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Biomedical subjects

W Y Ip

Publications and source records attributed to W Y Ip.

At least 19 recordsLinked to original sources
PubMed2006

Acute dislocation of the elbow caused by a solitary osteochondroma of the proximal radius.

A young man presented with acute dislocation of the left elbow at the radio-capitellar articulation caused by trapping of the biceps tendon at the stalk of a solitary osteochondroma. There was no deformity of the ulna and radius shaft suggestive of a developmental growth disturbance of the forearm bones. Good reduction could be achieved by simple relocation of the biceps tendon. The osteochondroma was excised.

Acute Disease↗
PubMed2005

The crisscross injury mechanism in forearm injuries.

INTRODUCTION: A new mechanism of injury of the forearm bones, crisscross injury, is described. It is more common than the Essex-Lopresti fracture dislocation. The old concept of isolated injury of one side of the radioulnar joint may be challenged. It often occurs in Mason type II fracture dislocation of the radial head or dislocation of radioulnar joints. MATERIALS AND METHODS: The first part was a cadaveric study of the crisscross injury of forearms. The second part was a clinical study of the crisscross injury in some cases of Mason type II fracture radial head and double dislocation of the radioulnar joint. RESULTS: The cadaveric study confirmed a stable crisscross fracture dislocation injury with intact interosseous membrane. The clinical study echoed the presence of this injury by imaging techniques. CONCLUSION: The crisscross injury mechanism explains the mirror pathogenesis of the traumatic fracture dislocation of the distal and proximal radioulnar joints with intact shaft of the radius and ulna. Co-existing subluxation or dislocation of the other radioulnar articulation must not be overlooked in cases of fracture dislocation of one radioulnar joint. Two types of crisscross injury of forearm bones are proposed.

Adult↗
PubMed2005

A novel artificial prosthetic replacement for the proximal interphalangeal joint of the hand--from concept to prototype.

This article describes the development of a proximal interphalangeal (PIP) joint prosthesis based on the principles of replicating anatomical surface components, the use of macrolocking intramedullary stem and the use of a cobalt-chrome alloy material. The design features are intended to obtain an optimal range of motion while retaining stability and longevity. The final prototype, for which a patent has been filed, is described.

Chromium Alloys↗
PubMed2004

Patient-controlled analgesia versus conventional intramuscular injection: a cost effectiveness analysis.

BACKGROUND: In previous studies comparing patient-controlled-analgesia and intramuscular pain management have been unable to provide conclusive evidence of the benefits of either method of postoperative pain control. AIM: The purpose of the study was to compare the efficacy and cost-effectiveness of intravenous patient-controlled-analgesia with intermittent intramuscular morphine for Chinese women in the first 24 hours following elective gynaecological surgery. METHODS: A randomized control design was used. The main outcomes were level of pain and cost for the two types of pain management. Participants indicated their level of pain at rest and when deep breathing or coughing on a 100 mm Visual Analogue Scale, on seven occasions within 24 postoperative hours. Costs for the two types of pain management were based on the costs of equipment, drugs and nursing time. RESULTS: A total of 125 women participated in the study. Mean pain level over the 24 hours in the patient-controlled-analgesia group was significantly lower than in the intramuscular group (P < 0.001). Mean pain level over the seven occasions for the patient-controlled-analgesia group was 11.83 points (95% CI 7.14-16.52) lower when at rest and 11.73 points (95% CI 5.96-17.50) lower during motion than the intramuscular group. Cost per patient was $81.10 (Hong Kong) higher for patient-controlled-analgesia than for intramuscular pain management. Women in the patient-controlled-analgesia group had significantly greater satisfaction with pain management than those in the intramuscular group (P < 0.001), but reported significantly more episodes of nausea (P < 0.05). CONCLUSIONS: While patient-controlled-analgesia was more costly, it was also more effective than conventional on-demand intramuscular opioid injections after laparotomy for gynaecological surgery.

Adolescent↗
PubMed2003

Effect of treatment of Helicobacter pylori on the prevention of gastroduodenal ulcers in patients receiving long-term NSAIDs: a double-blind, placebo-controlled trial.

BACKGROUND: There is controversy as to whether Helicobacter pylori and non-steroidal anti-inflammatory drugs interact to cause peptic ulcers. AIM: To study whether the eradication of H. pylori in patients on long-term non-steroidal anti-inflammatory drug therapy prevents the development of ulcers. METHODS: Patients infected with H. pylori whilst receiving long-term non-steroidal anti-inflammatory drug therapy, but with no ulcers at baseline endoscopy, were randomized to receive either triple antibiotic therapy (metronidazole 300 mg, clarithromycin 250 mg and amoxicillin 500 mg, given four times daily; n = 70) or placebo (n = 70) for 2 weeks. Non-steroidal anti-inflammatory drugs were continued throughout the study period. Endoscopy was repeated 12 weeks after the end of treatment. The development of ulcers was compared between the two groups. RESULTS: Endoscopy at 12 weeks revealed peptic ulcer development in five [7%; 95% confidence interval (CI), 2-16] of the patients who received triple therapy and in six (9%; 95% CI, 3-18) of those who received placebo (P = 1.00). No significant difference in the development of ulcers was found between patients with persistent H. pylori infection (7/80; 9%; 95% CI, 4-17) and those with the eradication of H. pylori (4/52; 8%; 95% CI, 2-19) (P = 1.00). CONCLUSIONS: The eradication of H. pylori in patients receiving long-term treatment with non-steroidal anti-inflammatory drugs did not prevent ulcer development. However, because the rate of ulcer development was low, a study with a larger sample size is required to confirm this finding.

Adolescent↗
PubMed2003

Effect of torsion on microarterial anastomosis patency.

All kinds of technical faults must be prevented in microvascular anastomosis for successful reconstructive microsurgery. Torsion at the anastomosis site is one of the most basic technical errors. In this study, we investigate the effect of different degrees of microarterial torsion on patency and its physical changes on anastomosis in a rat model. A total of 144 microanastomosis were performed in 72 Sprague-Dawley rats. They were divided into 9 groups. The anastomosis was performed at 0 degrees, 45 degrees, 90 degrees, 135 degrees, 180 degrees, 225 degrees, 270 degrees, 315 degrees, and 360 degrees of torsion randomly. Patency rates and the narrowest point of the artery after the anastomosis were recorded after 1 hour for each group. In the second stage of the study, the 9 groups were divided into 2 groups for patency rates and histopathological sampling at the second and seventh days postoperatively. The femoral arteries in all groups were all patent at the end of 1 hour. Only 5 microanastomosis were thrombosed (one in the 45 degrees group, one in the 225 degrees group, one in the 270 degrees group, and two in the 315 degrees group) at the second day of exploration. Only two arteries were thrombosed (one in the 45 degrees group and one in the 315 degrees group) at the seventh day of exploration. The patency rate was 96.8% in experimental groups excluding the control group. Different degrees of torsion had no statistically significant effect on the patency rates of microvascular anastomosis. Torsional repair of the femoral artery in the rat has no significant histopathologic changes, but alternately, endothelial integrity was affected by excessive degrees of torsion. Different degrees of torsion at the anastomosis site do not affect patency rates and cross sectional histology of rat femoral arteries. In clinical practice, minor torsion can be tolerated, however, factors affecting patency such as tension, diameter disproportion, and tight closure can affect the final result of anastomosis. We observed that torsional force of the vessel is distributed along the artery to the weakest point.

Anastomosis, Surgical↗
PubMed2003

Effect of torsion on microvenous anastomotic patency in a rat model and early thrombolytic phenomenon.

Torsion at the microanastomosis site is a basic fault and should be avoided. In this study, we investigate the effects of different degrees of microvenous torsion on patency and its physical changes on anastomoses in a rat model. One hundred anastomoses were performed at different degrees of torsion, using femoral veins of Sprague-Dawley rats. Anastomoses were performed at 0 degrees, 45 degrees, 90 degrees, 135 degrees, and 180 degrees of torsion randomly. Patency tests immediately, 1 h, and 1 week after the anastomoses were checked, using the refill test. Measurements of external diameter were recorded at three points: one at the anastomosis site, and the others 2 mm proximal and distal to the anastomotic site. Finally, histopathologic and scanning electron microscopy studies were performed. Subsequently, because of the peculiar phenomenon of early recannulation of the thrombosed vessels, 20 vessels were also explored on the first and the third days postoperatively. The data demonstrate that torsion at 180 degrees, compared with 0 degrees, 45 degrees, and 90 degrees, impaired patency significantly (P < 0.005). In the subsequent study of 20 veins that were thrombosed on the first day, all became patent on the third day and remained so. In conclusion, rotation of a microvenous anastomosis begins to affect the patency rate at 90 degrees of torsion, and at 180 degrees has a patency rate of only 25%. However, all become patent again from the third day onwards. Thrombosis of rat femoral veins without chronic obstruction results in rapid lysis of thrombus and transient proliferative changes.

Anastomosis, Surgical↗
PubMed2003

Command control for functional electrical stimulation hand grasp systems using miniature accelerometers and gyroscopes.

Recent commercially available miniature sensors have the potential to improve the functions of functional electrical stimulation (FES) systems in terms of control, reliability and robustness. A new control approach using a miniature gyroscope and an accelerometer was studied. These sensors were used to detect the linear acceleration and angular velocity of residual voluntary movements on upper limbs and were small and easy to put on. Five healthy subjects and three cervical spinal cord injured subjects were recruited to evaluate this controller. Sensors were placed on four locations: the shoulder, upper arm, wrist and hand. A quick forward-and-backward movement was employed to produce a distinctive waveform that was different from general movements. A detection algorithm was developed to generate a command signal by identifying this distinctive waveform through the detection of peaks and valleys in the sensor's signals. This command signal was used to control different FES hand grasp patterns. With a specificity of 0.9, the sensors had a success rate of 85-100% on healthy subjects and 82-97% on spinal cord injured subjects. In terms of sensor placement, the gyroscope was better as a control source than the accelerometer for wrist and hand positions, but the reverse was true for the shoulder.

Adult↗
PubMed2003

Childbirth expectations of Chinese first-time pregnant women.

BACKGROUND: This topic had not been researched previously and the information gained could have implications for midwives working with Chinese women everywhere. AIMS: To explore the specific childbirth expectations of Hong Kong Chinese first-time pregnant women. METHODS: This was a cross-sectional descriptive survey study and a Chinese version of the Childbirth Expectations Questionnaire was used to collect data. The sample consisted of 186 first-time pregnant women who first attended the antenatal clinic at a large public hospital in a major geographical region of Hong Kong. RESULTS: Results showed that the Chinese pregnant women, the majority of who had not attended childbirth education classes, had high expectations of support from both their partners and midwives during labour and delivery. Conversely, expectations toward their own ability to cope with pain were relatively low. In addition, the pregnant women expressed concerns about the severity of labour pain and indicated low expectations about minimal use of medical interventions during labour. CONCLUSIONS: This study results add to the existing literature about childbirth expectations of first-time pregnant Hong Kong Chinese women. Midwife educators should incorporate the findings into childbirth education classes to help pregnant women develop realistic and positive expectations.

Adaptation, Psychological↗
PubMed2001

Psychosocial correlates of fluid compliance among Chinese haemodialysis patients.

AIMS: The present study was designed to determine the psychosocial correlates of fluid compliance among patients receiving haemodialysis at two Hong Kong renal dialysis centres. BACKGROUND: There has been little consistency in the findings of correlations among any psychosocial variables and compliance behaviour. There is a need to further study these variables in an attempt to predict haemodialysis patient compliance to fluid restriction. METHODS: Ninety-two Chinese haemodialysis patients completed the Center for Epidemiological Studies Depression Scale (CES-D), The Multidimensional Health Locus of Control Form C Scale (MHLC), the Social Support Questionnaire, Short Form Scale (SSQ6) and a self-designed socio-demographic questionnaire. Daily interdialytic weight gain (DIWG) measure was used as an indicator of fluid compliance. RESULTS: The prevalence of compliance behaviour of Chinese haemodialysis patients was higher than that reported in western studies. There were significant negative correlations found between DIWG and total score on internal health locus of control and social support satisfaction score. However, internal health locus of control did not predict a significant portion of the DIWG variance. Significant predictors of DIWG included satisfaction with social support, comorbidity and monthly family income. Satisfaction with social support was the largest predictor of DIWG. CONCLUSIONS: The present findings suggest that assessing family income, comorbidity, and satisfaction with social support may be useful in identifying haemodialysis patients potentially at risk for difficulties in compliance with fluid restriction.

Adult↗
PubMed2001

Effects of using videotaped vignettes on enhancing students' critical thinking ability in a baccalaureate nursing programme.

AIM: The aim of this study was to determine the effects of using videotaped vignettes in promoting nursing students' critical thinking abilities in managing different clinical situations. BACKGROUND: The impetus for undertaking this study came from recognition of the need to develop the level of students' critical thinking within clinical nursing practice. Eight videotaped vignettes that simulated clinical situations were developed to promote baccalaureate nursing students' critical thinking abilities in managing clinical situations. Guidelines were also developed to stimulate students' discussion. DESIGN/METHODS: A pre-test/post-test design was employed to determine the effectiveness of videotaped vignettes in promoting critical thinking skills among these students. A final sample of 83 students completed all the pre-test and post-test questionnaires on critical thinking skills and nursing knowledge test specific to a vignette. RESULTS/FINDINGS: The findings indicate that students' post-test knowledge scores were significantly higher than the pre-test knowledge scores. While the post-test critical thinking skill test scores were slightly higher than those of the pre-test for the students, the difference was not significant. One reason for such findings may be the limited exposure students had to these new types of videotaped vignettes. After the course had been completed both students and teachers were asked to reflect and to indicate their level of satisfaction with the new approach. There was overall satisfaction with the new approach to teaching clinical skills as reflected in the interview data from both teachers and students. CONCLUSIONS: While there were positive outcomes in terms of helping students to relate nursing principles to clinical situations, more time for students to learn using videotaped vignette in tutorial hours remains a challenge for teachers in planning the lectures.

Adult↗
PubMed2001

Giant cell tumour of the tendon sheath of the hand: a pictorial essay.

Giant cell tumour of the tendon sheath is a soft tissue mass found occasionally in the hand. Its diagnosis can be readily made preoperatively if the characteristic MRI features are appreciated. This pictorial essay demonstrates and describes the imaging findings correlated with histopathological findings in a group of patients with proven giant cell tumour of the tendon sheath.

Adult↗
PubMed2001

A case of disseminated Mycobacterium marinum infection following systemic steroid therapy.

We describe the dissemination of Mycobacterium marinum infection from the right middle finger to the whole extremity and two legs, with the involvement of tendons and joints, in a patient who was treated with a steroid when Mycobacterium marinum infection was not suspected. The patient was successfully treated with a combined surgical and medical approach.

Aged↗
PubMed2001

Growing wrist mass.

A 46 year old man presented with a growing mass over his wrist. Erosions of the triquetrum and hamate were present radiographically. Magnetic resonance imaging (MRI) showed a solid mass arising from the extensor carpi ulnaris tendon, which was T(1) hypointense and isointense, T(2) hypointense, and bloomed on gradient echo images. The preoperative diagnosis of giant cell tumour of the tendon sheath was confirmed on histopathological examination of the excised specimen. The clinical, pathological, and imaging features, with emphasis on MRI findings, of this condition are reviewed.

Diagnosis, Differential↗
PubMed2001

Perceptions of role functions of psychiatric nurse specialists.

Specialized and advanced psychiatric nursing practice is an innovative concept in the health care service in Hong Kong. A clear definition of the role and practice of psychiatric clinical nurse specialists (CNS) is important for the development of expert psychiatric nursing practice but is still in a formative stage. A qualitative exploratory study was conducted to identify the psychiatric CNS's perceptions of their role and to compare their perceptions with those of their clinical psychiatric nurse colleagues. The main themes emerging from interviews, observations, and personal diary data were compared and condensed. Eight CNSs and 24 clinical nurse colleagues from acute care and community psychiatric nursing units voluntarily participated in the study. A four-component framework, including clinical practice, organization, education, and professional role, was adopted from nursing literature and used for categorization. The findings showed similarities of role perceptions in the clinical practice, organization, and education components between the CNSs and their nursing colleagues. Differences in role perceptions, concerns about inadequate knowledge and autonomy, and limitations in professional role are discussed.

Hong Kong↗
PubMed2001

Knowledge of and attitudes toward sex among Chinese adolescents.

This study was conducted to examine the knowledge of and attitudes toward sex of 178 Chinese secondary school students in Hong Kong. The data were collected using a questionnaire that comprised three parts: the Chinese version of the Mathtech Knowledge Test, the Chinese version of the Mathtech Attitude and Value Scale, and a demographic sheet seeking sociodemographic information. In general, students demonstrated a low level of sexual knowledge, especially in relation to adolescent marriage, the probability of pregnancy, and adolescent sexual activity. With regard to attitudes, students indicated positive attitudes toward importance of family and importance of birth control. Male students in comparison with their female counterparts had a higher level of agreement with premarital intercourse and the use of pressure and force in sexual activity.

Adolescent↗