Biomedical subjects

J J Chu

Publications and source records attributed to J J Chu.

10 recordsLinked to original sources

PubMed1992

One-stage operation for treatment after delayed diagnosis of thoracic esophageal perforation.

Perforation of the thoracic esophagus can be fatal unless diagnosed promptly and treated effectively. The high mortality with delayed treatment is due principally to an inability to effectively close the perforation and prevent leakage. From 1982 to 1988, 7 consecutive patients (aged 16 to 73 years) were treated after a delayed diagnosis (26 hours to 25 days) of thoracic esophageal perforation. In all patients, the perforation was closed after debridement with total exclusion of the esophagus (T-tube cervical esophagostomy plus absorbable ligatures applied to the esophagogastric junction and the cervical esophagus distal to the esophagostomy). Radical decortication and wide mediastinal and pleural drainage were also done. Nutritional supply was given through a feeding gastrostomy. Antibiotics were administered according to the results of cultures. All patients survived. Continuity of the esophagus was established by removal of the T tube and spontaneous absorption of the ligatures. Endoscopy and esophagography performed 4 weeks after the initial operation showed a well-healed esophagus without stenosis or leakage in all patients. No secondary thoracotomy or esophageal reconstruction was necessary. No dysphagia was noted during follow-up (range, 12 to 50 months; mean follow-up, 23 months). We conclude that primary closure of the perforation and total esophageal exclusion with the use of absorbable ligatures and T-tube esophagostomy can provide a one-stage operation with good results for repair of thoracic esophageal perforation diagnosed late.

Adolescent↗

PubMed1992

Serodiagnosis of tuberculosis by an enzyme-linked immunosorbent assay using mycobacterial antigen 60.

This study was undertaken to assess the diagnostic utility of an enzyme-linked immunosorbent assay using mycobacterial antigen 60 in patients with pulmonary tuberculosis. This test was applied to 210 adults, including 111 patients with active pulmonary tuberculosis, 80 control subjects and 19 patients with inactive pulmonary tuberculosis. Although the serums from the patients with active tuberculosis has a higher mean value of IgG antibody concentration than the control group, there was a considerable overlap of serum IgG antibody level between the two groups. 200 ELISA unit (EU) was established as a reasonable cut-off value, which gave an 80.2% (89/111) sensitivity for the group with active pulmonary tuberculosis and a specificity of 76.3% (61/80) only for the control group. The patients with inactive pulmonary tuberculosis had a positive rate up to 47.4% (9/19) when 200 EU was chosen as a cut-off value.

Adult↗

PubMed1992

[Valve replacement for aortic stenosis].

We retrospectively reviewed 122 consecutive patients with aortic stenosis from January 1977 to December 1990. There were 68 male and 54 female patients. Their age ranged from 5 to 73 years old (47 +/- 16, mean +/- SD). Sixty eight patients also had associated mitral valve lesion, 13 patients had tricuspid valve lesion, and 3 patients had coronary artery disease. Aortic valve replacement was performed on all patients. Mechanical valves were implanted in 86 cases and tissue valves in 36 cases. Associated procedures were performed in 54 cases: mitral valve replacement in 34 cases, mitral valve repair in 18 cases and coronary artery bypass grafting in 2 cases. A bicuspid aortic valve was found in 20 cases (16.4%). Hospital mortality was 4.9% (6 cases). Follow-up was completed in 95% of the surviving cases (110 cases). The survival rate was 82 +/- 3% at 13 years and redo-free rate was 73 +/- 8% at 13 years. Seven cases required redo operation, due to tissue valve degeneration in 5 and thrombosis of the mechanical valve in 2. All 7 patients survived. Late death occurred in 6 cases: 3 from malignancy, 2 from stroke and 1 from ventricular arrhythmia. We concluded that valve replacement for aortic stenosis is a safe and satisfactory procedure with good long-term results.

Adolescent↗

PubMed1992

[Migration of Kirschner wire from the right sternoclavicular joint into the main pulmonary artery. A case report].

The use of Kirschner wires (K-wires) for bone and joint fixation carries the risk of migration of the wire from the fixation site over time. However, review of the literatures disclosed rather few reports on this issue. We describe such a case in order to emphasize the potential complication and serious hazard that migration of such metallic devices can result in, especially when the fixation site is close to the thoracic cavity.

Adult↗

PubMed1991

Traumatic asphyxia.

During a 5-year period, we treated 14 cases of traumatic asphyxia. There were 12 male and 2 female patients ranging in age from 2 to 32 years. Most suffered crushing injuries at work or were run over by motor vehicles. Mild to severe cervicofacial cyanosis and petechiae developed in all patients. A fear response was reported by 12 of the patients. Subconjunctival hemorrhage was also found in 12 patients. Nine patients had tachypnea and 7 complained of dyspnea. Most of the patients suffered some associated injuries including 8 head injuries, 7 pulmonary contusions, and 6 cases of blunt abdominal trauma. Less-associated injuries were rib fractures, brachial and radial nerve injuries, hemothorax, and pneumothorax. The hospital stay ranged from 4 to 28 days (mean, 14 days) and follow-up from 10 to 60 months (mean, 32 months). Treatment for traumatic asphyxia included measurement of arterial blood gases, oxygen supplementation, and intubation with mechanical ventilation. The patients' recovery conditions were relative to the severity of injury and the associated injuries.

Adolescent↗

PubMed1991

Endothelium-dependent production of prostacyclin in human internal mammary artery.

The internal mammary artery (IMA) has become the conduit of choice in coronary artery bypass surgery because of superior long-term patency. It had been shown that IMA graft could release prostacyclin. Prostacyclin is a potent vasodilator and also can inhibit platelet aggregation. To determine the role of human IMA endothelium in production of prostacyclin, we tested the reactivity of segments of human IMA to hypoxia in vitro. Human IMAs were harvested during coronary artery bypass surgery. Prostacyclin was measured from fluid in the organ baths by radioimmunoassay of its major hydrolytic product 6-keto-prostaglandin F1 alpha. Rings (4 mm in length) of IMA, with and without endothelium, were suspended in organ baths containing physiologic salt solution. Rings were contracted with norepinephrine, and exposed to hypoxia (pO2 35 +/- 5 mmHg) for 15 minutes then reoxygenated. In segments with endothelium, hypoxia induced a transient relaxation followed by contraction. The transient relaxation was associated with a significantly increased production of 6-keto-prostaglandin-F1 alpha (from 34.1 +/- 2.7 pg/ml prehypoxia to 51.6 +/- 6.7 pg/ml during hypoxia, mean +/- SEM, p less than 0.05). This transient relaxation was blocked by indomethacin but not by NG-monomethyl-L-arginine (L-NMMA) and free radical scavengers (superoxide dismutase, catalase and deferoxamine). However, in segments without endothelium, the prehypoxia (14.7 +/- 0.9) and during hypoxia (15.5 +/- 1.4) level of 6-keto-prostaglandin F1 alpha were not increased and were significantly lower than those with endothelium. This study demonstrated that endothelium of IMA grafts could release prostacyclin either in a basal condition or upon stimulation of hypoxia. This ability possibly contributes to its long-term patency.

Cell Hypoxia↗

PubMed1990

Aortic regurgitation due to aortic root intimal tear as a result of blunt chest trauma.

We report a 31-year-old male patient who sustained blunt trauma to the chest, abdomen and left knee resulting in a liver laceration, left patella fracture and aortic regurgitation. Hepatorrhaphy, open reduction of the fractured patella and resuspension of the prolapsed aortic valve secondary to the aortic root intimal tear were performed subsequently. Prompt diagnosis and aggressive intervention of such injuries can lead to successful repair of potentially fatal cardiac trauma.

Adult↗

PubMed1989

Surgical management of congenital coronary artery fistula.

Over a period of 6 years, 8 patients underwent surgical treatment at our hospital for congenital coronary artery fistula (CAF). The ages of the patients ranged from 4 months to 50 years (mean 22.7 years). Continuous heart murmurs could be heard in all patients, except one. The diagnosis was made by retrograde aortography and/or selective coronary arteriography. Only one patients had associated cardiac disease. All the drainage sites of the CAF were on the right side of the heart (right atrium, right ventricle, pulmonary artery). Two patients had both right and left CAFs. Symptoms due to "coronary steal" by a coronary artery fistula were demonstrated by a nuclear medicine study in one of our patients. Four patients were operated on with the aid of cardiopulmonary bypass. The other 4 patients were treated with suture ligation directly. There was no surgical mortality or morbidity, and the longterm results have been good. Since surgical correction is safe and effective, it would appear desirable for all patients with CAF be operated on. However, surgical intervention is controversial in asymptomatic patients.

Adult↗

PubMed1989

Acute mitral regurgitation secondary to blunt chest trauma: report of a case.

A 24-year-old male patient who sustained blunt trauma to the chest resulting in a flail chest, myocardial contusion and injury to mitral valve is reported. An emergency surgical correction of the mitral lesion was performed. A high index of suspicion, prompt diagnosis and aggressive intervention of such injuries can lead to successful repair of such a potentially fatal cardiac trauma.

Acute Disease↗

PubMedDate not supplied

[Age and sex distribution of sexually transmitted diseases in Valladolid. A study of 5076 cases].

The age and sex distribution of 5,076 cases of S.T.D. dealt with between 1982 and 1988 at the Dermatological Dispensary of the Territorial Social Welfare Service in Valladolid are studied. The maximum frequency of S.T.D. (24.1% of cases) corresponded to the age group between 21 and 25 years, which was also the period for maximum prevalence of Neisseria gonorrhoeae (26.3%), Gardnerella vaginalis (30.7%), Candida albicans (27.4%) and acuminata condyloma (33.4%). Syphilis (19.9%), Chlamydia trachomatis (27%), Ureaplasma urealyticum (24.6%), Mycoplasma hominis (25.0%), Trichomonas vaginalis (23.0%) and genital herpes had maximum prevalence in the group between 26 and 30 years. Women were affected at younger ages than males. 16.9% of women with some S.T.D. were between 16 and 20 years of age, while only 6.5% of males with S.T.D. were in this age-group (p less than 0.001).

Adolescent↗