Biomedical subjects

T C Lin

Publications and source records attributed to T C Lin.

At least 37 records · Page 2Linked to original sources

PubMed2000

Preoperative carcinoembryonic antigen level as an independent prognostic factor in colorectal cancer: Taiwan experience.

BACKGROUND: Preoperative carcinoembryonic antigen (CEA) level is considered as a factor predictive of survival in colorectal cancer patients. Patients with normal (<5 ng/ml) or lower preoperative CEA levels were reported to have significantly longer survival. This study was carried out in an effort to evaluate the prognostic significance of preoperative CEA levels of patients with colorectal cancer in Taiwan. METHODS: Between 1990 and 1994, 218 patients with histologically confirmed colorectal cancers were evaluated retrospectively at the Veterans General Hospital-Taipei. All the patients had undergone potentially curative surgery. Patients with metastatic diseases were not included. 5-Fluorouracil-based adjuvant chemotherapy was administered if the patients had Dukes' C disease. Reference to the Dukes' classification was according to the classical criteria described in 1932 for carcinoma of the rectum and adapted for use in colonic tumors. Data on gender, age, degree of tumor differentiation, location of the tumor, tumor size, lymph node metastasis, penetration of the bowel wall and preoperative CEA levels were analyzed to determine their association with survival. Blood samples for CEA measurement were taken a few days before operation and were analyzed using the radioimmunoassay method. Multivariate analysis by Cox's proportional hazards regression model was performed to determine the most important predictors of survival among all of the possible variables. RESULTS: By univariate analysis, the size of the tumor (p = 0.012), lymph node metastases (p = 0.007), penetration of the bowel wall (p < 0.001) and preoperative CEA levels (p < 0.001) were found to be significant prognostic factors, while gender, age, degree of tumor differentiation and location of the tumor were not significant. By multivariate Cox analysis, lymph node metastases (p = 0.003), penetration of the bowel wall (p = 0.0001) and preoperative CEA levels (p = 0.0001) were found to be independent prognostic factors in colorectal cancer patients. CONCLUSIONS: The data from our study indicate that in addition to lymph node metastases and penetration of the bowel wall, the preoperative CEA levels are also an independent prognostic factor in non-metastatic colorectal cancer patients after curative surgery. This could serve as an appropriate modification to the initial Dukes' scheme in colorectal cancer.

Adenocarcinoma↗

PubMed2000

Phase II study of oral tegafur-uracil and folinic acid as first-line therapy for metastatic colorectal cancer: Taiwan experience.

BACKGROUND: Tegafur-uracil has become an important regimen in the treatment of metastatic colorectal cancer. Tegafur is a prodrug that is converted to 5-fluorouracil (5-FU) and has been reported to be less toxic and to have a higher therapeutic index. The additional advantage of tegafur is oral administration, an important consideration to improve the quality of life in these patients. Tegafur in combination with uracil is thought to have greater anti-tumor activity due to the inhibitory effect of uracil on the degradation of 5-FU by hepatic dihydropyrimidine dehydrogenase. Tegafur with folinic acid has been reported with modest efficacy and acceptable toxicity. The purpose of this study was to evaluate the effectiveness and toxicity profile of oral tegafur-uracil plus folinic acid in Chinese patients with metastatic colorectal cancer. METHODS: Between May 1998 and August 1999, 40 patients with metastatic colorectal carcinoma were enrolled in this study. All the patients had to have measurable lesions. The initial dose of tegafur-uracil was 300 mg/m2/day for 28 days, followed by a 7-day rest period. Folinic acid was administered orally at a dose of 60 mg/day concurrently with tegafur-uracil. For patients with neutrophil count <1500/microl or a platelet count <100,000/microl after treatment, the treatment was postponed for a maximum of 2 weeks. After that time, if the neutrophil count was 1000-1500/microl and the platelet count was 70,000-100,000 microl, the dose of tegafur-uracil was reduced by 50%, and if lower values resulted, the treatment was discontinued. RESULTS: Forty patients received a total of 318 courses of treatment and a response rate of 32.5% (95% CI, 18-47%), including five complete remissions and eight partial remissions, was achieved. Toxicity was mild and generally tolerable. Gastrointestinal toxicities, including diarrhea, nausea and vomiting, were the major side effects. Seven incidences (17.5%) of grade 3-4 gastrointestinal toxicity were observed. Hematological toxicities were minimal with no evidence of severe (grade 3 or 4) leukopenia and thrombocytopenia. No episode of hepatic, renal, cardiac or neurological toxicity occurred. Two patients (5%) developed transient painful fissuring erythroderma over their palms and soles (the hand-foot syndrome). CONCLUSIONS: The data from our study indicate that oral tegafur-uracil plus folinic acid is an active and tolerable first-line treatment for Chinese patients with metastatic colorectal cancer, with the additional advantage of being easily administered at home.

Adenocarcinoma↗

PubMed2000

Endoscopic placement of Sengstaken-Blakemore tube.

A Sengstaken-Blakemore (SB) tube, when used approximately, still has a place in the management of acute variceal bleeding. Due to a number of reported complications from the misplacement of this tube, an x-ray localization before full inflation of the gastric balloon is recommended as the standard of care. Here, we report a new technique of SB tube placement with endoscopic confirmation in three patients. This technique is easy, accurate, and can be performed in any unit where a patient with variceal bleeding can be managed. Because it cuts down on the need for an x-ray or ultrasound confirmation, this technique may well become the "standard of care" among the practicing gastroenterologists.

Aged↗

PubMed2000

Convulsions during superior laryngeal nerve block--a case report.

Complications following local anesthesia for fiberoscope-assisted intubation are rare. We report a case with surgical condition indicating awake endotracheal intubation for general anesthesia, suffering from convulsions after receiving left superior laryngeal nerve block to facilitate the procedure. The possible cause may be accidental injection of the local anesthetic into the vertebral artery. Although the amount of local anesthetic injected was small, its concentration in the brain might be high enough to cause convulsion. The central nervous system toxicity of local anesthetic depends not only on the dosage used, but also on the rate of injection, as well as the site at which it is injected. Starting from a small dose together with careful monitoring of patient's response is advised when nerve block in the neck is performed. Here, we also emphasize the importance of availability of resuscitation equipment for maintaining adequate ventilation and circulation in case of emergency.

Adult↗

PubMed2000

Intra-articular ketamine for pain control following arthroscopic knee surgery.

BACKGROUND: In an attempt to demonstrate the peripheral effect of ketamine on the synovia of knee joint and to smoothen the recovery from arthroscopic knee surgery, this study was designed to evaluate the analgesic effect of intra-articular ketamine injection after knee arthroscopy. METHODS: In a double blind randomized study, 60 patients were assigned to three groups. Group A patients received saline 5 mL intra-articularly after closure of the surgical wound to serve as control; group B patients received ketamine 0.5 mg/kg of body weight intra-muscularly to rule out the systemic effect and group C patients received ketamine 0.5 mg/kg of body weight diluted with saline up to 5 mL intra-articularly. After surgery, patients were evaluated for pain with visual analogue scale (VAS 0 to 10) for 24 h with the operated leg in the position of extension rest and active flexion of the knee joint to 60 degree angle. Rescue pethidine (1 mg/kg of body weight) was given intra-muscularly for pain relief at request every 4 h postoperatively if necessary. The time to first rescue analgesic request was recorded, and the total doses of pethidine were calculated. RESULTS: The results showed no difference in the VAS pain scores at rest and during active motion in the range of 60 degree among three groups during a 24 h observation. CONCLUSIONS: Ketamine had been reported to have peripheral analgesic effects with variable duration on measurements of pain and hyperalgesia. However, in the present study, we failed to demonstrate that ketamine could provide a clinically relevant peripheral analgesic effect for postoperative arthroscopic pain.

Adult↗

PubMed2000

Postoperative intramuscular dextromethorphan injection provides pain relief and decreases opioid requirement after modified radical mastectomy.

BACKGROUND: Narcotics are still the therapeutic mainstay for postoperative pain relief. However, many unwanted side effects are accompanied. NMDA antagonists have been demonstrated to produce analgesic and antihyperalgesic effects, moreover, to possess potentiated effect of narcotics on postoperative pain management. AIMS: To examine whether postoperative dextromethorphan (DM), an antitussive and also an NMDA antagonist, intramuscular injection (I.M.) reduced pain and analgesic requirement after modified radical mastectomy (MRM). METHODS: Sixty-one patients scheduled for MRM were included and randomly allocated into two groups. For the control group (n=31), patients received chlorpheniramine maleate (CPM, 20 mg) I.M., while in the DM group (n = 30), 40 mg DM containing 20 mg CPM (I.M.) was given at the end of surgery. Meperidine (1 mg/kg, I.M.) was prescribed for postoperative pain relief, if ask. The time to first meperidine injection, total meperidine consumption, worst pain score, bed-rest time, and meperidine-related side effects were recorded for 48 hours postoperation. RESULTS: A longer time to first meperidine injection (20.3 +/- 1.4 vs 1.5 +/- 0.2 hr, p < 0.001) and lower meperidine consumption (10.7 +/- 4.0 vs 70.7 +/- 8.9 mg, p < 0.001) were observed in the DM group than the control group. The average bed rest time was significantly shorter in the DM group than in the control group (18.9 +/- 1.5 vs 23.4 +/- 1.6 hr, p < 0.001). The number of patients who required meperidine injection (6 vs 27, p < 0.005) and meperidine-related side effects were significantly lower in the DM group than in the control group (1 vs 7, p < 0.025). No difference was noted in worst VAS pain score between the DM and the study groups. CONCLUSION: Postoperative DM I.M. injection provided an analgesic effect and reduced meperidine requirement after MRM.

Analgesics, Opioid↗

PubMed1999

Emission characteristics of VOCs from athletic tracks.

Dynamic and flow-through flux chambers are convenient tools for field measurements of gas or VOC emission flux from solid surfaces in the field. This study was undertaken to collect on site and quantify the emissions of volatile organic compounds (VOCs) released from athletic running tracks. Three typical types of tracks, one synthetic rubber and two tracks (types I and II) consisting mainly of polyurethane, were studied. They were all installed with adhesives and backings, both of which contributed significant amount of VOCs. VOCs released from the track surface were collected with a flux chamber and subsequently analyzed by a gas chromatograph/mass spectrometer (GC/MS). Also, for each track and at each selected time the emission flux and mass emission were measured on site under outdoor conditions over a period of 40 min. GC/MS analyses show that the VOCs emitted include 2-methyl furan, butanal, methyl ethyl ketone, benzene, heptane, methyl isobutyl ketone, toluene+octane, hexanal, nonane+ethylbenzene, xylenes+styrene, propyl benzene, decane, 1,3,5-trimethyl benzene, 1,2,4-trimethyl benzene, 1,2, 3-trimethyl benzene and undecane. Of these, hexanal was the common and principal compound for all three types of tracks. 2-Methyl furan and methyl isobutyl ketone were the characteristic compounds for the synthetic rubber and the type II of polyurethane tracks, respectively. In the field studies, no unique compounds were found in the type I of polyurethane tracks. For each of these three types of tracks the total-VOCs emission flux was correlated to the track age and track surface temperature. The results of multiple regression analysis showed good correlation. The type II polyurethane track had the highest decay rate, while the synthetic rubber track had the lowest decay rate. Two years after the track installation, the VOC concentrations measured at 1.5 m above the track, the breathing height of school children, were not significantly higher than the background levels.

Air Pollutants↗

PubMed1999

Scanning electron microscopy observation of vascularization around hydroxyapatite using vascular corrosion casts.

An intimate relationship exists between the regenerative response of the vascular and osseous elements following hydroxyapatite (HA) implantation. In order to fully comprehend the 3-dimensional vascular architecture around HA, dense HA particles were implanted into the tibiae of dogs. Following healing periods of 2 weeks, 1 month, and 3 months, the tibiae were prepared by the corrosion cast technique. Under scanning electron microscopy (SEM) observation, the characteristic vascular morphology of the HA-implanted cavity was successfully demonstrated. The initial vascularization began in the form of loose sinusoidal capillaries. Many sinusoids formed a complex network by anastomosing with each other. The newly formed vessels extended centripetally from the peripheral cavity wall and from the periosteal surface. Under greater magnification, the tapered vascular sprouting was shown to project into the space that was previously occupied by an HA particle. The presence of vascular sprouting is clearly an important indicator of angiogenesis. Increasing vascularization was demonstrated with time. The presence of vessels in the Haversian's canal indicated the more established vascularization. Almost full vascularization of the HA-implanted cavity was seen 3 months after implantation. The vascular organizational layout of the cavity was also clearly shown in the fractured transverse-sectioned sample. In the control without HA implantation, the central region of the cavity showed a hollow pattern in the initial stage. The vascularization looked like it was collapsing and not fully filling the cavity. However, remarkable differences of the final vascular pattern could not be found between the study and control group after 3-month implantation. The study provides the time-lapsed 3-dimensional vascular changes of the HA-implanted cavity, as well as the value of the corrosion cast technique in examining the bony circulation.

Animals↗

PubMed1999

Risk and patterns of brain metastases in colorectal cancer: 27-year experience.

PURPOSE: In patients with colorectal cancer, brain metastasis is infrequent. This study aims to elucidate the risk, pattern of occurrence, and survival time after different treatment modalities. METHODS: A retrospective review of all patients with colorectal cancer admitted to the Veterans General Hospital-Taipei between 1970 and 1996 from our hospital was performed. Univariate analysis for survival determination was performed. RESULTS: Brain metastases developed subsequent to surgery for colorectal cancer in 53 well-documented patients, at a median of 36 months after surgery. Brain metastases were more commonly seen in rectal cancer and often occurred concurrently with lung metastases. Forty of these patients received active intervention in terms of surgery, chemotherapy, or radiotherapy, with surgical intervention achieving a significantly increased mean survival time (+/- standard deviation) compared with chemotherapy or radiotherapy or both of 86.6 +/-17.35 vs. 2.9 +/- 0.59 months (P < 0.05). CONCLUSION: Increased awareness of the possibility of brain metastases, early diagnosis, and aggressive therapy can provide increased survival time for patients with colorectal cancer with brain metastases.

Adult↗

PubMed1999

Effects of punicalagin and punicalin on carrageenan-induced inflammation in rats.

Punicalagin and punicalin were isolated from the leaves of Terminalia catappa L. In this study, we evaluated the anti-inflammatory activity of punicalagin and punicalin carrageenan-induced hind paw edema in rats. After evaluation of the anti-inflammatory effects, the edema rates were increased by carrageenan administration and reduced by drug treatment. After 4 hr of carrageenan administration, the best effect group was the punicalagin (10 mg/kg) treated group (inhibition rate was 58.15%), and the second was the punicalagin (5 mg/kg)-treated group (inhibition rate was 39.15%). However, even if the anti-inflammatory activity of punicalagin was the same as punicalin at the 5 mg/kg dose, the inhibition effect from larger doses of punicalagin was increased, but there was a decrease with a larger dose of punicalin. The data showed that both punicalagin and punicalin exert anti-inflammatory activity, but treatment with larger doses of punicalin may induce some cell damages.

Animals↗

PubMed1999

Antioxidant activity of tannin components from Vaccinium vitis-idaea L.

Reactive oxygen molecules have been implicated as important pathological mediators in many clinical disorders and periodontal disease. To provide possible alternative treatment of periodontal disease, six tannins isolated from Vaccinium vitis-idaea L. were evaluated for anti-lipid peroxidation, anti-superoxide formation and free radical scavenging activity. The results showed that cinnamtannin B1 displayed the strongest anti-lipid peroxidation activity, proanthocyanidin A-1 displayed the strongest superoxide scavenging activity, and epicatechin-(4beta--> 6)-epicatechin-(4beta-->8, 2beta-->O--> 7)-catechin had the strongest anti-superoxide formation effect. We conclude that tannins isolated from V. vitis-idaea L. exhibited multiple antioxidant activity, and could be used for the treatment of periodontal disease.

Antioxidants↗

PubMed1999

Postoperative intramuscular dextromethorphan injection provides postoperative pain relief and decreases opioid requirement after hemorrhoidectomy.

BACKGROUND: Previous studies have shown that dextromethorphan (DM) produces an analgesic/antihyperalgesic effect. This study was designed to examine whether postoperative DM intramuscular (i.m.) injection could reduce post-hemorrhoidectomy pain. METHODS: At the end of the surgery, patients in the study group (n = 30) were given an intramuscular injection of 40 mg DM and 20 mg chlorpheniramine (CPM) while in the study group (n = 30), the patients were given intramuscular 20 mg CPM only. Pethidine (1 mg/kg, i.m.) was prescribed for postoperative pain relief if required. The time to first pethidine injection, total pethidine consumption, worst pain score, and pethidine-related side effects were recorded for 48 h postoperatively. RESULTS: The time from the end of operation to the first pethidine injection was 5.4 +/- 1.6 h and 17.8 +/- 3.7 h (P = 0.006) in the control group and the study group, respectively. Total pethidine consumption was 139.5 +/- 11.5 mg and 77.5 +/- 12.2 mg (P < 0.001) in the control group and the study group, respectively. The worst VAS score was 7.5 +/- 0.2 and 7.1 +/- 0.2 (P = 0.09) in the control and the study groups, respectively. The number of patients who required pethidine injection was 29 and 21 (P < 0.005) in the control and the study groups, respectively. The number of patients who suffered pethidine-related side effects was 7 and 1 (P < 0.025) in the control and the study groups, respectively. CONCLUSIONS: We found that intramuscular DM given at the end of operation could provide good postoperative pain relief and decrease the pethidine requirement after hemorrhoidectomy.

Adult↗

PubMed1998

Percutaneous mesenteric venous thrombectomy and thrombolysis: successful treatment followed by liver transplantation.

Mesenteric vein thrombosis (MVT) is a rare cause of intestinal ischemia. Because of its nonspecific symptoms, diagnosis is often delayed. We describe a patient with liver cirrhosis who developed acute MVT while waiting for liver transplantation. Surgical intervention carried a high risk because of her underlying cirrhosis. Mesenteric venous thrombectomy and thrombolysis were performed with an AngioJet (Possis Medical, Minneapolis, MN) thrombectomy device and streptokinase infusion through transjugular route. The patient subsequently received an orthotopic liver transplant. We also present a review of the literature about the occurrence and treatment options for MVT.

Aged↗

PubMed1998

Long-term epidural ketamine, morphine and bupivacaine attenuate reflex sympathetic dystrophy neuralgia.

PURPOSE: There is considerable evidence that NMDA receptor antagonists can abolish nociceptor hypersensitivity in animals. In the present case report, two patients with reflex sympathetic dystrophy were treated with ketamine, a NMDA antagonist, morphine and bupivacaine. CLINICAL FEATURES: Two patients were referred suffering from severe pain, allodynia, hyperaesthesia, swelling and disability over their right lower legs, diagnosed as reflex sympathetic dystrophy. They had received conventional treatments with non-steroid anti-inflammatory drugs (NSAIDs), steroids, anticonvulsant, antidepressant, epidural lidocaine sympathetectomy and rehabilitation which failed to provide satisfactory pain relief. We administered subanalgesic doses of ketamine (7.5 mg), morphine (0.75 mg) and 6 ml bupivacaine 0.1% via a lumbar epidural catheter three times per day. After several courses of treatment over three and six months, satisfactory pain relief was achieved in each patient. Both are now able to walk with slight weight bearing with the assistance of crutch. The treatment is continuing with further improvement of symptoms and signs. CONCLUSION: Epidural coadministration of low doses of morphine, ketamine and bupivacaine provided effective pain relief in two patients. This suggests synergy from this combination that provides an alternative treatment for reflex sympathetic dystrophy.

Adult↗

PubMed1998

Effect of the gasoline additives on PAH emission.

PAH emission from the powered engines fueled by a 95 leadfree gasoline (95-LFG), a 92 leadfree gasoline (92-LFG) and a Premium leaded gasoline (PLG) with two gasoline additives (SA and SB) were collected using a PAH sampling system with a particulate interception device. Twenty one PAHs were analyzed primarily by an GC/MS, while eight metal elements were determined mainly by an ICP-AES. This investigation showed that the gasoline additives contain more amounts of carcinogenic PAHs than gasolines do. Blending these additives do raise the PAH content in the gasolines, simultaneously, will emit more amount of PAHs from the tailpipe of engine exhaust. It is suggested that before a gasoline additive is commercialized, an assessment on its PAH emission should be evaluated to make sure that the additive will not emit more PAHs and cause adverse effect on public health.

Carcinogens↗

PubMed1998

Weekly 24-hour infusion of high-dose 5-fluorouracil and leucovorin in patients with advanced colorectal cancer: Taiwan experience.

Between January 1994 and November 1995, 41 patients with metastatic colorectal carcinoma were enrolled in this study. All these patients had recurrent disease after a prior 5-fluorouracil based adjuvant chemotherapy or failed to achieve response by prior chemotherapy that included 5-fluorouracil. 5-Fluorouracil, 2600 mg/m2, was administered concurrently with 100 mg/m2 leucovorin over 24 hours of continuous intravenous infusion. The treatment was repeated every week until progressive disease was documented. Forty-one patients received a total of 810 courses of treatment. The overall response rate was 17.1% (95% confidence interval 5.6-28.6%). In two patients who achieved complete response, the liver was the metastatic site. The median survival was 18.4 months for responders and 12.6 months for non-responders. Gastrointestinal toxicities including diarrhea, stomatitis, nausea and vomiting were the major side-effects. Sixteen incidences (39.0%) of grade 2-3 gastrointestinal toxicities were observed. One patient (2.4%) developed a grade 3 cardiac toxicity, and another one (2.4%) had a grade 2 neurotoxicity. Hematological toxicities were minimal with no evidence of severe (grade 2 or more) leukopenia or thrombocytopenia. We conclude that in patients with pretreated metastatic colorectal cancer, weekly 24-hour infusion of high-dose 5-fluorouracil and leucovorin is associated with higher efficacy and tolerable toxicity. This regimen is a good option as a second-line treatment for those whose diseases are recurrent from or refractory to prior 5-fluorouracil, and deserves a longer period of follow-up.

Adult↗

PubMed1998

Antioxidant and hepatoprotective activity of punicalagin and punicalin on carbon tetrachloride-induced liver damage in rats.

Punicalagin and punicalin, isolated from the leaves of Terminalia catappa L., are used to treat dermatitis and hepatitis. Both compounds have strong antioxidative activity. The antihepatotoxic activity of punicalagin and punicalin on carbon tetrachloride (CCl4)-induced toxicity in the rat liver was evaluated. Levels of serum glutamate-oxalate-transaminase and glutamate-pyruvate-trans-aminase were increased by administration of CCl4 and reduced by drug treatment. Histological changes around the liver central vein and oxidation damage induced by CCl4 also benefited from drug treatment. The results show that both punicalagin and punicalin have anti-hepatotoxic activity but that the larger dose of punicalin induced liver damage. Thus even if tannins have strong antioxidant activity at very small doses, treatment with a larger dose will induce cell damage.

Alanine Transaminase↗

PubMed1998

The changing pattern of intestinal tuberculosis: 30 years' experience.

SETTING: Although the incidence of tuberculosis had been decreasing for many years, it has recently risen. OBJECTIVES: To investigate the changes in the pattern and distribution of intestinal tuberculosis and to alert surgeons to the importance of maintaining a high index of suspicion for this disease entity. DESIGN: Retrospective analysis of 134 patients with intestinal tuberculosis discharged from the Veterans General Hospital in Taipei from 1965 to 1995. All records, bacteriological examinations and pathological specimens were reviewed and extracted onto a standard questionnaire. RESULTS: A decline in the case numbers of intestinal tuberculosis was noted after 1975. However, there seems to be a slight rise in case numbers since 1990. The average age of those patients after 1990 (64.8 years) is higher than those before 1990 (44.4 years). None of our patients had clinical signs of human immunodeficiency virus (HIV) infection. Most patients (81.3%, 109/134) had not received a definite diagnosis until surgery. Active pulmonary tuberculosis was found in 37 patients (29.1%). CONCLUSION: The possible reasons for the rise in cases of intestinal tuberculosis in our patients may be linked to an increased life expectancy, the reappearance of some formerly 'silent' tuberculosis cases, and relapse in patients having received incomplete antituberculosis chemotherapy. Its insidious and non-specific clinical presentation makes the diagnosis of intestinal tuberculosis difficult. An increased index of suspicion and greater familiarity with the disease may shorten the time of diagnosis and may also prevent some unnecessary operations.

Adolescent↗