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Biomedical subjects

K Y Huang

Publications and source records attributed to K Y Huang.

At least 19 recordsLinked to original sources
PubMed2001

Sharps injuries among hospital support personnel.

Sharps injuries (SIs) among support personnel in hospitals have received little attention in the scientific literature. A cross-sectional study was undertaken to measure the incidence of SIs in Taiwanese support personnel. All support personnel, including laundry workers, cleaners, porters and central supply workers, from 16 hospitals were surveyed for SIs, sustained between June 1996 and July 1997. Either a questionnaire or face-to-face interviews, for those staff with a literacy problem, were used. Of the 862 persons eligible for study, 79.4% (684) were evaluable. Few staff (30.4%) had attended a prevention programme and 61% had suffered an SI in the past year. Few (25.4%) reported their injury. Hollow-bore needles, of which 72.2% had been used, were associated with 42.2% of injuries. Cleaners sustained the majority (65.7%) of injuries, and inappropriate disposal was associated with 54.7% of all injuries. For those staff employed for more than four years, the risk of sustaining an injury increased significantly with length of employment (P<0.001). Most of the injuries were sustained by cleaners handling sharps inappropriately disposed of by clinical staff. A safer environment for support staff could be achieved with the co-operation of clinical staff to correctly dispose of sharps to ensure single handling of sharps. A formal orientation of support staff in the reporting of SIs would enable clinical assessment and management of injuries, as well as an evaluation of needle and sharps safety in the healthcare setting.

Accidents, Occupational↗
PubMed2001

Adversarial search by evolutionary computation.

In this paper, we consider the problem of finding good next moves in two-player games. Traditional search algorithms, such as minimax and alpha-beta pruning, suffer great temporal and spatial expansion when exploring deeply into search trees to find better next moves. The evolution of genetic algorithms with the ability to find global or near global optima in limited time seems promising, but they are inept at finding compound optima, such as the minimax in a game-search tree. We thus propose a new genetic algorithm-based approach that can find a good next move by reserving the board evaluation values of new offspring in a partial game-search tree. Experiments show that solution accuracy and search speed are greatly improved by our algorithm.

Algorithms↗
PubMed2001

Ataxia telangiectasia: report of two cases.

Ataxia telangiectasia (A-T) is a rare autosomal recessive multisystem disease. The diagnosis of A-T is based on the typical clinical picture: ataxia and telangiectasia. However, an increase in (alpha-fetoprotein (AFP) level and the identification of the A-T mutated gene (ATM) assist in an early diagnosis. Here we report two cases of A-T diagnosed in our hospital (case 1: a 7-year-old boy; case 2: an 8-year-old girl). Both of these patients had typical clinical pictures of ataxia and telangiectasia, AFP was also increased (case 1:471.2 ng/dL; case 2: 196 ng/dL). T-cell dysfunction was noted in both patients. Case 1 had IgG2 deficiency and case 2 had IgA, IgG2 and IgG3 deficiency. Case 2 developed malignant lymphoma at 9 years of age and died of pneumonia with respiratory failure at 10 years of age. Because of rhe rarity of A-T in Taiwan, we report two cases to help pediatricians make an early diagnosis of A-T if they have a patient with progressive ataxia and oculocutaneous telangiectasia.

Ataxia Telangiectasia↗
PubMed2001

Spontaneous femoral neck fracture complicating a healed subtrochanteric fracture--a case report.

A rare case of spontaneous femoral neck fracture complicating a healed subtrochanteric fracture was encountered in an 85-year-old female. The subtrochanteric fracture was caused by a minor trauma with no other combined injury. Patient received close reduction and internal fixation two days later and the fracture healed in three months. Six months after operation, spontaneous ispilateral femoral neck fracture occurred without trauma. Although there were some reports about subcapital fracture or femur neck fracture complication after operation, this is the first case of spontaneous femoral neck fracture after healed subtrochanteric fracture which was treated with a 95 degrees dynamic condylar screw (DCS) and side plate previously without technical error.

Aged↗
PubMed2000

Epidemiology of cervical and trochanteric fractures of the proximal femur in 1996 in Kaohsiung City, Taiwan.

The goal of this study was to determine the incidence of cervical and trochanteric fractures of the proximal femur in 1996 in Kaohsiung City, Taiwan. Kaohsiung City is the industrial and commercial center of southern Taiwan, with a population of 1,433,621 in 1996. The number of individuals over 65 years of age accounted for 6.2% of the total population. Data from the archives of reimbursement of the National Health Insurance program were used to investigate the incidence of fractures of the proximal femur. This study detected 580 cervical and trochanteric fractures (40.5 fractures per 100,000 population per year) in 261 males (35.8 fractures per 100,000 men per year) and 319 females (45.3 fractures per 100,000 women per year), with 420 (72%) of these fractures occurring in individuals over 65 years of age. The age-specific incidences of cervical and trochanteric fractures increased exponentially with age in both genders. The overall ratio of cervical to trochanteric fractures was 1:1.04. The mean ages of women with cervical or trochanteric fractures (71.6 and 74.0 years, respectively) were significantly higher than those of males (59.9 and 64.8 years, respectively; P < 0.01). The age-adjusted incidences of fractures of the proximal femur in Kaohsiung City were higher than in other Asian countries, but were lower than in Western countries such as the United States and Norway. The urban lifestyle and low daily calcium intake may be responsible for this increased incidence of proximal femoral fractures in Kaohsiung City.

Adult↗
PubMed2000

Experimental infection with bovine herpesvirus-4 enhances atherosclerotic process in rabbits.

An association of herpesvirus and atherosclerosis has been suggested by seroepidemiologic studies and detection of the virus in arterial tissues. To facilitate the studies of the pathogenic role of herpesvirus in atherosclerosis, we established a rabbit model of atherosclerosis with bovine herpesvirus type-4 (BHV-4). Forty New Zealand White rabbits were randomly divided into six groups. Groups 1, 2, and 3 were inoculated iv with BHV-4 and control Groups 4, 5, and 6 with normal saline. Groups 1 and 4 were fed a regular diet throughout the experiment; Groups 2 and 5 were fed a diet supplemented with 2% cholesterol for 3 weeks starting at 3 weeks postinoculation; and Groups 3 and 6 with a diet supplemented with 2% cholesterol for 6 weeks starting at 3 days postinoculation. Extensive atherosclerotic lesions in Groups 2, 3, and 6, and small lesions in two rabbits in Group 1 were observed, but no obvious lesions were observed in Groups 4 and 5. BHV-4 DNA was demonstrated by polymerase chain reaction and liquid hybridization in aortic sections, various tissue samples, and peripheral blood mononuclear cells of all infected rabbits. Our studies demonstrated that BHV-4 can accelerate the atherosclerotic process in rabbits, and that experimental infection of rabbits with BHV-4 can be a useful atherosclerosis model.

Animals↗
PubMed2000

Core decompression for osteonecrosis of the femoral head at pre-collapse stage.

Twenty-five patients (27 hips) were retrospectively studied for core decompression in the treatment of osteonecrosis of the femoral heads at pre-collapse stage, Ficat and Alert stages I and II, from Apr. 1984 to Jun. 1998 with follow-up period at least 1 yr (mean 28 months). Eleven hips (10 patients) were considered to have failed due to progressive collapsed more than 2 mm, severe pain or reoperation. We further analyzed the results with regard to the stages, the size of the necrotic area according to the Ohzono classification, the lateral head index (LHI) and the Kerboul combined necrotic angle. The survival rate according to the Ohzono classification was type 1B: 100%, 1C: 44%, 2: 25%, and 3B: 0%. Hips with Kerboul angle less than 250 degrees revealed satisfactory results in all except one hip. All hips with Kerboul angle more than 250 degrees collapsed. Fourteen of the 15 hips (93%) with lateral head index more than 20% did not collapse and all hips except one (7/8) with LHI less than 12% collapsed. We conclude core decompression yields satisfactory results in osteonecrotic femoral heads at pre-collapse stage and with small necrotic area or good lateral buttress.

Adult↗
PubMed2000

Failure of the locking mechanism between the acetabular metal shell and the polyethylene liner after primary total hip arthroplasty--a case report.

The short and intermediate-term clinical and radiographic results associated with Harris-Galante II porous-coated acetabular modular cup without cementing have been excellent in most patients. Nevertheless, its modular design introduced the potential for failure of the locking mechanism. There are four pairs of locking ties on the rim of metal shell to fix the polyethylene liner within it. Failure of any locking tine would result in less rigid fixation between the metal shell and the polyethylene liner and potentially produce instability or even disassembling of the liner. Only nine cases have been reported previously about the fractures of the locking tine, but it has never been reported in literature in Taiwan. We report a case with fracture of one tine following minor trauma at five years after primary total hip arthroplasty. During reoperation, scratching injury on the outer surface of the polyethylene liner in contact with the inferior tines of the metal shell was noted. Although no disassembling of the liner was noted, the remaining locking mechanism was found to be less rigid when the liner was taken out of the shell. The locking mechanism of HG II cup may be mechanically weak and may fail without major trauma; therefore, its design ought to be improved in an attempt to prevent postoperative dissociation of the polyethylene liner.

Acetabulum↗
PubMed1999

Needlestick and sharps injuries among health-care workers in Taiwan.

Sharps injuries are a major cause of transmission of hepatitis B and C viruses and human immunodeficiency virus in health-care workers. To determine the yearly incidence and causes of sharps injuries in health-care workers in Taiwan, we conducted a questionnaire survey in a total of 8645 health care workers, including physicians, nurses, laboratory technicians, and cleaners, from teaching hospitals of various sizes. The reported incidence of needlestick and other sharps injuries was 1.30 and 1.21 per person in the past 12 months, respectively. Of most recent episodes of needlestick/sharps injury, 52.0% were caused by ordinary syringe needles, usually in the patient units. The most frequently reported circumstances of needlestick were recapping of needles, and those of sharps injuries were opening of ampoules/vials. Of needles which stuck the health-care workers, 54.8% had been used in patients, 8.2% of whom were known to have hepatitis B or C, syphilis, or human immunodeficiency virus infection. Sharps injuries in health-care workers in Taiwan occur more frequently than generally thought and risks of contracting blood-borne infectious diseases as a result are very high.

Accidents, Occupational↗
PubMed1999

Prevalence of nonreporting behavior of sharps injuries in Taiwanese health care workers.

BACKGROUND: Health care workers (HCWs) were surveyed to identify factors associated with nonreporting behavior of sharps injuries (SIs) in Taiwan. METHODS: We surveyed 10,469 full-time medical, nursing, technical, and supporting personnel employed at 16 randomly selected hospitals from 132 available accredited teaching hospitals in Taiwan. Information about the most recent injury and reporting behavior after an SI were collected from July 1996 to June 1997 by using a pretested structured questionnaire. Eleven categories, including an open-ended option, were provided for participants to explain their nonreporting behavior. RESULTS: Questionnaires were completed by 82.6% (8645) of our sample, of whom 87.3% reported to have experienced a recent SI. A used item was the most commonly (P <. 001) involved item in an SI, and SIs with a used item were significantly more likely (odds ratio 3.6; CI 95%, 3.03-4.26; P <. 001) to be reported compared with an SI that involved unused items. A total of 81.8% of injuries were not reported, with job category significantly affecting reporting behavior (P <.001). Medical staff had the highest nonreporting rate (85.2%). Although attendees of a prevention program were statistically more likely (P <.001) to report an injury compared with nonattendees, the level of reporting in both groups was not encouraging (21.3% and 17.2%, respectively). All reasons given for nonreporting were disconcerting, but none more so than the use of subjective assessment of risk by 21.7% of HCWs who did not report their injuries. Other reasons for not reporting SIs included that the item was unused (34%) and that the HCW was too busy to report the SI (14.9%), unaware of reporting requirements (14. 4%), or immune to hepatitis B virus (12.4%). CONCLUSIONS: With 82% of SIs in Taiwanese HCWs going unreported, the expected national incidence will be seriously underestimated and impact the appropriateness of prevention programs. The very low rate of reporting suggests that the current reporting system requires simplification. Because most injuries involved used items, the reporting systems also should include a more responsive management component. The results also suggest that the current prevention programs, currently provided by the general nursing department, require expert content knowledge in infection control if nonreporting and SIs are to be reduced.

Humans↗
PubMed1999

Differential distribution of apolipoprotein E in young and aged spontaneously hypertensive and stroke-prone rats.

OBJECTIVES: To evaluate whether the differential distribution of apolipoprotein E among lipoprotein fractions and hepatic expression of the apolipoprotein E gene are causal factors in the regulation of lipid metabolism and physiological functions in young and aged spontaneously hypertensive and stroke-prone rats. DESIGN AND METHODS: Biochemical analyses were performed on serum and hepatic specimens from young (2-month-old) and aged (8-month-old) spontaneously hypertensive rats, stroke-prone spontaneously hypertensive rats and normotensive Wistar-Kyoto rats. Levels of apolipoprotein E among various lipoprotein fractions were determined using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Liver concentrations of apolipoprotein E mRNA were analyzed by Northern blotting and relative levels of apolipoprotein E mRNA in different strains of rats were compared. Statistical analysis was performed by measuring correlations between hepatic apolipoprotein E mRNA levels and biological parameters. RESULTS: Levels of apolipoprotein E in high-density and low-density lipoproteins were significantly lower in hypertensive rats than in age-matched normotensive Wistar- Kyoto rats. Although there was a significant increase in high-density lipoprotein apolipoprotein E contents in all aged animals, the elevation in aged hypertensive rats was much less than that in aged normotensive rats. Levels of apolipoprotein E in the very-low-density lipoprotein fraction were diminished in young stroke-prone rats but were remarkably high in aged rats. Steady-state levels of apolipoprotein E mRNA increased with age in all strains of rats, whereas aged hypertensive rats exhibited lower apolipoprotein E mRNA levels than aged normotensive rats. CONCLUSIONS: The distribution of apolipoprotein E among various lipoprotein fractions was dramatically altered with age, and the alteration varied among different strains of rats. The differential distribution of apolipoprotein E in young and aged spontaneously hypertensive and stroke-prone rats suggests that apolipoprotein E could be a causal factor that disturbs the homeostasis of lipids and lipoproteins and perturbs physiological functions in hypertensive rats.

Aging↗
PubMed1999

Hip arthroplasty for osteonecrosis in patients with systemic lupus erythematosus.

Thirty-seven hip arthroplasties including 19 bipolar hemiarthroplasties (BH) and 18 total hip arthroplasties (THA) were performed in our hospital in 23 patients with systemic lupus erythematosus (SLE) for femoral head osteonecrosis between July 1984 and July 1996. These patients were followed up retrospectively to compare the results of BH and THA. One case with right side BH and left side THA expired about 1 year after operation and was excluded from this study. In both groups, these hips with pre-operative osteonecrosis were subclassified in Ficat and Arlet classification. The mean duration of follow-up was 44.5 months (24-85 months) for THA was 70.2 months (24-119 months) for BH. The mean Harris scores pre-operatively were 56.7 +/- 1.09 points in the BH group and 50.7 +/- 1.29 points in the THA group. The mean post-operative scores were 81.9 +/- 4.37 points in the BH group and 95.5 +/- 0.80 points in the THA group at final follow up. The clinical results of the THA group were better than those of the BH group. However, at an early stage before collapse of the femoral head (Ficat stage II), the results of BH were as good as those of THA. Five BH were converted to THA at the time ranging from 39 months to 113 months (mean 63.2 months) after primary operation due to acetabular cartilage wearing or severe groin pain. The failure rate of BH group was 27.8% (5/18). There was no loosening or revision in the THA group. Although the follow-up durations were different in these two groups, the clinical result was obviously superior in the THA group, particularly after the femoral heads had collapsed. Considering the relatively short life span of SLE patients, we prefer THA over BH in the treatment of the femoral head osteonecrosis in SLE patients. However, based on our results, BH is still a very good choice of treatment before the collapse of the femoral head.

Adolescent↗
PubMed1999

Comparison of antileukemic immunity against U937 cells in atopic asthmatics versus healthy controls.

To assess the antitumor effects in atopic asthmatics versus healthy adults, we designed this study using in vitro mononuclear cells (MNC) culture as an immunity model with human leukemic U937 cells as the target. MNCs were collected from asthmatic subjects and healthy controls. Conditioned media from the MNC cultures (MNC-CM) were collected after stimulation with various concentrations of phytohemagglutinin (PHA). We treated U937 cells with these MNC-CMs, then assayed their proliferation and differentiation after 5 days of culture. At lower PHA doses (1.25 microg/ml), as well as in absence of PHA, the asthmatic MNC-CMs inhibited U937 cells growth to a slightly greater extent than did the MNC-CMs from controls. In contrast, when higher doses of PHA were used (5, 10 microg/ml), this growth-inhibiting effect was dramatically reversed. The dual effect of MNC-CM in these two groups was also shown in U937 cell differentiation assay, assessed as follows: morphological change by Liu's staining, functional change by NBT reduction test and CD 14 expression by flow cytometric detection. We suggest that the antileukemic effects of MNCs from asthmatic patients result from a slightly immunopotentiated status. This immunity may be dramatically reversed, however, after marked activation of MNCs.

Adult↗
PubMed1998

Minocycline and cefotaxime in the treatment of experimental murine Vibrio vulnificus infection.

We conducted an in vivo study with the mouse model of Vibrio vulnificus infection to evaluate the efficacies of therapy with minocycline or cefotaxime alone and in combination. V. vulnificus was introduced subcutaneously into the area over the right thigh. The inoculum size ranged from 1.0 x 10(3) to 1.2 x 10(8) CFU from experiment to experiment but was constant for all animals in the same experiment. Antibiotics were given intraperitoneally 2 h after the bacteria were inoculated. In experiments 1 to 4, the standard dose for humans was used to treat the infection, while in experiment 5, five times the standard dose for humans was used to treat the infection. In experiment 1, with a small inoculum of 5 x 10(3) CFU, all mice in the saline-treated control group and the cefotaxime-, minocycline-, and combined antibiotic-treated groups survived. In experiment 2, with a moderate inoculum of 1.2 x 10(5) CFU, all the mice in the three antibiotic-treated groups survived, while only two of nine mice in the control group survived. In experiment 3, with a large inoculum of 8.0 x 10(7) CFU, six of nine mice in the combined antibiotic-treated group survived, while only one of nine mice in the cefotaxime-treated group and none of the mice in the control and minocycline-treated groups survived. In experiment 4, with a large inoculum of 1.2 x 10(8) CFU, 8 of 20 mice in the combined antibiotic-treated group survived, while none of the 20 mice in the control group, the group treated with cefotaxime alone, and the group treated with minocycline alone survived. In experiment 5, in which mice were infected with a large inoculum of 6.6 x 10(7) CFU and treated with five times the standard human dose of antibiotics, 10 of 12 mice in the combined antibiotic-treated group survived, while only 4 of 12 mice in the minocycline-treated group, 1 of 12 mice in the cefotaxime-treated group, and none of the mice in the control group survived. In experiments 3 to 5, the difference in the survival rates between the combined antibiotic-treated and minocycline-treated groups was statistically significant (P < 0.05). These results indicate that combination therapy with cefotaxime and minocycline is distinctly more advantageous than therapy with the single antibiotic regimen for the treatment of severe experimental V. vulnificus infections.

Animals↗
PubMed1998

Modified Mitchell osteotomy for hallux valgus.

From 1988 to 1995, 96 patients (161 feet) underwent a modified Mitchell distal metatarsal osteotomy performed for mild-to-moderate hallux valgus. On AP x-rays of the standing foot, the average intermetatarsal angle was corrected from 15 degrees to 9 degrees, and the first metatarsophalangeal angles were corrected from an average of 41 degrees to 15 degrees. Criteria for evaluation of clinical results included relief of pain, appearance of foot, and shoe wear. After an average follow-up of 38 months, the overall satisfaction rate was 92.5%. Complications included 13 pin tract infections, two delayed unions, and two correction losses. The most common late sequela was transfer metatarsalgia of the lesser toes, which occurred in 20 feet (12.4%), leading to some dissatisfaction. The Mitchell osteotomy can be used on cases with less than 20 degrees of intermetatarsal angle, offering a stable construct with easy postoperative care.

Adolescent↗
PubMed1997

In vitro synergism between cefotaxime and minocycline against Vibrio vulnificus.

We conducted time-kill studies to evaluate the inhibitory activities of either cefotaxime or minocycline alone and the two drugs in combination against a clinical strain of Vibrio vulnificus. The MICs of cefotaxime and minocycline were 0.03 and 0.06 microg/ml, respectively. When approximately 5 x 10(5) CFU of V. vulnificus per ml was incubated with cefotaxime at 0.03 or 0.05 microg/ml, the bacterial growth was inhibited during the initial 2 and 8 h, respectively. Thereafter, V. vulnificus regrew and the level of growth reached that of the control. Within the dose range of less than five times the MIC, the duration of the inhibitory effect of cefotaxime was proportional to its concentration. When minocycline at 0.015, 0.03, 0.045, and 0.06 microg/ml was used to evaluate the inhibitory effect, a similar trend was observed. Either antibiotic at a concentration of five times the MIC or greater prevented the regrowth of V. vulnificus for at least 48 h. When cefotaxime at 0.05 microg/ml and minocycline at 0.045 microg/ml were combined in the same culture, the inhibitory effect against V. vulnificus persisted for more than 48 h, with no regrowth noted. The use of a combination of these two antibiotics resulted in the reduction of growth by 6 orders of magnitude compared to the use of either of the two antibiotics alone, and the number of surviving organisms in the presence of the antibiotics combined was approximately 3 orders of magnitude less than that in the starting inoculum. We conclude that cefotaxime and minocycline acted synergistically in inhibiting V. vulnificus in vitro.

Anti-Bacterial Agents↗
PubMed1997

Mouse skin damage caused by a recombinant extracellular metalloprotease from Vibrio vulnificus and by V. vulnificus infection.

Vibrio vulnificus wound infection is characterized by an intense acute cellulitis which spreads along the subcutaneous tissue with severe tissue destruction. Toxins produced by the bacteria appear to be involved in the pathogenesis of skin necrosis and to facilitate microbial dissemination in vivo. We report microscopic studies of mouse skin damage caused by a single intradermal injection of V. vulnificus or of an extracellular metalloprotease isolated from this organism. The gene encoding this metalloprotease has been cloned and expressed in Escherichia coli. The crude metalloprotease extract obtained from the periplasmic fraction by osmotic shock was used in this study. Intradermal injection of this preparation resulted in marked edematous changes of the skin, which extended throughout the dermis and subcutaneous tissues and into adjacent muscles. The collagen and elastic fibers degenerated and some muscle cells even appeared necrotic. Blood vessels became congested, with moderate perivascular neutrophil and mononuclear cell infiltration. There was no evidence of necrotic changes in the blood vessel itself. These results show that the damage to the connective tissues caused by V. vulnificus is at least partly attributable to its protease. Therefore, the protease seems to be an important virulence factor of this microbe.

Animals↗