Biomedical subjects

Meei-Shyuan Lee

Publications and source records attributed to Meei-Shyuan Lee.

23 records · Page 2Linked to original sources

PubMed2002

The effect of anesthetic techniques on hemostatic function in arthroscopic surgery: evaluation by thromboelastography.

BACKGROUND: Anesthetic techniques are known to affect blood hemostasis, which may be responsible for the pathogenesis of postoperative venous thromboembolism. The purpose of this study was to evaluate the effect of general and spinal anesthesias on blood hemostasis using thromboelastography. METHODS: Forty patients undergoing arthroscopic knee surgery were enrolled for study and randomly allocated to one of two groups, to receive either general (GA; n = 20) or spinal anesthesia (SA; n = 20). In addition to thromboelastography, prothrombin and activated partial-thromboplastin time, and haematocrit and platelet count were also examined concurrently. Blood was sampled and examined before anesthesia to provide the baseline data (Time 1). Three more evaluations were performed at different time, i.e., twenty minutes after induction of anesthesia and just prior to skin incision (Time 2), thirty minutes after skin incision (Time 3), and three hours after surgery (Time 4). RESULTS: There were no intra- or inter-group differences noted as comparing the measured parameters obtained prior to, during, or three hours after surgery. CONCLUSIONS: From the present study, we do not find any individual anesthetic technique which would have effect on the hemostasis of patients who received diagnostic arthroscopic surgery.

Anesthesia, General↗

PubMedDate not supplied

Preoperative cotreatment with dextromethorphan and ketorolac provides an enhancement of pain relief after laparoscopic-assisted vaginal hysterectomy.

OBJECTIVES: Both N-methyl-D-aspartate receptor antagonists and nonsteroidal anti-inflammatory drugs have been demonstrated to produce better postoperative pain relief. The concept of multimodal analgesia has also been used for clinical pain management. The aim of the present study was to examine the analgesic effect of preoperative cotreatment with dextromethorphan (DM) and ketorolac on postoperative pain management after laparoscopic-assisted vaginal hysterectomy (LAVH). METHODS: Eighty ASA physical status I or II patients scheduled for LAVH were included and randomly assigned to 1 of 4 groups. Patients received intramuscular (IM) chorpheniramine 20 mg+ intravenous (IV) 2 mL of normal saline, IM DM 40 mg+IV 2 mL of normal saline, IM chorpheniramine 20 mg+IV 60 mg (2 mL) of ketorolac, and IM DM 40 mg+IV ketorolac 60 mg as the groups C, DM, Keto, and DM+Keto, respectively. All patients were given a patient-controlled analgesia (PCA) with morphine for pain relief postoperatively. Analgesic effects were evaluated using Visual Analog Scale pain scores at rest and during coughing, time to first PCA request for pain relief, total morphine consumption, bed rest time, and the time to first passage of flatus for 48 hours after surgery. RESULTS: Patients in DM and Keto groups had significantly better pain relief than patients in group C. Patients in DM+Keto group exhibited the best postoperative pain relief among groups in the following several categories: time to first trigger of PCA, total morphine consumption, the worst Visual Analog Scale, bed rest time, and the time to first passage of flatus, demonstrating an enhanced effect between DM and ketorolac. Neither synergistic nor antagonistic interaction was observed between DM and ketorolac. DISCUSSION: Preoperative treatment with both DM and ketorolac diminish postoperative pain. Our results suggest that the N-methyl-D-aspartate antagonist-DM and the nonsteroidal anti-inflammatory drugs-ketorolac cotreatment provide an enhancement of analgesia for postoperative pain management in patients after LAVH surgery.

Adult↗

PubMedDate not supplied

Effect of treadmill exercise on circulating thyroid hormone measurements.

OBJECTIVES: Effects of exercise on circulating thyroid hormone (TH) values remain controversial. We sought to observe the effect of treadmill exercise on serum TH values in highly selected subjects. METHODS: Twenty-six healthy male military recruits aged 23-27 (mean, 25) years were studied. All had maintained identical diet and physical activity for a week before the test. Serum samples were drawn before (baseline) and immediately, 1, 4, 24, 24 and 48 h after maximal exercise (on a treadmill, Bruce protocol). All subjects completed the protocol with normal ECG results. Specimens were analyzed to measure 3,3',5-triiodothyronine (T(3)), thyroxine (T(4)), free T(4) (FT(4)), free T(3) and thyroid-stimulating hormone (TSH) in the same assays. To determine the possible effect of hemodynamic changes, hematocrit (Hct)-adjusted data were also compared. RESULTS: Hemoconcentration, as reflected by increased Hct, was found immediately after exercise. No significant changes of serum mean TH values before and after exercise were found except for TSH, which increased significantly immediately after exercise (1.72 vs. baseline 1.42 IU/l, p < 0.01). Values for T(3), T(4), and TSH increased significantly immediately after exercise, as compared to other postexercise values. However, the changes became insignificant after Hct adjustment. The FT(4) values showed a reciprocal increase after exercise that became significant after Hct correction. Significantly negative correlation was found between FT(4) and TSH values, but these values were still well within the normal range. CONCLUSIONS: Maximal treadmill exercise does not greatly affect the determination of concentrations of circulating THs.

Adult↗

PubMedDate not supplied

Monitoring bolus nasogastric tube feeding by the Brix value determination and residual volume measurement of gastric contents.

BACKGROUND: Critically ill patients do not always tolerate nasogastric tube feeding. Gastric residual volumes (GRVs), obtained by aspiration from a nasogastric tube, are widely used to evaluate feeding tolerance and gastric emptying, but controversy exists about what constitutes the true GRV (diet formula or digestive juice) and how it should affect management. In this pilot study, we used the Brix value (BV) measurement of gastric contents to monitor both GRV and food content in patients receiving nasogastric feeding. METHODS: Forty-three patients receiving bolus nasogastric feeding were monitored for 24 hours before entry into the study and then divided into 2 groups according to traditional use of GRV; patients with low GRVs (< 75 mL) were placed in group 1, whereas patients with higher GRVs (> 75 mL) were placed in group 2. All subjects were given 250 mL of polymeric formula by bolus nasogastric infusion, followed by BV measurement of gastric contents at 0, 30, 60, 120, and 180 minutes. All gastric fluid was aspirated after 180 minutes of feeding; the volume was recorded and BV measurement made, then reinstilled with an added 30 mL of dilutional water, after which a final aspiration and BV measurement was performed. Calculated GRV and volume of formula remaining in the stomach was determined by derived equations. RESULTS: Serial BV measurements decreased in both groups after bolus feeding. For patients in group 2, the decrease was less such that at 180 minutes, the mean BV for gastric contents was significantly higher than for those patients in group 1 (10.1 vs 5.1, respectively; p < .01). Aspirated GRV, calculated GRV, and volume of formula remaining in the stomach at 180 minutes were significantly greater for patients in group 2 compared with those in group 1. Use of refractometry in combination with traditional use of GRV identified 4% (1/25) of patients in group 1 with low GRVs who might have possible gastric dysmotility (> 20% of initial 250-mL volume of formula remaining at 180 minutes) and ensured that 72% (13/18) of patients in group 2 with higher GRVs had sufficient gastric emptying (< 20% of initial 250 mL volume of formula remaining). CONCLUSION: This pilot study raises the feasibility that refractometry and the BV measurement of gastric juice may be a promising tool for bedside monitoring of tolerance and gastric emptying in patients receiving nasogastric feeding, providing valuable complementary information to traditional use of GRV.

Adult↗

PubMedDate not supplied

Expression and regulation of retinoid-inducible gene 1 (RIG1) in breast cancer.

BACKGROUND: Retinoid-inducible gene I (RIG1) is a growth regulator protein that exhibits activities to suppress cellular growth and induce cellular differentiation and apoptosis. This study analyzed the expression and regulation of RIG1 in breast cancer cells in vitro and in vivo. MATERIALS AND METHODS: Expression of RIG1 RNA in breast cancer tissues was analyzed using RNA in situ hybridization. Regulation of RIG1 expression by 17beta-estradiol (E2) was analyzed by semi-quantitative reverse transcription polymerase chain reaction. RESULTS: RIG1 expression in 47 breast cancer tissues was detected mostly in the cytoplasm and in some nuclei. Levels of both cytoplasmic and nuclear RIG1 mRNA were significantly lower in 20 estrogen receptor-positive (ER+) than in 27 ER-negative (ER-) tissues (p < 0.05), in 20 progesterone receptor-positive (PR+) than in 27 PR-negative (PR-) tissues (p < 0.01), and in 14 ER+/PR+ than in 21 ER-/PR-tissues (p < 0.05). Basal levels of RIG1 and ER mRNA were inversely related between ER+ (MCF-7 WS8 and ZR75-1) and ER- (ZR-75-30) breast cancer cells. E2 (1 nM) treatment for two days suppressed RIG1 mRNA levels in MCF-7 WS8 and ZR-75-1 cells, but not in the ER- ZR-75-30 cells. The E2-mediated down-regulation of RIG1 expression was time- and concentration-dependent in ZR-75-1 cells. CONCLUSION: The negative association between RIG1 and ER expression in breast cancer tissues and down-regulation of RIG1 by E2 in breast cancer cells in vitro suggest that RIG1 expression is negatively regulated by E2 through activation of the ER in ER+ breast cancer cells.

Breast Neoplasms↗