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Biomedical subjects

T Fung

Publications and source records attributed to T Fung.

18 recordsLinked to original sources
PubMed2003

Reconstruction for chronic dislocation of the hip.

We analysed one surgeon's attempt to reconstruct the hip in 66 patients (84 hips) with chronic dislocation and to restore the height of the centre of rotation above the transverse teardrop line, the body-weight lever arm, the abductor lever arm, and the abductor angle to normal. The outcome was assessed using a patient profile at 0, 10 and 20 years, a clinical assessment of pain, mobility and the range of active movement. We measured the work done by active movement against gravity, radiological signs of loosening, migration and subsidence, and the need for revision. We used survival at ten years and revision as the endpoint. The incidence of complications was higher than in arthroplasty for primary osteoarthritis of the hip, but the outcome was considered satisfactory. The advantages of a flanged cemented socket were demonstrated. A custom-made, laterally reduced, Charnley extra small CDH femoral prosthesis was used in certain cases.

Adult↗
PubMed1999

Elevated neuronal Cdc2-like kinase activity in the Alzheimer disease brain.

Neurofibrillary tangles (NFT) in Alzheimer's disease (AD) consist largely of hyperphosphorylated tau protein. Many of the phosphorylation sites on tau are serine/threonine-proline sequences, several of which are phosphorylated in vitro by neuronal Cdc2-like kinase (Nclk), a kinase composed of Cdk5 and its activator(s). Thus, tau hyperphosphorylation in AD may result in part from deregulation of Nclk. To test this hypothesis, we examined Nclk activity in prefrontal and cerebellar cortex from 15 postmortem AD and 16 age-matched control subjects, and corrected either for Cdk5 level or for neuronal loss. The ratio of Nclk activity in prefrontal versus cerebellar cortex was then compared. When corrections were made for neuronal loss, the ratios of kinase activity in prefrontal versus cerebellar cortex were significantly higher in AD (6.45+/-0.86) than the controls (3.13+/-0.46; P = 0.003). This finding is consistent with a role for Nclk in the pathogenesis of NFT in AD.

Aged↗
PubMed1999

Parenteral antibiotic use in acute-care hospitals: A standardized analysis of fourteen institutions.

Despite increasing concerns regarding the need to optimize appropriate antibiotic use in hospitals, a standardized method for evaluating interinstitutional antibiotic use has not been developed. To address this issue, antibiotic use was analyzed by means of a uniform methodology among 14 acute-care hospitals. Data were standardized by use of a defined daily dose for each antibiotic while adjusting for patient volume by calculating use per 1000 patient-days. Within the group, there was a 68% range in total parenteral antibiotic expenditures and wide variability in the use of individual agents. Analysis of these differences indicated that only the use of active antibiotic-management programs clearly correlated with antibiotic cost per 1000 patient-days (P<.001). Given these results, we believe that wider comparative analysis of antibiotic use with a standardized methodology in conjunction with standardized analysis of nosocomial infection rates and antibiotic resistance data may enhance the stewardship of antibiotics in acute-care hospitals.

Anti-Bacterial Agents↗
PubMed1999

Maternal serum screening for Down syndrome in a teaching hospital in Hong Kong.

OBJECTIVE: To study prospectively the use of maternal serum alpha-fetoprotein (AFP) and total beta-human chorionic gonadotropin (hCG) concentrations for screening of Down syndrome in Hong Kong. METHODS: AFP and total beta-hCG were measured in serum samples from 1638 singleton Chinese pregnancies at 14-22 weeks of gestation, recruited over a twelve-month period. Gestational ages were determined by ultrasonographic parameters measured at the same visit as the test for all cases. The gestational-age-specific and weight-adjusted medians for serum AFP and total beta-hCG were calculated. Risk for fetal Down syndrome (FDS) was derived by mathematical modeling of the medians together with maternal age. Amniocenteses were offered to women with a calculated FDS risk of 1:270 or greater. RESULTS: The gestational-age-specific and weight-adjusted medians for maternal serum AFP were similar to previous studies while that of total beta-hCG were higher. A total of 101 patients (6.1%) were classified as being high risk for FDS, including 3.4% (48/1394) of those younger than 35 years of age and 21.7% (53/244) of those who were 35 or above. There were 4 cases of Down syndrome, 1 case of Tumer syndrome and 1 of Edward syndrome. Three out of the four cases of Down syndrome were screened positive, corresponding to a detection rate of FDS of 75%. A case of Tumer syndrome was also screened positive. A case of trisomy 18 was found to have very low levels of AFP [0.262 multiple of median (MoM)] and total beta-hCG (0.115 MoM). CONCLUSIONS: Maternal serum screening using double biochemical markers (AFP and total beta-hCG) in combination with gestational dating by ultrasonography is effective in the detection of fetal Down syndrome and possibly other chromosomal disorders in Chinese pregnant women.

Adult↗
PubMed1997

Vibromyography as a quantitative measure of muscle force production.

This study was undertaken to investigate the use of vibromyography (VMG) as a tool for quantifying skeletal muscle force production. Fourteen healthy volunteers were pretested using a Cybex isokinetic dynamometer to determine their isometric quadricep maximum voluntary contraction (MVC) values. On the basis of these results, the subjects were separated into two groups: high-force ("HF" MVC mean = 289 ft.lb., range 254-330) and low-force ("LF" MVC mean = 154 ft.lb., range 101-198). A vibromyographic piezoelectric accelerometer (Dytran 3115A) and electromyographic (EMG) surface electrodes were affixed to the rectus femoris muscle and recordings were obtained at 20, 40, 60, 80, and 100% MVC. Root mean squares, median and mean values were computed from digitized data in the time domain while peak values were calculated from a fast Fourier transform for both the VMG and EMG data. A two-way repeated measures MANOVA using relative values and a linear regression model using absolute values were studied using BMDP and MiniTab software. Linear correlations were found between quadricept force and all EMG variables (R2 range 0.71-0.90) except peak (R2 = 0.39). The relationship between VMG and force was less linear (R2 range 0.19-0.69) because VMG values reach a plateau or even drop at 80% and 100% MVC. The HF-LF group differences were significant (p < 0.05), for all VMG values with the exception of root mean squares, but were not significant (p > 0.05) for all four EMG values. This study shows that, while EMG can discriminate force production within a given subject, VMG is a better discriminator of absolute muscle force values between subjects, particularly up to 60% MVC.

Adult↗
PubMed1996

Evaluation of a self-medication program.

OBJECTIVE: To determine the effect of an inpatient self-medication program (SMP) on the ability to self-medicate, patient medication knowledge, compliance, and patient morale. DESIGN: Randomized controlled clinical trial. POPULATION: One hundred seven consecutive patients admitted to a geriatric assessment and rehabilitation program were randomized to either participate in the SMP or to receive standard care. INTERVENTION: The SMP was a three-stage program in which patients were given increasing responsibility for the administration of their own medications. MEASUREMENTS: Ability to self-medicate on discharge from hospital; medication compliance at 1 month; patient medication knowledge; Philadelphia Morale Scale. MAIN RESULTS: Participation in the self-medication program did not increase the proportion of patients who were able to self-medicate on discharge from hospital. Compliance was improved by the program. On a proportional basis, the self-medication group made significantly fewer medication errors than the control group at 1-month follow-up (0.045 vs 0.086, P < .001). There were no significant differences in morale or medication knowledge between the SMP and control groups, although both groups made significant gains in knowledge about the names, administration times, and purposes of their medications from admission to follow-up (P < .001). CONCLUSIONS: A SMP can improve compliance in geriatric patients who are discharged to the community. Participation in a SMP does not improve patients' morale nor does it improve their medication knowledge more than pharmacy counselling alone. Participation in a SMP is unlikely to increase the probability that patients will be able to self-medicate on discharge. Cognitive factors limit patients' ability to self-medicate.

Aged↗
PubMed1994

The worst combinations of child abuse and neglect.

We have studied the impact of various kinds of abuse and neglect on the child's perception of himself and his future. We found, when considering physical abuse, physical neglect, verbal abuse, emotional neglect, and sexual abuse, that less than 5% of these mistreatments occurred in isolation. Since the vast majority of mistreated children are subject to more than one kind of abuse or neglect, it was important to delineate which combinations have the greatest effect. We found that a combination of physical neglect, physical abuse, and verbal abuse had the greatest impact on children, affecting such things as their enjoyment of living and hopes for the future. An early age of onset for verbal abuse and emotional neglect was significantly associated with greater severity and frequency of mistreatment. Neglect appears to be a precursor to abuse in many cases.

Adolescent↗
PubMed1994

The effects of pregnancy loss on women's health.

A survey of women patients in the practices of family physicians in Victoria, B.C. was undertaken to determine the factors associated with pregnancy losses and their effect on women's health. Questionnaires returned by 1428 women with 2961 pregnancies showed that a higher number of losses, particularly abortions, correlates both with poor health and the need to obtain professional help in dealing with the loss(es). Partner support appears to be one of the most important factors in maintaining a pregnancy.

Adaptation, Psychological↗
PubMed1992

Agoraphobic avoidance and panic frequency as predictors of laboratory induced panic reactions.

This study examined the importance of agoraphobic avoidance and frequency of panic as predictors of psychological and physiological responses of panic sufferers to a laboratory based provocation procedure. Psychophysiologic comparisons were made between 22 panic disorder patients and 15 controls, at baseline and across three periods of carbon dioxide gas inhalations (1, 3, 5%; balance oxygen). Subjective measures of anxiety, frightening cognitions and body sensations were obtained across the phases. Physiological measures of minute ventilation, breathing rate, tidal volume, end tidal CO2 and heart rate were also obtained. Between group comparisons revealed significant differences between the groups on the subjective measures with no significant differences occurring on the physiological measures. Within group analyses revealed that pre-session questionnaire measures of agoraphobia avoidance and panic frequency predicted the degree of anxiety, frightening sensations and cognitions during baseline and 5% CO2 inhalation. The results indicated that both self-reported agoraphobic avoidance and panic frequency are strong clinical predictors of psychological reactions of panic sufferers during laboratory provocation.

Adult↗
PubMed1992

Causes of child abuse and neglect.

This paper is a study of child abuse and neglect from the perspective of the child. Generally, the mistreatment of children was associated with "poor care" from parents, attributed mainly to immaturity, marital problems, alcohol abuse, unemployment, drug abuse and lack of money. Differences in attribution are noted between males and females, and some differences are noted by the age of the child. When factors other than the causes given by the children were taken into account, mistreatment was significantly related to family break-up, as well as long-term disinterest and lack of affection from the parents. When the children were asked for their "worst experience in life," the most common responses were "abuse" "family break-up," and for the juvenile offenders "getting charged with a crime."

Child↗
PubMed1991

A randomized controlled trial of early amniotomy.

OBJECTIVE-To determine if a policy of early amniotomy resulted in a reduction in mean labour duration when compared to a policy of conservation of the membranes. DESIGN-A single-centre randomized controlled trial. SETTING-A tertiary care teaching hospital in Alberta, Canada. SUBJECTS-Ninety-seven term nulliparae in spontaneous labour, baby in cephalic presentation. INTERVENTION-Early amniotomy versus intent to keep membranes intact. MAIN OUTCOME MEASURES-Interval from randomization to delivery, rate of abnormalities of fetal heart rate tracings, cord artery blood pH, Apgar scores. RESULTS-The mean interval from randomization to delivery was 390.9 (SE 29.1) min in the amniotomy group and 442.9 (SE 34.1) min in the control group (P = 0.251). There were no differences between groups in the occurrence of fetal heart rate tracing abnormalities, nor was there a difference in the proportion of babies with abnormal Apgar scores, or abnormal cord pH (less than 7.20). CONCLUSION-The results of the study fail to support the long held belief that early amniotomy is an effective method for reducing labour duration.

Amnion↗
PubMed1985

Epilepsy after a first unprovoked seizure in childhood.

One hundred sixty-eight children with an initial afebrile, unprovoked seizure were identified from a regional EEG laboratory. This case-finding method seemed justified because 86% of regional physicians indicated they order an EEG after a first seizure. Clinical information and recurrence rate were determined from records and telephone calls. Eighty-one percent had been seen by a pediatric neurologist. Overall, 51.8% recurred, and of those with a recurrence, 79% had additional seizures. Recurrence rates were highest in those with abnormal neurologic examination, focal spikes on EEG, and complex partial seizures. The lowest rates of recurrence followed a generalized tonic-clonic seizure, with normal EEG and normal neurologic examination. Prescription of anticonvulsants did not alter the recurrence rate.

Child↗
PubMed1982

The identification of capsaicinoids in tear-gas spray.

"Natural" capsaicin has been identified in "Halt!" sprays by thin-layer chromatography (TLC), high performance liquid chromatography (HPLC), infrared spectrophotometry (IR), and gas chromatography/mass spectrometry (GC/MS). Individual capsaicinoids have been identified as capsaicin, dihydrocapsaicin, and nordihydrocapsaicin. The recommended analytical procedure for small samples is HPLC followed by GC/MS. The alternative procedure of solvent extraction and preparation TLC followed by IR is recommended for large samples.

Capsaicin↗
PubMedDate not supplied

Ambulation after sheath removal: a comparison of 6 and 8 hours of bedrest after sheath removal in patients following a PTCA procedure.

OBJECTIVE: To determine whether ambulation of patients at 6 hours after sheath removal, compared with the institution's standard of 8 hours, would produce a change in hematoma formation, bleeding tendencies at the sheath introducer site, and/or patients' perceptions of pain after percutaneous transluminal coronary angioplasty (PTCA). DESIGN: A quasi-experimental research design was used. Each patient was randomly assigned to either the control group, which required 8 hours of bedrest after sheath removal, or the experimental group, which required 6 hours of bedrest after sheath removal. SETTING: Intensive care unit of a 400-bed urban teaching hospital in western Canada. SAMPLE: A convenience sample of 85 male and female patients admitted to the intensive care unit after an elective PTCA between June 1991 and November 1992. METHOD: Each subject was randomly assigned to 6 or 8 hours of bedrest after sheath removal. A demographic data tool, the short form of the McGill Pain Questionnaire, a Hematoma Assessment Instrument, and a Bleeding Tendency Assessment Instrument were used to collect the data. These instruments were administered to the patients at various intervals after sheath removal. DATA ANALYSIS: Results were analyzed to determine if the additional 2 hours of bedrest in the control group contributed to an increase in pain perception. Demographic information was analyzed by use of descriptive statistics. Parametric and nonparametric tests were also used to analyze the data. RESULTS: Ambulation of patients at 6 hours after sheath removal produced no significant increase in hematoma formation at the puncture site when compared with patients who ambulated 8 hours after sheath removal (p = 0.0001). There was a higher probability of a hematoma developing the day after the PTCA procedure if the activated clotting time (ACT) was high (p = 0.0034). Only one subject in the experimental group developed delayed bleeding; therefore, statistical analysis was unable to be performed on this data. When controlling for age, gender, type of procedure, previous PTCA, history of back pain, analgesic during the procedure, analgesic after the procedure, and cardiologist, the experimental group had significantly lower pain scores than the control group at 8 hours after sheath removal (p = 0.0001). CONCLUSION: This study supports our hypothesis that decreasing the amount of time patients are required to remain flat and supine is associated with no increase in hematoma and bleeding tendencies and is associated with a reduction in the perceptions of pain. The results appear to support ambulation of patients at 6 hours after sheath removal.

Adult↗
PubMedDate not supplied

Chest muscle activity and panic anxiety: a preliminary investigation.

This report represents a pilot investigation of the role of chest muscle electromyographic (EMG) activity in developing panic episodes. Chest EMG activity was obtained as part of a larger study examining ventilatory differences between panic sufferers and normal controls. Frontalis EMG, heart rate, and minute ventilation (breathing rate and tidal volume) were also obtained during the study. The ventilatory procedure involved exposing the subjects to three periods of carbon dioxide gas inhalations (1%, 3%, 5%; balance oxygen). Subjective measures of frightening cognitions and body sensations were obtained across the inhalation phases as well. The panic disorder subjects were divided, on the basis of subjective anxiety ratings obtained throughout the study, into high anxious (HA) and low anxious (LA) panic disorder groups. The HA panic disorder patients exhibited significantly higher chest EMG activity than the LA panic disorder patients and controls across all phases of the experiment. In addition, the chest EMG predicted, better than the other physiologic measures, the number of frightening cognitions and sensations reported by the subjects during the baseline and 5% CO2 inhalation phases. Overall, the results were supportive of the further study of chest wall EMG activity in the pathogenesis of panic attacks.

Adult↗
PubMedDate not supplied

Does Cybex testing increase knee laxity after anterior cruciate ligament reconstructions?

Long-term stability of the knee after anterior cruciate ligament reconstruction is imperative. Testing protocols that use isokinetic systems are commonly performed despite controversies as to their safety. The purpose of this study was to test whether one episode of isokinetic testing would cause an increase in anterior tibial translation. Twenty-four subjects who had anterior cruciate ligament reconstructions 153 to 300 days earlier volunteered for the study. Initially, subjects walked on a treadmill at 5 km/hr for 10 minutes to test the effect of exercise on displacement measurements. One week later, subjects performed a maximal knee flexion-extension test on the Cybex dynamometer at 60, 150, and 240 deg/sec. Anterior tibial displacement at 133.5 N was obtained from force-displacement curves produced by KT-2000 arthrometer testing at nine intervals: before exercise on the treadmill, at four intervals after treadmill exercise, and at four intervals after Cybex testing. Repeated measures analysis of variance did not show a significant exercise effect, interaction between type of exercise and time interval, or change after Cybex testing for the reconstructed knee displacement, the contralateral knee displacement, or side-to-side difference. The average difference before and after Cybex testing was 0.1 mm for the reconstructed knee. In conclusion, a single Cybex test, performed at least 6 months after surgery, did not affect anterior tibial displacement in this study sample.

Adolescent↗
PubMedDate not supplied

Choice vegetables simultaneously for beta carotene. Vitamin C and fibre.

Beta-carotene, vitamin C, and fibre are found mainly in produce, that is, vegetables, fruits and grains. Unfortunately, grains, which have high content of fibre, are not normally consumed whole, and the most fibrous part might actually miss the alimentary tract. Fruits, which have high content of Vitamin C and are usually consumed unrefined, are expensive when not in season. In this article, we examine the possibility of maintaining recommended levels simultaneously of the nutrients mentioned with a short list of more popular vegetables, namely, broccoli, carrot, peas, sweet potato, and spinach.

Ascorbic Acid↗