 patients with ICH, we also found small, low attenuated lesions on the brain computed tomography, however, without clinical correlations. Except for arteriovenous malformation in 1 patient, all angiograms failed to show vasculopathy or vasospasm. Contrary to what one might surmise from previously published reports, methamphetamine inhalation is at least as likely to produce ICH as it is to produce brain infarction.

Administration, Inhalation↗
PubMed1994

[Ischemic stroke in Taiwan].

An extensive survey of stroke in Taiwan was carried out by members of the Neurological Society, R.O.C. (Taiwan). Of a total 7,355 acute stroke patients who were admitted to 26 teaching hospitals in Taiwan (January 1 through December 31, 1985), there were 3,949 (53.7%) patients of cerebral infarction (CI). There was little seasonal variation in CI occurrence. In 90.5% of CI patients, the age of onset was above 50 years. The male to female ratio was 1.51:1. Hypertension was noted in 2,648 patients (67.1%), diabetes in 1,030 (22.9%), and heart disease in 953 (17.4%). A previous history of one or more strokes was obtained in 24.6% of the CI patients, and transient ischemic attacks (TIAs) in 6.4%. The stroke onset during the ordinary activities was noted in 41.1% of the CI patients, during sleep in 12.8% and at rest in 9.9%. CI occurred most frequently in the morning hours (24.0%). The majority of patients (85.9%) underwent computed tomography which provided valuable information in making distinction between cerebral infarction and cerebral hemorrhage. Angiography was performed in 3.3% of the patients for visualizing the stenosis and/or occlusion of the intracranial and the extracranial vessels. The mortality rate for CI was 8.4%, and 49.4% of fatal cases died within the first week after onset. At the time of discharge, the stroke survivors were rated "recovered" in 10.8% of CI patients, "minimally disabled" in 26.3%, "moderately disabled" in 38.0% and "severely disabled" in 16.9%.

Cerebral Infarction↗
PubMed1993

A randomized controlled trial on the treatment for acute partial ischemic stroke with acupuncture.

The effectiveness of acupuncture in acute stroke remains largely untested and unproved. A randomized, controlled trial was carried out to study the feasibility of acupuncture in combination with conventional supportive treatment for acute stroke patients. A total of 30 patients, aged 46-74, with the onset of symptoms within 36 h were enrolled into the study after appropriate screening. All patients gave informed consent. Basing on the same supportive treatment, patients were randomly assigned to a treatment with or without acupuncture. The procedure and acupoint selection were discussed and decided through several meetings of a group of senior acupuncture doctors in Taiwan. Acupuncture was applied 3 times/week for 4 weeks. During the study period, there were no problems in conducting this trial in terms of patient availability and acceptance, and physician cooperation. A significantly better neurologic outcome was observed in the acupuncture group on day 28 and day 90. The improvement in neurologic status was greatest in patients with a poor neurologic score at baseline. There were no important side effects except for one episode of dizziness related to acupuncture treatment. The data and results of this study will be used as a guideline for planning a full-scale clinical trial, e.g. sample size calculation, method of randomization with stratification of prognostic factors, choosing acupuncture points and technique of acupuncture.

Acupuncture Points↗
PubMed1993

Color Doppler imaging of orbital arteries for detection of carotid occlusive disease.

BACKGROUND AND PURPOSE: Distal to a hemodynamically significant stenosis, the Doppler effect becomes dampened. Thus, measuring the flow profile in the ophthalmic artery and the central retinal artery with color Doppler imaging may provide hemodynamic information about the carotid circulation. METHODS: To validate the flow profile measurement with color Doppler imaging in the ophthalmic and central retinal arteries and to determine the sensitivity and specificity of this examination in the detection of hemodynamically significant carotid stenosis, we compared color Doppler imaging examinations with ocular pneumoplethysmography and ophthalmodynamometry examinations in 66 patients with atherothrombotic ischemic cerebrovascular disease. The degree of carotid stenosis in these patients was determined by a duplex scan with color Doppler imaging, and 57 patients underwent angiography to verify the stenosis. RESULTS: The flow velocities (systolic peak velocity and end-diastolic velocity) and pulsatility indices (A/B ratio and resistance index) in the ophthalmic and central retinal arteries decreased as the degree of carotid stenosis increased. There is a statistically significant difference in the mean of systolic peak velocity and the mean of end-diastolic velocity of the ophthalmic and central retinal arteries among groups with various degrees of carotid stenosis (P < .02). Using the flow velocities of the ophthalmic and central retinal arteries to diagnose carotid stenosis (> or = 75% stenosis and occlusion), 8 cm/s for systolic peak velocity in the central retinal artery and 29 cm/s for systolic peak velocity plus flow direction reversal in the ophthalmic artery gave the maximum accuracy (sensitivities, 84% and 85.7% and specificities, 89.6% and 81.7%, respectively). The systolic peak velocity in the central retinal artery varied directly with the systolic pressure of the ophthalmic and central retinal arteries. CONCLUSIONS: The flow velocity and pulsatility in orbital arteries examined by color Doppler imaging provide further hemodynamic information; this test can be used to complement current sonographic examination of carotid disease.

Aged↗
PubMed1992

Incidence of stroke in Taiwan.

BACKGROUND AND PURPOSE: Few epidemiological studies concerning the incidence of stroke have been conducted in Taiwan. In an attempt to investigate this common disease, we studied the incidence of stroke in Taiwan in a prospective incidence study. METHODS: A cohort of 8,562 stroke-free people were followed up for 4 years to observe new stroke occurrence. The methods of sampling the study population have been reported elsewhere. In addition to the help of local doctors, who reported the new stroke cases, we also sent public nurses to visit the study population annually to screen the new cases of stroke. RESULTS: There were 104 (61 men and 43 women) first-ever stroke cases identified by a neurologist in a period between October 1, 1986 and December 31, 1990. The average annual incidence rate of first-ever stroke for people aged 36 years or older in this study was 330 per 100,000. Incidence rate was higher in eastern Taiwan and in rural communities. Percentages of the major types of stroke were as follows: cerebral infarction, 71%; cerebral hemorrhage, 22%; subarachnoid hemorrhage, 1%; and unclassified, 6%. The significant risk factors for stroke were hypertension and intake of food with a high sodium content. CONCLUSIONS: The age-specific incidence rates in this study are higher than those reported from the United Kingdom and the United States. The rates are close to those in a report from Japan and a report from a city in mainland China at the same latitude. Cerebral hemorrhages are more common among people in Taiwan than among Occidental people.

Adult↗
PubMed1991

Percutaneous reposition of dislodged coils in the treatment of a vertebral arteriovenous fistula--with CT follow-up.

We report a case of vertebral arteriovenous fistula in which embolization was complicated by migration of two coils and a partially inflated balloon. In order to relieve compression to the spinal cord, the displaced balloon was punctured percutaneously. For both relieving compression to the spinal cord and obliterating the residual fistula, the dislodged coils in the partially thrombosed epidural venous sinus were removed percutaneously and placed in the fistula, and more coils were implanted in the fistula percutaneously through the needle. CT follow-up half a year later showed complete resolution of compression of the spinal cord and complete recovery from myelopathy was clinically apparent.

Adult↗
PubMed1990

Secondary prevention of ischemic stroke with low dose acetylsalicylic acid.

In order to evaluate the efficacy of low dose acetylsalicylic acid (ASA) for the secondary prevention of ischemic stroke, this cooperative multicenter clinical trial was conducted on a non-blind basis. Patients having a first transient ischemic attack (TIA), reversible ischemic neurological deficit (RIND) or completed ischemic stroke were eligible for this trial. A total of 590 patients including 47 cases of TIA, 23 cases of RIND and 520 cases of completed stroke entered this study. These patients were allocated by the time of admission to one of the following 5 trial regimens: (1) vasodilators having no known inhibitory effect on platelet function (control group), (2) dipyridamole (DP) 50 mg 3 times a day (DP group), (3) ASA 300 mg once a day (ASA 300 mg group), (4) ASA 300 mg once in combination with DP 50 mg 3 times a day (ASADP group), and (5) ASA 100 mg once a day (ASA1 group). No difference in effect between the control and DP groups was observed, nor between the ASA 300 mg and ASADP groups. Therefore, we combined the control and DP groups to make a non-ASA group, and joined the ASA 300 mg and ASADP groups to make an ASA3 group. The differences in the cumulative event-free rate appeared to be significant between the non-ASA group and the ASA3 group and also between the non-ASA group and the ASA1 group. But the frequency distribution of age, territory of stroke, diabetes mellitus, cardiac disease, hematological disease and hyperuricemia were significantly different among these 3 study groups. We thus included these covariates in the Cox's proportional hazard model to control their possible confounding effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Common carotid artery dissection diagnosed by ultrasonic image: report of a case.

Carotid artery dissection is not uncommon and usually starts at the internal carotid artery. It rarely begins in the common carotid artery. It may cause symptoms of cerebral vascular insufficiency such as stroke and transient ischemic attacks. The case reported here is a 38-year-old man with an acute onset of left hemiparesis 2 hours after drinking three bottles of beer. Computed tomographic scan showed cerebral infarction in the territory of the right middle and anterior cerebral arteries. Ultrasonic imagings showed an intimal flap, starting at the bifurcation of the right common carotid artery, indicative of arterial dissection. Angiography confirmed the diagnosis and the arterial dissection appeared to extend into and terminate at the internal carotid artery.

Adult↗
PubMed1989

The serial hemostasis-related changes in patients with cerebral infarction: comparison between progressing and non-progressing stroke.

Serial determinations of beta-thromboglobulin (BTG), platelet factor 4 (PF4), fibrinopeptide A (FPA), antithrombin III (ATIII), protein C (PC), fibrin (ogen) degradation product (FDP), FDP D-dimer, activated partial thromboplastin time (APTT), prothrombin time (PT), and euglobulin lysis time (ELT) were performed in 18 patients with non-progressing stroke and 14 patients with progressing stroke in order to predict the development of progressing stroke. Increasing levels of BTG, PF4 and FDP with frequent fluctuation were noted in both kinds of stroke. Fluctuation of FPA levels was also noted but was less pronounced. PC levels were found to be slightly decreased with fluctuation but the mean was still in the lower normal limit. BTG, PF4 and PC all elevated at the time of deterioration of physical condition in patients with progressing stroke, whereas FPA had no definite change at that time. From our study, we conclude that both platelet activation and coagulation process do occur in both kinds of stroke. But the latter plays a minor role in the formation of thrombosis. The hemostasis change, especially concerning the thrombosis formation, probably plays a role in the development of progressing stroke, but we cannot predict their development even by the detections of the newly known molecular substances appearing in various steps of the hemostatic mechanism. Development of new tests for understanding the whole dynamic change of the thrombosis process is necessary for accurate prediction of the progressing stroke in the future.

Aged↗
PubMed1989

Prevalence of stroke in Taiwan.

We investigated the prevalence of stroke in Taiwan in an epidemiologic study of stroke, diabetes, and cardiovascular disease that used a two-phase survey design. The study population was drawn by cluster sampling and consisted of both urban and rural communities from four regions of Taiwan. There were 8,705 people 36 years of age or older interviewed during the period of October 1 to December 31, 1986, and 143 cases of completed stroke were later identified by a neurologist. The point prevalence rate for people aged 36 or older in our study was 1,642/100,000 population (95% confidence interval 1,389-1,942/100,000). Prevalence rates differed significantly among the four study regions and between urban and rural communities; prevalence was greater in northern Taiwan and in urban communities. Percentages of the major types of stroke in 143 stroke survivors were as follows: cerebral infarction 67.1% (96 cases), cerebral hemorrhage 14.0% (20 cases), subarachnoid hemorrhage 4.2% (six cases), and unclassified 14.7% (21 cases). Of the stroke survivors, 67.1% were independent in activities of daily living, and 75.5% were independent in ambulation. Hypertension, heart disease, diabetes mellitus, and a family history of stroke were significantly more common in stroke survivors than in strokefree individuals.

Adult↗
PubMed1988

Ocular bruits in ischemic cerebrovascular disease.

A total of 72 ocular bruits in 50 patients with symptoms of atherothrombotic ischemic cerebrovascular disease were studied with continuous-wave Doppler ultrasonography with spectrum analysis (Dopscan). Fourteen patients also had conventional angiography, and 14 had digital subtraction angiography. Ocular bruits by augmentation flow due to occlusion (seven bruits, 9.7%) or tight stenosis (17 bruits, 23.6%) of the contralateral internal carotid artery accounted for only 24 ocular bruits (33.3%). In contrast, siphon stenosis ipsilateral to the ocular bruit was a very common finding. All 14 patients studied with conventional angiography had variable degrees of siphon stenosis ipsilateral to the ocular bruits; there was one angiography failure. We conclude that siphon stenosis can cause ocular bruit alone or can act in combination with augmentation flow by contralateral carotid occlusion or tight stenosis. The difference in their relative occurrence in our patients compared with previous reports probably reflects racial differences in the distribution of stenotic or occluded lesions of the carotid artery between our patients and Caucasian patients. The ocular bruit was the only auscultatory finding in more than a quarter of our patients (14 of 50, 28%).

Aged↗