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Biomedical subjects

W T Hung

Publications and source records attributed to W T Hung.

At least 37 records · Page 2Linked to original sources
PubMed1998

Genetic and environmental risk factors for Parkinson's disease in a Chinese population.

An epidemiological study of the environmental and genetic factors as well as the possible interplay between them was conducted among 215 patients with Parkinson's disease and 313 controls in a Chinese population in Hong Kong. In univariate analysis, a regular tea drinking habit was found to be a protective factor, which had not been reported before. Smoking (a protective factor), family history, duration of pesticide exposure (in years) in farming and pesticide exposure during farming in women (both risk factors) have been reported previously. In multivariate analysis, current smoking reached borderline significance at the 5% level and the variables, years exposed to pesticides and family history were significant at the 10% level. By contrast with the common occurrence of polymorphism of the CYP2D6 gene (a gene involved with xenobiotic metabolism) in white people, it is very rare in China and is not thought to be a significant factor contributing to Parkinson's disease in Chinese people.

Aged↗
PubMed1997

Postoperative MRI of anorectal malformation.

Twenty-five patients who had pull-through rectum (PTR) surgery, some of whom suffered from fecal incontinence, soiling or constipation were studied by magnetic resonance imaging (MRI) postoperatively. MRI demonstrated 14 patients with proper placement of the PTR between the puborectal muscle and external sphincter muscle; four patients with improper placement of the PTR outside the puborectal muscle and external sphincter muscle (one with excess perirectal fat); one patient with disruption of the puborectal muscle and external sphincter muscle; three with hypoplasia of the puborectal muscle and external sphincter muscle; three with asymmetric placement of PTR in the levator ani (one with excess perirectal fat). MRI also depicted seven patients with spine anomalies; five with tethered cord; and 10 with genitourinary tract anomalies. The patients with correct location of PTR all had good fecal continence except three patients (two with soiling and one with constipation) who had tethered cord and ganglion cell dysfunction at the PTR. The patients with improper placement of PTR or poorly developed pelvic muscles all had fecal incontinence. Our study emphasizes that MRI can depict the causes of postoperative incontinence, detect anomalies and help to plan further surgery.

Adolescent↗
PubMed1997

Manifestations and surgical treatment of choledochal cyst in different age group patients.

Whether early surgery is necessary for asymptomatic choledochal cyst is still controversial. In order to evaluate the manifestations of choledochal cyst on different age group patients, we investigated 57 patients, 36 females and 21 males, who underwent surgery for choledochal cyst at National Taiwan University Hospital from July 1988 to June 1995. Of these, 93% were classified as type I according to the Alonzo-Lej or Todani classification method. Patients were divided into three groups according to their age at surgery: group I, 14 infants (< 1-yr); group II, 28 children (1-16 yr); and group III, 15 adults (> 16 yr). The most common symptom in infants was jaundice, while abdominal pain was the most frequent in children and adults. Preoperative evaluation of liver function showed that alanine aminotransferase was higher in group II (160 +/- 77 IU/L) and group III (164 +/- 75 IU/L) than group I (74 +/- 28 IU/L). A higher tendency of biliary sludge and stone formation was noticed in group III (6/15, 40%) when compared with group I (2/14, 14.3%) and group II (5/28, 17.9%). The incidence of high bile amylase concentration in the choledochal cyst was higher in groups II (16/21,76.2%) and III (9/11, 81.8%) than in group I (2/9, 22.2%). There was more inflammatory changes detected in the choledochal cyst wall and gall bladder by histologic examination in older patients (groups II and III). Therefore, an early surgery for choledochal cyst is suggested for prevention of liver injury, biliary sludge, stone formation and pancreatitis.

Adolescent↗
PubMed1997

Hypovolemic shock induced by laparoscopic cholecystectomy--a case report.

Since its introduction and development in the 1960s, laparoscopic cholecystectomy has become widely accepted by the medical community and the public as the treatment of choice for various gallbladder disorders. We present a 46-year-old male who underwent laparoscopic cholecystectomy, during which inadvertent penetration of the first trocar resulted in injury of the abdominal aorta and then hypovolemic shock ensured. The time from notification of shock by the anesthesiologist to switch of procedure to exploratory laparotomy for stanching hemorrhage was twenty minutes. During the intervention, blood loss was over 3,000 ml and despite rapid infusion of plasma expander, blood pressure could only be maintained between 40/18 to 60/20 mmHg. After the patient became stabilized and blood pressure was elevated to acceptable levels, conventional cholecystectomy was performed instead. Perioperative blood loss of 7,300 ml was estimated. In total, the patient received 24 units of packed red blood cells, 12 units of fresh frozen plasma, and 12 units of platelets. After the operation, the patient was transferred to the surgical ICU for further observation. For 24 h at the ICU, blood pressure remained unstable, urine output decreased gradually, and scrotal and leg edema developed. Forty-four h after admission to the surgical ICU, arrhythmia and profound hypotension were noted and cardiac arrest ensued. After resuscitation for 2 h, the patient could not be revived and succumbed to cardiovascular decompensation secondary to acute renal shutdown and continuous retroperitoneal hemorrhage.

Cholecystectomy, Laparoscopic↗
PubMed1996

Alimentary tract duplications.

A total of 17 patients with alimentary tract duplications underwent surgery at National Taiwan University Hospital from 1978 to 1994. Fifteen patients (88%) had gastrointestinal duplication and two (12%) had esophageal duplication. Common presenting symptoms of gastrointestinal duplication were melena and abdominal pain. The ileum was the most common site of duplication. Multiple duplications were seen in three patients. All duplications were cystic, except for one single appendiceal duplication. Ectopic gastric mucosa was detected in nine of the 16 nongastric duplications. One patient with ileal duplication had ectopic pancreatic tissue. Twelve patients received resection of the duplication with a segment of bowel and primary anastomosis, three patients underwent simple excision and two patients had partial resection of the duplication and stripping of the residual mucosa. Two patients had other associated congenital anomalies: one had ventricular septal defect and the other, imperforate anus and malrotation of intestine. There was no operative mortality or morbidity in this series.

Abdominal Pain↗
PubMed1996

Dynamic stiffness and implications for assisting the operation of the left ventricle.

The distribution of bending strain and stiffness in the wall of the left ventricle (LV) is relevant to the augmentation of its function by a modified skeletal-muscle wrap in the new surgical procedure of cardiomyoplasty. A novel approach to ventricular mechanics is presented which blends some finite-element results in engineering with new data available on ventricular geometry. Two simplified axisymmetric strip-element models of the LV are used to illustrate aspects of myocardial stiffness in the bending-strain-energy distribution and the effect on wrap synchronization of a change in cross-fibre stiffness when the heart has nonuniform or ectopic beats. The nonlinear and time-dependent nature of both camping and wall stiffness is derived from differential equations governing the dynamic paths from systole to diastole of finite wall elements around the periphery of an oblique LV slice using magnetic resonance imaging (MRI) data. This leads to a geometric method for determining these parameters. Results for time-dependent stiffnesses of elements in their trajectories are presented for a normal heart.

Biomechanical Phenomena↗
PubMed1995

T-tube drainage for the treatment of high jejunal atresia.

Since 1976, the authors have used T-tube drainage for the treatment of diaphragmatic type, high jejunal atresia. Twelve cases were operated on. All cases survived the operation. On the fourteenth to thirtieth postoperative day, T-tubes were removed when the dilated proximal intestine returned to normal size.

Drainage↗
PubMed1994

Erythrocyte sedimentation rate studies in whole human blood.

Precise measurements have been made of the rate of sedimentation of whole blood in which the concentrations of red blood cells and the plasma proteins have been systematically varied. The contribution of each factor to the sedimentation process is expressed in terms of three parameters that describe the sedimentation curve: the set-up time, and the slopes of the first and second phases of settling. This analysis affords delineation between the onset and the degree of aggregation of the red blood cells as contributors to the usual ESR value, the height of plasma in a 200 nm blood column after 60 min. In terms of the 60 min ESR value, an increase in the haematocrit or albumin concentration inhibits sedimentation, the latter only slightly, whereas an increase in the concentration of globulin or fibrinogen accelerates sedimentation, with fibrinogen showing the more marked effect.

Blood Proteins↗
PubMed1992

Thromboelastogram fails to predict postoperative hemorrhage in cardiac patients.

To determine the clinical usefulness of the thromboelastogram in the prediction of postoperative hemorrhage in cardiac patients, we related the results of routine coagulation tests (RCTs) and thromboelastography with the amount of chest tube drainage postoperatively in 101 patients requiring cardiopulmonary bypass. Our data indicated that there was no correlation between RCT results and thromboelastographic variables. No single variable of RCTs and thromboelastography correlated well with the amount of chest tube drainage postoperatively. Before the onset of cardiopulmonary bypass, the most frequent abnormalities detected by thromboelastograms were fibrinolysis and hypocoagulability resulting from factor deficiency. Hypercoagulability detected by thromboelastograms occurred in 13% of patients after cardiopulmonary bypass and usually was not detected by RCTs. The incidence of false-negative thromboelastograms and RCT results in patients who had excessive hemorrhage of unknown cause was 46% and 52%, respectively. The incidence of fibrinolysis as detected by thromboelastograms was similar before and after bypass, but only 2 of the 18 patients with fibrinolysis had excessive hemorrhage postoperatively. Our results indicate that neither RCTs nor thromboelastography predicts the likelihood of excessive hemorrhage in patients after cardiopulmonary bypass. The thromboelastographic results should be interpreted cautiously because of the high rate of unreliable results.

Blood Coagulation Tests↗
PubMed1992

Diagnostic model for local temporal thermal change at the skin of the breast during extended application of diagnostic ultrasound.

A biophysical model is derived to account for the temporal thermal change at the skin of the breast as a result of ultrasound stimulation at the suspect lesion for seven minutes, with responses recorded using an infrared camera. Twenty-two patients were studied. The observed temporal responses for malignant cases have a different pattern from those of the benign cases studied and a mathematical model is used to investigate the controlling parameters. A new method is used to estimate the coefficients of the resulting difference equation which allows more useful diagnostic parameters to be computed than the corresponding continuous bioheat equation. The model is used to fit the experimental data. The results suggest that this method might be a rapid and noninvasive aid for distinguishing between benign and malignant breast tumours.

Biophysical Phenomena↗
PubMed1992

Monitoring of heparin-induced anticoagulation with kaolin-activated clotting time in cardiac surgical patients treated with aprotinin.

High-dose aprotinin appears to enhance the anticoagulant effects of heparin, as documented by increases in the activated clotting times (ACTs) during cardiopulmonary bypass; hence, some authorities have advocated reducing the dose of heparin in patients treated with aprotinin. An in vitro study by our group suggested that the increase of the ACT in the presence of aprotinin and heparin may be due to the use of celite as surface activator. We compared celite and kaolin as surface activators for the measurement of the ACT in cardiac surgical patients treated with aprotinin and in patients given no aprotinin. This double-blind, randomized, placebo-controlled study included 30 patients, of whom 14 received aprotinin and 16 received a placebo. Before, during, and after cardiopulmonary bypass, the ACT was measured with two Hemochron 400 systems with 12 mg of either celite (C-ACT) or kaolin (K-ACT) used as surface activator and with one Hepcon HMS system (HR-ACT), which uses kaolin as activator. The latter also was used for measurement of the blood heparin concentration. The ACTs of blood without heparin did not differ between aprotinin and control patients. During anticoagulation with heparin and cardiopulmonary bypass, the average C-ACTs were 784 +/- 301 s (aprotinin) and 496 +/- 120 s (control) (P < .001); the K-ACTs were 502 +/- 131 s (aprotinin) and 458 +/- 101 s (control) (P > .05); the HR-ACTs were 406 +/- 87 s (aprotinin) and 423 +/- 82 s (control) (P > .05), which was consistently less than C-ACT and K-ACT.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

In vitro effects of aprotinin on activated clotting time measured with different activators.

The effects in vitro of aprotinin on the activated clotting time measured with both celite- and kaolin-activated tubes were investigated in 21 consecutive patients requiring cardiopulmonary bypass. Four whole-blood samples (2 ml per sample) from each patient were tested simultaneously with Hemochron automated timing systems (International Technidyne Corp., Edison, N.J.) before, during, and after cardiopulmonary bypass. One tenth milliliter of either aprotinin (at a final concentration of 80, 120, or 180 KIU/ml) or saline solution was mixed in vitro with blood samples before determination of the activated clotting time. Aprotinin had no inhibitory effect on the activated clotting times of unheparinized blood. After heparin administration, aprotinin in the above concentrations prolonged the activated clotting times measured with celite-activated tubes by 47% to 71%, as compared with the measurements of the activated clotting time without the addition of aprotinin. The activated clotting times in kaolin-activated tubes were not increased, however, by the in vitro addition of aprotinin. Our in vitro results indicate that aprotinin in concentrations from 80 to 180 KIU/ml does not significantly enhance the inhibitory effects of heparin on the intrinsic coagulation system as evaluated by measurement of the activated clotting times in kaolin-activated tubes. The anticoagulation effect of heparin in patients receiving aprotinin infusion should be monitored with kaolin-activated instead of celite-activated tubes because the celite makes the measured activated clotting time unreliable in patients receiving aprotinin therapy. These in vitro results require confirmation in vivo in patients receiving aprotinin therapy.

Aged↗
PubMed1992

[Seroepidemiological analysis of hepatitis B virus infection between anesthesia personnel and hospital administration staffs in Changhua Christian Hospital].

For hospital personnel, transmission of virus is a common and serious occupational hazard. Other than suffering from physical discomfort, these infected hospital staffs may also transmit the disease to patients through their blood, mucous or secretion contamination. The purpose of this study is intended to understand the condition of hepatitis B virus infection between anesthetists and hospital administration staffs. Forty-six anesthetists (study group) and 90 hospital administration staffs (control group) were volunteers of the study. Blood samples for serologic and biochemical test of hepatitis B virus infection in each participant were proceeded from October to December 1990. To investigate personal recognition about hepatitis B infection, each was requested to fill up a questionnaire after blood sampling. We also retrieved the chart of all participators for their annual hepatitis B serologic result in order to find out the incidence of seroconversion. Among the 136 participators, 20 (14.7%) were HbsAg carriers. Only 28 (20.6%) of all the participators were free from infection and seronegative. However, it was found that there was no significant difference (P greater than 0.05) between the two groups, no matter in HbsAg positive or seronegative incidence. There was 10 (1.27%) incidence of seroconversion during 790 times of person-year observation. Though not significant (P less than 0.05), there was a double fold (2.2 times) seroconversion rate in the study group than that of the control group. Twenty (19.9%) seropositive participators knew that they are hepatitis B carrier or had been infected. Generally, anesthetists seemed better than hospital administration staffs in realizing that they were infected or carrier from the data of serological test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Treatment of Hirschsprung's disease with a modified Duhamel-Grob-Martin operation.

Since 1965 we have treated Hirschsprung's disease with a modified Duhamel-Grob-Martin operation. During this time, there have been many changes in principles of treatments and the operative technique has been reinforced. It will be divided into three different periods. From 1965 to 1980, 202 cases of Hirschsprung's disease were treated with a modified Duhamel-Grob-Martin procedure. This method had several advantages--minimum complications; good fecal control and continence; and no enlargement of the remaining colon--but anastomotic leakage and local infection were the main disadvantages. Since 1980 the operation technique has been reinforced in several points: complete preoperative colon preparation; selection of suture materials; and gentle, meticulous, and accurate surgical technique. Forty-six more patients were treated. No anastomotic leakage and local infection were experienced in this group. From April 1984 to January 1990, all patients with Hirschsprung's disease received the pull-through procedure without the colostomy even in the neonates. Eighteen infants less than 2 months of age have been treated. All patients survived the operation without any significant complications.

Anal Canal↗
PubMed1991

Relaxation distribution function of intracellular dielectric zones as an indicator of tumorous transition of living cells.

The response decay data of living cells subject to electric polarization is associated with their relaxation distribution function (RDF) and can be determined using the inverse Laplace transform method. A new polynomial, involving a series of associated Laguerre polynomials, has been used as the approximating function for evaluating the RDF, with the advantage of avoiding the usual arbitrary trial values of a particular parameter in the numerical computations. Some numerical examples are given, followed by an application to cervical tissue. It is found that the average relaxation time and the peak amplitude of the RDF exhibit higher values for tumorous cells than normal cells and might be used as parameters to differentiate them and their associated tissues.

Animals↗
PubMed1990

Diagnosis of atretic prolonged obstructive jaundice; technetium 99m hepatolite excretion study.

Since 1982 we have developed a diagnostic method for differentiation between atretic prolonged obstructive jaundice (biliary atresia) and nonatretic prolonged obstructive jaundice in a neonate. The first report was presented at the Fukuoka Meeting in 1983. Analysis of duodenal juice (excretion test of intravenous injected hepatolite into the duodenum) has proved to be extremely reliable to differentiate biliary atresia from nonatretic prolonged obstructive jaundice. The major diagnostic features of the study are (1) biliary tract to bowel transit of radiotracer, and (2) observation on color of duodenal juice. Diagnostic accuracy was 98.4%. It is time-saving, requiring only 6 hours, noninvasive, and simple.

Bile Acids and Salts↗
PubMed1989

Adult Hirschsprung's disease.

This report presents a series of 17 patients with adult Hirschsprung's disease treated at the National Taiwan University Hospital and its affiliated hospitals from 1965 to 1988. Adults with Hirschsprung's disease may present with symptoms and operative findings different from those of children with Hirschsprung's disease. The symptoms, signs, criteria for diagnosis, operative findings, and operative procedures are presented.

Adolescent↗