Biomedical subjects

R-J Chen

Publications and source records attributed to R-J Chen.

4 recordsLinked to original sources

PubMed2006

Laparoscopic appendectomy in the elderly.

BACKGROUND: This study aimed to compare the outcomes of laparoscopic and open appendectomy among the elderly. METHODS: Data on 53 elderly patients with a diagnosis of suspected appendicitis were prospectively collected and retrospectively reviewed. Among these patients, 24 had undergone laparoscopic appendectomy (LA) and 29 had undergone open appendectomy (OA). The indications for either method were based on the patient's choice. RESULTS: No statistically significant difference in operative time was found between the LA (70 +/- 28 min) and OA (60 +/- 22 min) groups. There was no statistically significant difference in lengths of hospital stay between the LA (4.8 +/- 3.0 days) and OA (5.0 +/- 3.1 days) groups, and there was a statistically significant difference in the postoperative analgesic doses between the LA (0.5 +/- 0.3 doses) and OA (1.7 +/- 1.5 doses) groups. No conversion of laparoscopic to open surgery was necessary, and no intraabdominal abscesses developed. CONCLUSION: According to this study, LA is as safe and effective as OA for the elderly. Furthermore, it significantly reduces postoperative wound pain.

Aged↗

PubMed2006

Urgent laparoscopic cholecystectomy in the management of acute cholecystitis: timing does not influence conversion rate.

BACKGROUND: The optimal treatment of acute cholecystitis is urgent laparoscopic cholecystectomy. Most reports suggest that a delay of 72 or 96 h from onset of symptoms leads to a higher conversion rate. This study assessed the conversion rate in relation to the timing of urgent laparoscopic cholecystectomy for acute cholecystitis. METHODS: During a 12 month period, 112 patients received laparoscopic cholecystectomy for acute cholecystitis at a tertiary care university hospital in central Taiwan. Data were collected prospectively. RESULTS: The overall conversion rate was 3.6% (4/112). Of 62 procedures performed within 72 h from onset of symptoms, 2 were converted, as compared with 2 of 50 procedures after 72 h. Of 76 procedures performed within 96 h from onset of symptoms, 3 were converted, as compared with 1 of 36 procedures after 96 h. There were no mortalities or common bile duct injuries. CONCLUSIONS: The conversion rate for urgent laparoscopic cholecystectomy among patients with acute cholecystitis can be as low as 3.6%. The timing of urgent laparoscopic cholecystectomy has no impact on the conversion rate.

Adult↗

PubMed2004

Cyclosporine C2 monitoring is superior to C0 in predicting acute cellular rejection in heart transplant recipients in Taiwan.

The cyclosporine (CsA) blood concentration at 2 hours postdose (C2) has been shown to be better than trough level (C0) to predict acute cellular rejection (ACR) in solid organ transplantations. We tried to assess the superiority of C2 monitoring to C0 in heart transplantation (HTx). Prospective data were collected from the HTx recipients from November 1991 to April 2003. The 100 patients surviving longer than 3 months after HTx, provided 237 sample sets, with ACR graded by endomyocardial biopsy (EMB) and concurrent C0 and C2 levels. ACR was defined as International Society of Heart and Lung Transplantation (ISHLT) grade lb or higher. Nonparametric methods, logistic regression model, and receiver operating characteristic (ROC) analysis were used. There was no significant demographic heterogeneity between ACR and non-ACR groups. C2 was significantly lower in ACR than non-ACR groups (P = .0192) whereas C0 showed no significant difference. In the logistic regression model, C2 was a significant predictor against ACR (P = .026, odds ratio = 0.76 per 100 ng/mL), but C0 was not. ROC analysis showed that C2 of 600 ng/mL might provide the optimal cut-off point, with a sensitivity of 51.23% and a specificity of 71.43%, but C0 did not show this association. In conclusion, C2 monitoring is superior to C0 for predicting ACR in HTx. ACR should be suspected when the C2 value is below 600 ng/mL.

Administration, Oral↗

PubMedDate not supplied

Detection of gonadotropin-releasing hormone receptor and its mRNA in primary human epithelial ovarian cancers.

The hypothalamic neuropeptide gonadotropin-releasing hormone (GnRH) serves a key role in regulating mammalian reproductive function. An extrapituitary role for GnRH in the normal and malignant reproductive tissues has been postulated. The purpose of our study is to demonstrate the presence and levels of GnRH receptor (RGnRH) protein and its mRNA in normal and malignant tissues of ovary. Normal human ovarian tissues (n = 13), as well as epithelial ovarian cancer specimens from stages I-IV (n = 39), were obtained from appropriate patients at operation room. Monoclonal antibodies against RGnRH were used for immunohistochemical evaluation of paraffin-embedded ovarian tissue sections by methods of streptavidin-biotin immunostaining. The molecular size and levels of RGnRH were determined by enhanced chemiluminescence-Western blot assay. The amount of RGnRH mRNA was detected by reverse transcriptase polymerase chain reaction (RT-PCR). The rate of positive immunostaining in ovarian cancers was 53.8% (21/39). The rate of positive staining in the late stage (stages III and IV) was significantly higher than that in the early stage (stages I and II). A single band of molecular weight of about 60 kDa was detected from protein extracts of ovarian cancer as well as from normal ovary. The mean values of fold increase of signal intensities of 60 kDa detected by Western blots in stages I-IV ovarian cancers were 2.39, 2.42, 2.78, and 3.62, respectively, as compared with normal ovarian tissues. The overall positive rate of Western blot analysis for ovarian cancers was 59% (23/39). The mean values of signal intensity of RT-PCR products of RGnRH mRNA in stages I-IV were 2.24, 2.58, 3.10, and 3.20, respectively. The positive rate of overexpression of RGnRH mRNA in ovarian cancer was 70% (21/30). The differences of mean values of signal intensities of Western blot staining (2.41 versus 2.85) as well as RT-PCR products (2.40 versus 3.11) between the early stage and the late stage of ovarian cancers were statistically nonsignificant. Mechanism of autocrine regulation of tumor growth in human epithelial ovarian cancer can be explained by the coexistence of GnRH, RGnRH, and its mRNA, according to our own and other studies. The level of RGnRH expressed by ovarian cancer might be used for targeting chemotherapeutic agents to those patients who harbor RGnRH-positive tumors.

Blotting, Western↗