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Biomedical subjects

W M Tang

Publications and source records attributed to W M Tang.

At least 19 recordsLinked to original sources
PubMed2007

Ganoderma lucidum polysaccharide peptide reduced the production of proinflammatory cytokines in activated rheumatoid synovial fibroblast.

The aim of the current study was to elucidate the potential therapeutic effect of Ganoderma lucidum polysaccharide peptide (GL-PP) in rheumatoid arthritis (RA). The effects of GL-PP on cell proliferation and cytokine production were studied in RA synovial fibroblasts (RASF). GL-PP significantly inhibited the proliferation of RASF. Following the incubation with GL-PP, production of interleukin (IL)-6 and monocyte chemoattractant protein (MCP)-1 in RASF were significantly increased as expressed as percentage change from basal values. However, the actual effects were minimal due to the low basal values. When RASF were activated by IL-1beta or lipopolysaccharides, IL-8 and MCP-1 production increased many folds. GL-PP significantly suppressed their productions. The inhibitory effects of GL-PP on cytokine production in RASF were at least in part, by inhibiting the nuclear factor-kappa B (NF-kappaB) transcription pathway. Our results demonstrated that GL-PP had the unique ability to modulate cytokine production in RASF and warrants further investigation into its mechanism of action.

Arthritis, Rheumatoid↗
PubMed2006

Four X-chromosomal STRs and their allele frequencies in a Chinese population.

X-chromosomal markers are particularly useful for solving complex problems relating to kinship and deficiency paternity analysis. In the present study, population genetics data of four X-chromosomal short tandem repeats (STRs) DXS8378, HPRTB, DXS7423 and DXS7132 were obtained by analyzing 500 unrelated Chinese individuals (250 males and 250 females). Population genetics data obtained from the Chinese were compared with those of the Asian and European population. Mutations in X-chromosomal markers were analyzed based on a total of 61 proven father-child and 45 proven mother-child pairs.

Chromosomes, Human, X↗
PubMed2006

Assessment of the proximal femoral morphology using plain radiograph-can it predict the bone quality?

We evaluated the relationship between the radiological indices that assessed the proximal femoral morphology and the degree of osteoporosis in 45 Chinese cadaveric femora. Canal-calcar ratio, canal flare index, morphological cortical index, and canal bone ratio were determined in the plain anteroposterior radiographs. Canal bone ratio is the ratio between the endosteal and outer diameters of the proximal femur at 10 cm below the lesser trochanter. Bone mineral density of the proximal femora was measured with dual-energy x-ray absorptiometry, and T score that depicted the degree of osteoporosis was determined. Canal bone ratio showed a strong correlation with the T score (r = -0.71, P < .001) and the best overall performance in diagnosing osteoporosis with receiver operating characteristic curve analysis. The proximal femur was likely to be osteoporotic if the canal bone ratio was 0.49 or higher.

Absorptiometry, Photon↗
PubMed2006

Rapidly progressive necrotising fasciitis following a stonefish sting: a report of two cases.

Two patients developed rapidly progressive necrotising fasciitis after being stung by a stonefish. Both were given a hot-water bath for pain relief. The hot water may have accelerated bacterial growth and the consequent development of necrotising fasciitis. Vibrio vulnificus was cultured from one patient. It is recommended that patients should receive high dose of oral and intravenous antibiotic prophylaxis for vibrio prevention. Antibiotics should be given before or during, not after, a hot-water bath, and the patient's condition should be monitored closely.

Adult↗
PubMed2006

Necrotizing fasciitis in rheumatic diseases.

Necrotizing fasciitis is an uncommon but life-threatening complication in immunocompromised hosts. We reported four patients with rheumatic diseases complicated by necrotizing fasciitis and reviewed 14 others from literature search. Most patients were on corticosteroid treatment. Septic shock, disseminated intravascular coagulopathy and acute renal deterioration were common giving rise to an overall mortality rate of 27.8%. Septic arthritis may also complicate the condition. Statistical analysis on the series showed the lack of major surgical debridement as the only risk factor associated with increased mortality (RR 7.5, 95% CI 2.1-27.3, P = 0.01). Timely debridement of necrotic tissue is important for reducing mortality.

Adult↗
PubMed2005

Residual posterior femoral condyle osteophyte affects the flexion range after total knee replacement.

We followed up 92 patients with total knee replacement and a pre-operative knee flexion of at least 90 degrees . The patients were followed up regularly at 3 months, 6 months and 1 year. The outcome measured was the amount of maximum passive knee flexion at the end of 1 year after replacement. The potential factors affecting the final flexion range were investigated. After regression analysis, apart from pre-operative knee flexion (p<0.001), the most significant independent surgical factors that predict the amount of post-operative flexion were presence of residual posterior femoral condyle osteophyte (p=0.046) and overstuffing the patella by more than 2 mm during resurfacing of the patella (p<0.001).

Aged↗
PubMed2005

Intraobserver errors in obtaining visually selected anatomic landmarks during registration process in nonimage-based navigation-assisted total knee arthroplasty: a cadaveric experiment.

This study investigated the intraobserver errors in obtaining visually selected anatomic landmarks that were used in registration process in a nonimage-based computer-assisted total knee replacement (TKR) system. The landmarks studied were center of distal femur, medial and lateral femoral epicondyle, center of proximal tibia, medial malleolus, and lateral malleolus. Repeated registration in the above sequence was done for 100 times by a single surgeon. The maximum combined errors in the mechanical axis of the lower limb were only 1.32 degrees (varus/valgus) in the coronal plane and 4.17 degrees (flexion/extension) in the sagittal plane. The maximum error in transepicondylar axis was 8.2 degrees. The errors using the visual selection of anatomic landmarks for the registration technique of bony landmarks in nonimage-based navigated TKR did not introduce significant error in the mechanical axis of the lower limb in the coronal plane. However, the error in the transepicondylar axis was significant in the "worst-case scenario."

Arthroplasty, Replacement, Knee↗
PubMed2005

Sagittal bowing of the distal femur in Chinese patients who require total knee arthroplasty.

PURPOSES: The importance of the femoral sagittal bowing on total knee arthroplasty is under-recognized. The bowing could lead to potential errors in positioning of the femoral component if it is ignored. We aimed to document the femoral sagittal bowing at different segments of the Chinese femur and to discuss the implications of this sagittal bowing on total knee arthroplasty. METHODS: One hundred lateral radiographs of the entire lower limbs of 85 Chinese patients admitted for total knee arthroplasty were digitized. The radii of curvature of the intramedullary canal of the proximal, middle and distal one-third of the femora were measured. RESULTS: The average age of the patients was 67.3 years. The radii of curvature of the proximal, middle and distal one-third of the femora were 1081.6, 926.2 and 715.1 mm, respectively. The distal one-third of the femora was significantly more bowed than the other parts of the femora (p<0.001). The distal femoral bowing was more profound in rheumatoid patients and in those with a short femur. CONCLUSIONS: The lateral contour of the Chinese femur is like a hockey stick. This exaggerated sagittal bowing in the Chinese femur can affect the final sagittal position of the femoral component and has implications for the choice of implant design. In revision setting, a long and straight press-fit stem might either endanger the anterior cortex or deflect the femoral component to an abnormally extended position.

Adult↗
PubMed2004

Translation and validation of Arthritis Impact Measurement Scales 2 into Chinese: CAIMS2.

OBJECTIVE: To evaluate the validity, reliability, and cultural relevance of the Arthritis Impact Measurement Scales 2 (AIMS2) as a health assessment tool for Chinese-speaking patients with arthritis. METHODS: The cultural relevance, language equivalency, and content validity of the AIMS2, Chinese version (CAIMS2) were evaluated by an expert panel. Measurement performance was tested on 240 subjects (rheumatoid arthritis = 81, osteoarthritis = 77, healthy = 82). Subjects (n = 175) were retested within 2 weeks for testing of reliability. RESULTS: Three items were modified and 2 items were added, as suggested by the expert panel. Interitem reliability was satisfactory (intraclass correlation coefficient 0.8552-0.9594). Test-retest reliability of the CAIMS2 subscales ranged from 0.770 to 0.952 in subjects in whom the CAIMS2 was self administered. Significant score differences between patients with arthritis and healthy subjects were found in all 12 subscales, except for the support from family and friends and tension subscales. CAIMS2 subscale scores correlated with clinical and laboratory measures of disease activity and patients' perceived quality of life as measured using the Chinese version of the World Health Organization Quality of Life instrument. CONCLUSION: Empirical data support CAIMS2 is a valid and reliable health status measure for Chinese speaking patients with arthritis.

Activities of Daily Living↗
PubMed2004

Posterior cruciate ligament-substituting total knee arthroplasty in young rheumatoid patients with advanced knee involvement.

The integrity and strength of the posterior cruciate ligament (PCL) in the rheumatoid knee are known to be suboptimal. However, the results of PCL-substituting total knee arthroplasty in rheumatoid patients are not well documented. We reviewed 86 PCL-substituting total knee arthroplasties in 52 rheumatoid patients with grade IV or V radiographic disease. The mean age at surgery was 41.9 years. All patients underwent follow-up evaluation for an average of 7.8 years. Revision was performed for 1 knee because of aseptic loosening of the tibial component, and for 3 knees because of deep infection. An isolated insert exchange was performed on one knee. Using revision of any component for aseptic loosening or radiographic loosening as the end point, the mean 10-year survival rate was 94.0%.

Actuarial Analysis↗
PubMed2004

Factors leading to blood transfusion among Chinese patients undergoing total knee replacements: a retrospective study.

PURPOSE: To investigate the risk factors leading to blood transfusion among Chinese patients undergoing total knee replacement. METHODS: From July 2001 to June 2002, a total of 128 primary total knee replacements were performed in 83 Chinese patients (38 unilateral and 45 one-stage sequential bilateral). No pharmaceutical prophylaxis against deep vein thrombosis was used. The risk factors leading to allogenic blood transfusion were analysed. RESULTS: The important predictive factors for postoperative blood transfusion were preoperative haemoglobin level (p=0.005), intra-operative blood loss (p<0.001), and bilateral total knee replacements (p<0.001). CONCLUSION: To reduce the need of allogenic blood transfusion, we suggest administering erythropoietin or iron supplements to increase the haemoglobin level for patients undergoing total knee replacement. Routine use of intra-operative blood salvage can be considered for patients undergoing one-stage bilateral total knee replacement. Use of a postoperative blood salvage system is recommended for surgeries that may result in major intra-operative blood loss.

Aged↗
PubMed2004

Extensively coated femoral components in revision hip arthroplasty: follow-up study of 23 patients.

PURPOSE: To review the outcome of revision hip arthroplasty using extensively coated femoral components. METHODS: We reviewed the results of revision involving 24 extensively porous-coated cementless femoral components in 23 patients, whose mean age was 52.4 years (range, 28.0-79.0 years). Most revisions were performed for aseptic loosening of the previously cemented femoral component. All patients were followed up for a minimum period of 24.0 months (mean, 61.1 months). RESULTS: Of the 24 femoral stems, 20 showed bone ingrowth, 3 showed stable fibrous ingrowth, and one was unstable because of deep infection. Intra-operative anterior femoral diaphyseal perforation occurred in 2 hips during the insertion of straight femoral components of 200 mm. Postoperative radiographs displayed marked cortical erosion in 3 other hips and cortical perforation in one. CONCLUSION: The results from the use of extensively coated femoral components were promising. Nevertheless, anterior cortical perforations were also common, which may be related to more bowing of the femora among the Chinese patients. Caution must be exercised when inserting a long, straight, extensively coated femoral component.

Adult↗
PubMed2003

Full weight bearing after non-cemented total hip replacement is compatible with satisfactory results.

Two matched groups of 29 patients underwent hydroxyapatite-coated non-cemented total hip replacement. One group was started on immediate protected-weight-bearing walking and the other group was started on immediate full-weight-bearing walking. They were followed up regularly for 2 years. They were assessed with Harris hip score clinically and Engh's criteria of osteo-integration radiographically. No difference was found between the two groups. All patients had excellent clinical outcome after hip replacement, and all femoral stems were stable radiographically. Patients can walk with full weight bearing safely immediate after hydroxyapatite-coated non-cemented total hip replacement.

Adult↗
PubMed2003

Efficacy of a single dose of cefazolin as a prophylactic antibiotic in primary arthroplasty.

We analyzed the wound infection rate of 1,367 primary total hip and knee arthroplasties performed between 1991 and 1999. Two hundred and fifteen arthroplasties were performed with 3 doses (3 x 750 mg) of cefuroxime, and 1,152 arthroplasties were performed with a single preoperative dose (1 x 1 g) of cefazolin as antimicrobial prophylaxis. All wound infections that occurred within 2 years of the index surgery were analyzed. The deep wound infection rate of total hip arthroplasty was 1.1% (95% confidence interval [CI], 0%-3.3%) in the cefuroxime group and 1.1% (95% CI, 0%-2.2%) in the cefazolin group (Fisher's exact test, P = 1.0). The deep wound infection rate of total knee arthroplasty in the cefuroxime group (1.6%; 95% CI, 0%-3.8%) was not significantly different from the cefazolin group (1.0%; 95% CI, 0.3%-1.7%) (Fisher's exact test, P =.63). We concluded that a single dose (1 g) of cefazolin given at anesthetic induction offered similar protection to 3 doses (3 x 750 mg) of cefuroxime in preventing infection in primary total joint arthroplasty.

Aged↗
PubMed2003

Practicing cementing technique with a toy: Play-Doh.

Cementing technique has direct impact on the longevity of a total hip arthroplasty, and the proper technique can only be acquired by practice. Using acrylic bone cement to practice cementing technique in a bioskill workshop is expensive and can cause occupational hazards. In this article, we describe a toy that can replace acrylic bone cement in a bioskill workshop. Play-Doh (Hasbro Inc, Pawtucket, RI) is an inexpensive, reusable and non-toxic modeling toy that mimics the doughy phase of acrylic bone cement.

Arthroplasty, Replacement, Hip↗
PubMed2003

The shape and size of femoral components in revision total hip arthroplasty among Chinese patients.

OBJECTIVE: 39 sets of preoperative hip X-rays were studied to find out whether Chinese patients need revision femoral components with a different shape and size from western patients. METHODS: From July 1998 to June 2001, the pre-revision X-rays of 39 revision total hip replacements among 38 Chinese patients (21 men and 17 women) were studied. The component size that produced the best distal canal-filling in the anteroposterior X-ray was determined by using templates of 200-mm femoral components used commonly for Caucasian patients. RESULTS: The diameter of the component needed was 13.5 mm or less in 54% of cases, compared with only 17% for Caucasian patients as reported in the literature (p<0.01). When lateral templates of the corresponding size were put over the lateral X-rays, the anterior cortex of the 200-mm straight stem was shown to have thinned by 2.0 mm or more in 36% of hips; for 200-mm bowed stem, there was thinning of the anterior cortex by 2.0 mm or more in only 5% of hips (p<0.01). CONCLUSION: Chinese patients are likely to need smaller femoral components than Caucasian patients, and may benefit from bowed-stem components in femoral revision.

Adult↗