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Biomedical subjects

R A Wong

Publications and source records attributed to R A Wong.

8 recordsLinked to original sources
PubMed1996

Clinical presentation and management of iatrogenic colon perforations.

BACKGROUND: Because iatrogenic colonic perforation is uncommon, surgical management of this complication has been based on the civilian trauma experience. In this study, we determine the incidence, clinical presentation, and management of colonic perforations resulting from colonoscopy or barium enema. PATIENTS AND METHODS: The medical records of all patients with colorectal perforations due to barium enema or colonoscopy seen over a 5-year period were reviewed. RESULTS: Twenty-one patients, 12 males and 9 females aged 66 +/- 16 years, undergoing evaluation for polyps and bleeding (11), diverticulosis (4), diarrhea (2), or miscellaneous indications (4) sustained colonic perforation from colonoscopy (18; 0.20%) or barium enema (3; 0.10%). Abdominal pain, 66% (13), and fever, 24% (5), were the most frequent symptoms encountered and extraluminal air, 67% (14), the most common radiologic finding. The site of perforation was the rectosigmoid in 62% (13) of patients. Eighteen patients underwent surgery; 11 within 24 hours (group I) and 7 patients within 6.0 +/- 4 days (group II). Fifty percent (9 of 18) had primary repair or resection with anastomosis without mortality. Of the 6 patients initially treated nonoperatively, 3 subsequently underwent surgery. Both deaths, one in group I and one in group II, occurred in patients who had colonic diversion for perforation following colonoscopy. CONCLUSION: We conclude that in the absence of significant contamination either primary repair or resection and anastomosis can be performed with acceptable morbidity for iatrogenic perforations of the colon.

Adolescent↗
PubMed1991

In vivo proliferation of adoptively transferred tumor-infiltrating lymphocytes in mice.

The adoptive transfer of tumor-infiltrating lymphocytes (TILs) in conjunction with interleukin-2 (IL-2) administration can mediate a reduction in established pulmonary and hepatic metastases of a variety of murine tumors as well as in patients with metastatic melanoma. To characterize further the fate of adoptively transferred TILs, the uptake of the thymidine analog 5-[125I]iodo-2-deoxyuridine ([125I]UdR) into the DNA of dividing cells was used to study the in vivo proliferation and migration patterns of transferred TILs in C57BL/6N mice. Animals received 500 rad of total body irradiation prior to cell transfer to separate incorporation of radiolabel into endogenous lymphoid cells from that into transferred TILs. Mice were subsequently treated with i.v. injections of TILs or no cells followed by i.p. injections of Hanks' balanced salt solution or IL-2. At various time points, mice received [125I]UdR, and 20 h later tissues were removed and counted on a gamma analyzer. A proliferation index (PI) was calculated by dividing the mean cpm of organs of experimentally treated mice by the mean cpm of organs of control mice. Animals receiving TILs alone demonstrated small increases in [125I]UdR in the lungs, liver, and spleen of saline-treated controls (PI = 1.4, 1.6, and 1.7, respectively, on day 4), while animals treated with 50,000 U of IL-2 alone showed greater increases in the lungs, liver, kidneys, and spleen (PI = 3.9, 6.1, 3.3, and 15.8). Mice receiving TILs plus IL-2 demonstrated the highest levels of radiolabel incorporation in the same organs (PI = 10.5, 19.4, 10.2, and 22.4). Over a period of 10 days, TIL plus IL-2 treated animals continued to incorporate significantly greater amounts of [125I]UdR for as long as high-dose IL-2 was administered. Animals treated with TILs demonstrated increased incorporation of radiolabel with increasing doses of IL-2. Injection of irradiated TILs did not result in an increased uptake of [125I]UdR into these tissues, thus confirming that TIL proliferation is responsible for the radiolabel uptake in animals receiving TILs alone or TILs plus IL-2. Additionally, fluorescein-labeled anti-Thy-1.1 antibody identified proliferating TILs derived from congenic B6.PL Thy 1a/CY (Thy-1.1) animals in the lungs, spleen, and liver of recipient C57BL/6N (Thy 1.2) mice. In summary, we have demonstrated that adoptively transferred TILs distribute widely after i.v. injection and can proliferate in various tissues especially under the influence of exogenous IL-2.

Animals↗
PubMed1988

Geriatrics emphasis in physical therapy. A historical survey.

The number of elderly individuals and the health care needs of elderly persons are rapidly growing. Are physical therapists interested and involved in meeting the needs of this geriatric group? One measure of physical therapists' interest is the quantity of geriatrics-related articles that appear in our profession's journal. The purpose of this study was to conduct a historical review of the number of geriatrics-related articles published in Physical Therapy. All articles indexed under "geriatrics" between January 1921 and June 1987 were identified and categorized in five-year time intervals to assess trends over time. Geriatrics-indexed articles generally appeared infrequently in the Journal, averaging one article every two years. All Physical Therapy articles published between January 1980 and June 1987 were read to determine whether they exhibited a geriatrics orientation. An average of six geriatrically oriented articles appeared in the Journal annually (about 5% of all articles annually). An increased number of geriatrics articles appeared in the Journal between 1980 and 1987. An imbalance clearly exists when an age group that comprises 25% of our patient population receives attention in only 5% of the Journal articles. As a profession, we must examine our attitudes toward and perceptions about elderly persons if we are to address their needs responsibly.

Aged↗
PubMed1986

High voltage versus low voltage electrical stimulation. Force of induced muscle contraction and perceived discomfort in healthy subjects.

High voltage pulsed galvanic stimulation (HVPGS) and low voltage neuromuscular stimulation (LVNMS) techniques were compared for peak torque of an induced isometric contraction, perceived discomfort, and subjective preference of treatment. The high voltage current used a 40-microseconds monophasic waveform, and the low voltage current used a 300-microseconds biphasic waveform. Both currents used a pulse rate of 50 pps. Both HVPGS and LVNMS were administered to one muscle group, either knee extensors or plantar flexors, of 24 healthy subjects. An isokinetic dynamometer was used to assess peak torque. The perceived discomfort experienced with each type of electrical stimulation was quantified by the use of a visual analog scale. For all dependent measures, data first were analyzed for the whole treatment group and then analyzed for each subgroup. Correlated t tests for the whole group and the plantar flexor muscle subgroup demonstrated that HVPGS produced a significantly greater average peak force of muscle contraction than LVNMS and HVPGS was perceived to be significantly less uncomfortable than LVNMS. No significant differences were found between treatments in the knee extensor muscle subgroup for these dependent variables. Chi-square analysis revealed a subject preference for HVPGS in the whole group and in both subgroups. This study indicates that HVPGS can produce a stronger, less uncomfortable, induced isometric muscle contraction than LVNMS.

Consumer Behavior↗
PubMed1984

Changes in sympathetic tone associated with different forms of transcutaneous electrical nerve stimulation in healthy subjects.

The purpose of this study was to determine the effect of four different forms of transcutaneous electrical nerve stimulation (TENS) on sympathetic tone in healthy subjects. Twelve subjects received high frequency, low frequency, burst frequency, and placebo stimulation to one upper extremity. Treatments were given on different days. Ipsilateral and contralateral fingertip skin temperatures were measured at three intervals for each treatment: 1) after a 25-minute rest period before stimulation, 2) after a 25-minute treatment, and 3) 25-minutes posttreatment. High, low, and burst frequency TENS significantly increased sympathetic activity in the ipsilateral extremity immediately after treatment. Similar trends in temperature change were seen on the contralateral side. The effects of the three nonplacebo treatments did not differ from each other. Further research is needed to assess sympathetic effects of TENS on patient groups. The results suggest that monitoring skin temperature as part of a TENS assessment may be warranted, especially in patients with distal vascular impairments.

Adolescent↗
PubMed1977

Automated microdensitometry and quantification of lipoproteins by agarose gel electrophoresis.

A major obstacle in the application of quantitative microelectrophoresis has been tedious manipulations and calculations. To overcome these difficulties, we have developed an automatic system for the microdensitometry and calculations as part of a quantitative agarose gel electrophoresis facility. Results are internally standardized by serum cholesterol and/or triglyceride measurements. The hardware consists of a densitometer, an analog to digital converter, a cathode ray tube terminal, a teleprinter, and a small computer. A program in 4K words allows sample coding, electrophoretic scan display, indexing, and systematic identification of each peak. Data are acquired from scans of electrophoretic patterns of serum alone or in combination with the 1.006 gm/ml VLDL top and/or bottom preparative lipoprotein fractions. As many as 30 scans can be stored in 4K words of memory and then sent via high-speed telephone line to a larger computer for remote processing. The analysis corrects for baseline drifts and pre-beta asymmetry and will properly identify and quantify the amount of VLDL, LDL, and HDL with corrections for "sinking pre-beta" and "floating beta" in LDL and VLDL, respectively. Results are given in milligrams per 100 milliliter as well as percentile rank and standard deviation score ranking of each lipoprotein class as compared to an appropriate normal reference population. The latter data are in a form more meaningful to the physician and patient and provide a quantitative dimension to lipoprotein phenotyping.

Adult↗