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T S Lin

Publications and source records attributed to T S Lin.

At least 37 records · Page 2Linked to original sources
PubMed2001

Video-assisted thoracoscopic "resympathicotomy" for palmar hyperhidrosis: analysis of 42 cases.

BACKGROUND: There are rare reports of video-assisted thoracoscopic resympathicotomy for patients with palmar hyperhidrosis. I present our experience in treating a persistent or recurrent palmar hyperhidrosis after primary endoscopic sympathectomy or sympathicotomy and discuss the perioperative management. METHODS: We reoperated on 42 patients using a technique of video-assisted thoracoscopic resympathicotomy. All patients were placed in a semi-sitting position under single- or double-lumen intubated anesthesia. An 8-mm, 0 degrees thoracoscope was used to interrupt the nerve conduction to the palms from the T2 and T3 ganglia, through one or two 0.8-cm subaxillary incisions. RESULTS: The reasons for failure of endoscopic sympathectomy or sympathicotomy in 26 patients included pleural adhesion (15 of 26, 57.7%), incorrect identification of T2 ganglion (3 of 26, 11.5%), vessel overriding or close to sympathetic nerve (3 of 26, 11.5%), incomplete interruption of sympathetic nerve (2 of 26, 7.7%), medially located sympathetic nerve (2 of 26, 7.7%), and aberrant venous arch (1 of 26, 3.8%). The causes of recurrent palmar hyperhidrosis after primary transthoracic endoscopic sympathicotomy or sympathectomy (TES) in 16 patients included a possible effect of T3 ganglion (8 of 16, 50%), Kuntz fiber (3 of 16, 18.8%), nerve regeneration (3 of 16, 18.8%), and incomplete interruption of T2 ganglion (2 of 16, 12.5%). Surgical complications included pneumothorax (1 patient, 2.4%), hemothorax (1 patient, 2.4%), and compensatory sweating (36 patients, 86%). All patients had obtained successful bilateral sympathectomies and had satisfactory results after a mean of 32.1 months of follow-up. CONCLUSIONS: Video-assisted thoracoscopic resympathicotomy is an effective and safe method for a previously unsuccessful sympathectomy or recurrent palmar hyperhidrosis if the surgeon acknowledges possible anatomic variations and can overcome the problems related to pleural adhesions.

Adolescent↗
PubMed2001

Evaluation of fatigue in Parkinson's disease patients with stimulated single fiber electromyography.

OBJECTIVES: Fatigue is a disabling and dopa-resistant symptom in Parkinson's disease (PD). Pathological studies have shown that both peripheral and central cholinergic systems are involved in PD. Electrophysiological investigation showed decremental muscle responses following repetitive nerve stimulation (RNS). We hypothesized that fatigue in PD patients may be secondary to cholinergic defect at the neuromuscular level. MATERIAL AND METHODS: Twenty PD patients with disabling fatigue symptoms were enrolled. We used stimulated single fiber electromyography (s-SFEMG) to evaluate the neuromuscular junction of these patients. For every patient, at least 15 muscle fibers were tested at the rate of 10 Hz with the method described by Trontelj et al. The individual mean consecutive difference (i-MCD) was obtained from 100 constant consecutive single fiber potentials. The i-MCD values in each patient were averaged to obtain the mean MCD (m-MCD). RESULTS: None of the 20 PD patients with disabling fatigue symptoms had an m-MCD over 29 micros or more than 10% of the i-MCD values over 41 micros. The neuromuscular junction was intact in terms of normal jitter (expressed as MCD) and an absence of blocking. CONCLUSION: Our findings indicate that the cholinergic system at the neuromuscular level is not affected in PD patients with fatigue symptoms.

Aged↗
PubMed2001

Fullerenes as a new class of radioprotectors.

PURPOSE: To evaluate the radioprotective activity of C3, a regioisomer of water-soluble carboxyfullerene and a potent free radical scavenger, on both normal and tumour cells. MATERIALS AND METHODS: The murine committed bone-marrow stem cells for both granulocytes and monocytes (GM-CFC) were used to represent normal cells. For tumour cells, murine Ehrlich ascites tumour cells grown in regular tissue culture (EAT-T) and in the peritoneal cavity of CD1 mice (EAT-PC) and human HeLa cells were used. Cells were preexposed to varying concentrations (1-100 microg/ml) of C3 at 37 degrees C for 30 min before they were irradiated. Clonogenic assays were used to determine survival. The protection factor (PF), defined as the ratio of survival with and without C3, was then determined. RESULTS: C3 protected GM-CFC in a concentration-dependent manner up to 50 microg/ml, and no additional protection was seen at 100 microg/ml. The PF was 1.77 when bone-marrow cells were pre-exposed to 50 microg/ml of C3 before they were irradiated with 2 Gy. The value of PF increased to 2.38 when 4 Gy was used. In sharp contrast, C3 exerted less radioprotective effect on tumour cells. The PF values were 1.07, 1.43 and 1.07 for EAT-T, EAT-PC, and HeLa cells, respectively, when 2 Gy was given in the presence of 50 microg/ml of C3. These values increased to 1.40, 1.75 and 1.27, respectively, when 4Gy was given. The dose-modifying factors at 10% survival were 1.37 and 1.15 for GM-CFC and EAT-PC, respectively. CONCLUSION: C3 exhibits a radioprotective effect on a class of normal haemopoietic progenitor cells. It also protects tumour cells, but to a lesser degree. It appears that C3 and other water-soluble fullerenes have a potential to be a new class of cytoprotectors.

Animals↗
PubMed2001

Synthesis of halogen-substituted 3-deazaadenosine and 3-deazaguanosine analogues as potential antitumor/antiviral agents.

Various 2-halogen-substituted analogues (38, 39, 43 and 44), 3-halogen-substituted analogues (51 and 52), and 2',3'-dihalogen-substituted analogues (57-60) of 3-deazaadenosine and 3-halogen-substituted analogues (61 and 62) of 3-deazaguanosine have been synthesized as potential anticancer and/or antiviral agents. Among these compounds, 3-deaza-3-bromoguanosine (62) showed significant cytotoxicity against L1210, P388, CCRF-CEM and B16F10 cell lines in vitro, producing IC50 values of 3, 7, 9 and 7 microM, respectively. Several 3-deazaadenosine analogues (38, 51, 57 and 59) showed moderate to weak activity against hepatitis B virus.

Animals↗
PubMed2001

Video-assisted thoracoscopic T2 sympathetic block by clipping for palmar hyperhidrosis: analysis of 52 cases.

BACKGROUND: Endoscopic thoracic sympathectomy or sympathicotomy is a standard method in treating palmar hyperhidrosis, but postoperative compensatory sweating may be troublesome in some patients. Therefore, we designed a new technique for only T2 sympathetic blocking by clipping instead of interruption of the sympathetic trunk. PATIENTS AND METHODS: Between September 2000 and July 2001, we saw a total of 100 patients with palmar hyperhidrosis who underwent video-assisted thoracoscopic sympathetic blocking of the T2 ganglion. All patients were placed in a semisitting position under single-lumen intubated anesthesia. We performed sympathetic blocking by clipping of the T2 ganglion at the level of the second and third rib beds using an 8-mm, 0 degree thoracoscope (Storz). RESULTS: We supposed that the postoperative improvement in palmar hyperhidrosis would be perfect. The operation could be accomplished within 30 minutes. All patients were discharged within 4 hours after the operation. Surgical complications were minimal, without surgical mortality. A few patients were willing to receive the reverse operation and should get improvement of compensatory sweating after removal of the endo clips. CONCLUSION: We believe that video-assisted thoracoscopic T2 sympathetic block by clipping will be a safe and effective method of treating patients with palmar hyperhidrosis. Compensatory sweating may be improved by the reverse operation: removal of the endo clip.

Adolescent↗
PubMed2001

Pitfalls and complication avoidance associated with transthoracic endoscopic sympathectomy for primary hyperhidrosis (analysis of 2200 cases).

BACKGROUND: Transthoracic endoscopic sympathectomy (TES) has been already a standard method for the treatment of primary hyperhidrosis. There are rare reports about possibly encountered problems during TES. Therefore, we present our experience in treating palmar and axillary hyperhidrosis and discuss the resoluble methods of potential problems during and after TES. PATIENTS AND METHODS: From June 1994 to October 1999, there were 2200 patients with palmar or axillary hyperhidrosis underwent TES. There are 926 males and 1274 females. Their mean age was 23.4 years old (range: 5-65). All except 12 patients were placed in half-sitting position under single or double-lumen intubation anesthesia. Either a 6-mm or 8-mm, 0degrees thoracoscope, (Karl Storz, Germany) was used to perform sympathectomy thru 0.8 cm incisions below each axilla. Ablation of T2 ganglion was performed in treating patients with palmar hyperhidrosis. Ablation of T3 and T4 ganglia was performed for patients with axillary hyperhidrosis. All except 22 patients were discharged 4 hours after TES, and returned to their activities within one week. RESULT: Successful sympathectomy were achieved up to 2178 patients (99%), but the rates of incidental unusual findings and possibly encountered problems during TES were 5.6% and 7.1% alternatively. Surgical complications included pneumothorax (10 patients, 0.45%), Hemothorax (2 patients, 0.09%) segmental atelectasis (12 patients, 0.55%), mild wound infection (3 patients, 0.14%) and compensatory sweating (1936 patients, 88%). There was no surgical mortality case. But pleural adhesion (54 patients, 2.45%), repeat sympathectomy (27 patients, 1.23%), obscured upper sympathetic trunk by adipose tissue (22 patients, 1%), medially located sympathetic trunk (18 patients, 0.81%), great vessels overriding or close to the sympathetic trunk (15 patients, 0.68%), aberrant vessels (3 patients, 0.14%), transient bradycardia (3 patients, 0.14%) and re-expansion pulmonary edema (1 patient, 0.05%) might occur during TES. CONCLUSION: Potential complications may happen during and after TES. But nearly all endoscopic sympathectomy could be achieved if surgeons acknowledge possible anatomic variation and has ability to overcome pleural adhesions.

Adolescent↗
PubMed2000

STAT signaling in the pathogenesis and treatment of leukemias.

Leukemias continue to cause significant mortality in adults and children, and the use of standard cytotoxic chemotherapy has reached a therapeutic plateau. Thus, there is great interest in treatments directed against inappropriately activated cell signaling pathways which stimulate the uncontrolled growth of neoplastic cells. Increasing evidence suggests that the STAT signaling cascade may be one target of these therapies. Signal transducer and activator of transcription (STAT) proteins are critical in mediating the response of hematopoietic cells to a diverse spectrum of cytokines. Constitutive STAT activation is present in many malignancies and has been especially well characterized in acute and chronic leukemias. While STAT activation is a common characteristic of leukemias, the specific pattern of activated STATs and the manner by which STAT activation occurs vary with each disease. STAT tyrosine phosphorylation can occur through inappropriate Jak activation or by direct activation of an oncoprotein such as Bcr/Abl, and STAT serine phosphorylation may play an important role in leukemias as well. Thus, the STAT signaling pathway is an attractive target for therapeutic intervention, and strategies designed to inhibit STAT activation and STAT mediated gene transcription may play an important role in the next generation of anti-leukemia therapies. Oncogene (2000).

Acute Disease↗
PubMed2000

Analysis of motor unit firing patterns in patients with central or peripheral lesions using singular-value decomposition.

We applied the singular value decomposition (SVD) method to study single motor unit firing patterns. Two projects were carried out: (1) a computer simulation study to confirm the meanings of two SVD parameters, the eigenvalue corresponding to the positive-slope eigenvector (PEV) and that corresponding to the negative-slope eigenvector (NEV); and (2) a clinical study for which electromyographic (EMG) recordings were made from first dorsal interosseous muscle in patients with stroke, myopathies, or neuropathies and in healthy control subjects. Results of computer simulation reveal that the NEV reflects the amount of instantaneous firing variability, whereas the PEV/NEV (P/N) ratio exhibits the relative effect of a trend in the firing pattern. In human studies, the P/N ratio of stroke patients was significantly higher than that of the controls, whereas their NEV was comparable. By contrast, in the myopathy and neuropathy groups, the NEV increased significantly, whereas the P/N ratio did not. These results suggest that the SVD method decomposes the motor unit (MU) firing variation into two components and that the mechanism for increased firing variability is different for supraspinal and spinal-infraspinal lesions.

Adolescent↗
PubMed2000

Repeat transthoracic endoscopic sympathectomy for palmar and axillary hyperhidrosis.

BACKGROUND: Patients undergoing an unsuccessful sympathectomy experience dryness on one hand and excessive sweating on the other. This is embarrassing for the patients, and resolution of both a previous failed sympathectomy and recurrent hyperhidrosis is important. METHODS: From September 1995 to January 1998, 24 patients (11 men and 13 women; mean age, 28.2 years) underwent repeat transthoracic sympathectomy (TES). The repeat TES was performed with patients under general anesthesia using either a standard single-lumen endotracheal tube (12 patients) or a double-lumen endotracheal tube (12 patients). Ablation of T2 and T3 ganglia and any Kuntz fiber was performed in treating patients with palmar hyperhidrosis, and a similar procedure was performed on T3 and T4 ganglia for patients with axillary hyperhidrosis. RESULTS: The reasons for failure of the previous TES were pleural adhesion (14/24), intact T2 ganglion (5/24), aberrant venous arch drainage to the superior vena cava (2/24), incomplete interruption of sympathetic nerve (2/24), and possible reinnervation (1/24). The mean operation time was 28 min (range, 18-72 min). In all, 23 patients had a satisfactory result, without recurrence of palmar or axillary hyperhidrosis. The mean follow-up time was 22 months (range, 5-30 months). The average hospital stay was 1.8 days. There was no surgical mortality. CONCLUSION: Repeat TES is a safe and effective method for treating both an unsuccessful sympathectomy and recurrent palmar or axillary hyperhidrosis.

Adolescent↗
PubMed2000

DNA adduct level in lung tissue may act as a risk biomarker of lung cancer.

Lung cancer is a leading cause of mortality in Taiwan. We hypothesised that high susceptibility to DNA damage in the target organ acts as a risk biomarker for the development of lung cancer. To verify this hypothesis, the aromatic/hydrophobic DNA adduct levels of non-tumorous adjacent lung tissues from 73 primary lung cancer patients and 33 non-cancer controls were evaluated by 32P-postlabelling assay. Wilcoxon rank sum test showed that DNA adduct levels in lung cancer patients (49.58+/-33.39 adducts/10(8) nucleotides) were significantly higher than those in non-cancer controls (18.00+/-15.33 adducts/10(8) nucleotides, P<0.001). The DNA adduct levels among lung cancer and non-cancer samples were not influenced by smoking behaviour and cigarette consumption. Our data also showed that the polymorphisms of cytochrome P4501A1 (CYP1A1) Msp1, glutathione S-transferase M1 (GSTM1) and the combination of both genetic polymorphisms were not related to the DNA adduct levels. Interestingly, positive association between CYP1A1 protein expression and DNA adduct levels was found when CYP1A1 protein expression in lung specimens from lung cancer patients was examined by immunohistochemistry. Multivariate linear regression analysis indicated that the DNA adduct level was not associated with gender, smoking behaviour, or genetic polymorphisms of CYP1A1 and GSTM1. Moreover, multivariate logistic regression analysis showed that persons with high DNA adduct levels (>48.66 adducts/10(8) nucleotides) had an approximately 25-fold risk of lung cancer compared with persons with low DNA adduct levels (</=48.66 adducts/10(8) nucleotides). In conclusion, DNA adduct levels in lung tissue may be a more reliable lung cancer susceptibility biomarker than DNA adduct levels in leucocytes. In addition, higher susceptibility to DNA damage in lung cancer patients may partly play a role in the development of lung cancer.

Adenocarcinoma↗
PubMed2000

Time-course analysis of stretch reflexes in hemiparetic subjects using an on-line spasticity measurement system.

Spasticity after a stroke is usually assessed in a score form by subjectively determining the resistance of a joint to an externally imposed passive movement. This work presents a spasticity measurement system for on-line quantifying the stretch reflex of paretic limbs. Four different constant stretch velocities in a ramp-and-hold mode are used to elicit the stretch reflex of the elbow joint in spastic subjects. The subjects are tested at supine position with the upper limb stretched towards the ground, in contrast with the horizontally stretched movement used in other studies. By subtracting the baseline torque, reflex torque measured at a selected low stretch velocity of 5 deg/sec, the influence of gravity torque and inertial in vertical stretching mode can be minimized. The averaged speed-dependent reflex torque (ASRT), defined as the measured torque deviated from the baseline torque, is used for quantifying the spastic hypertonia. Four subjects having incurred cerebrovascular accident (CVA) are recruited for time-course study in which the measurements are taken at 72 hours, one week, one month, three months, and six months after onset of stroke. During the development of spasticity, the changes of ASRT and velocity sensitivity of ASRT of the involved and the intact elbow joints are discussed.

Elbow Joint↗
PubMed2000

Synthesis and biological evaluation of 1,3-oxathiolane 5-azapyrimidine, 6-azapyrimidine, and fluorosubstituted 3-deazapyrimidine nucleosides.

(2R,5S)-5-Amino-2-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]- 1,2,4-triazine-3(2H)-one (8) and (2R,5R)-5-amino-2-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]-1,2,4-tr iazine-3(2H)-one (9) have been synthesized via a multi-step procedure from 6-azauridine. (2R,5S)-4-Amino-1-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]-1,3, 5-triazine-2(1H)-one (11) and (2R,5R)-4-amino-1-[2-(hydroxymethyl)-1,3-oxathiolan-5-yl]- 1,3,5-triazine-2(1H)-one (12), and the fluorosubstituted 3-deazanucleosides (19-24) have been synthesized by the transglycosylation of (2R,5S)-1-[2-[[(tert-butyldiphenylsilyl) oxy]methyl]-1,3-oxathiolan-5-yl] cytosine (2) with silylated 5-azacytosine and the corresponding silylated fluorosubstituted 3-deazacytosines, respectively, in the presence of trimethylsilyl trifluoromethanesulfonate as the catalyst in anhydrous dichloroethane, followed by deprotection of the blocking groups. These compounds were tested in vitro for cytotoxicity against L1210, B16F10, and CCRF-CEM tumor cell lines and for antiviral activity against HIV-1 and HBV.

Animals↗
PubMed2000

Transthoracic endoscopic sympathectomy for craniofacial hyperhidrosis: analysis of 46 cases.

BACKGROUND AND PURPOSE: Craniofacial hyperhidrosis may result in social phobia and has a strong negative impact on the quality of life. The traditional therapeutic options are psychotherapy and pharmacologic treatment, but these often fail. We wished to investigate whether transthoracic endoscopic sympathectomy (TES) of the lower part of the stellate ganglion is efficient and safe in the treatment of craniofacial hyperhidrosis. PATIENTS AND METHODS: Between July 1995 and September 1999, a total of 21 men and 25 women with a mean age of 41.2 years (range 22-58 years) underwent TES for craniofacial hyperhidrosis. All patients were placed in a semisitting position under single-lumen intubated anesthesia. We ablated the lower part of the stellate ganglion at the second rib using a storz 8-mm 0 degrees thoracoscope via one 0.8-cm incision just below each axilla. Questionnaires were sent to all patients postoperatively. RESULTS: Among these 46 patients, 92 sympathectomies were performed. Usually, TES was accomplished within 15 minutes (range 7-20 minutes). The surgical complications were minimal: one segmental atelectasis of the lung (2%). There was no surgical mortality. With a mean postoperative follow-up of 32.1 months (range 3-51 months), the results of TES were highly satisfactory in most patients although 37 (80%) developed compensatory sweating of the trunk and lower limbs, the distribution being the axillae in 15 (33%), back in 36 (78%), lower chest and abdomen in 22 (48%), lower limbs in 34 (74%) and sole in 1. The recurrence rates of craniofacial hyperhidrosis were 0 in the first and the second years and 2% each in the third and fourth years. CONCLUSION: Transthoracic endoscopic sympathectomy is a safe and effective method for treating craniofacial hyperhidrosis.

Adult↗
PubMed2000

Combined microvascular anastomosis: experimental and clinical experience.

A short operative time and a high successful rate of microvascular anastomosis are the goals of many plastic surgeons. The authors present their experimental and clinical experience in microvascular anastomoses with the use of a combination of continuous suture and interrupted tie. Twenty rats were divided into two groups. The aorta and inferior vena cava were used for microvascular anastomoses. The vessels of 10 rats were repaired with conventional interrupted suture, and the vessels of the other 10 rats were repaired with combined anastomoses. A total of 150 clinical microvascular surgeries during the past 2 years are also presented, all of which were performed using the combined method. Microvascular anastomoses with the combined method were completed faster than when using the conventional interrupted method in experimental studies. Clinically, no direct microvascular anastomosis failed with the use of combined method. Microvascular anastomosis with the use of the combined continuous suture and interrupted tie resulted in satisfactory outcomes. This technique has the advantages of both interrupted and continuous methods, but not their shortcomings.

Animals↗
PubMed2000

Pancreaticocolonic fistula after extensive corrosive injury from esophagus to jejunum.

We report a case of extensive corrosive injury to the jejunum after ingestion of about 200 ml of hydrochloric acid as an attempted suicide. Subtotal esophagectomy, total gastroduodenectomy, segmental resection of the jejunum and partial pancreatectomy were performed in the first two operations. Forty-five days after surgery, the patient was well and discharged. Six months later, the patient underwent esophageal reconstruction surgery. During surgery, a pancreaticocolonic fistula between the head of the pancreas and the transverse colon was found. The esophageal reconstruction using the transverse colon was performed via the retrosternal route.

Adult↗