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Biomedical subjects

Y S Yeh

Publications and source records attributed to Y S Yeh.

At least 19 recordsLinked to original sources
PubMed1997

Efficacy of surgical treatment in traumatic central cord syndrome.

BACKGROUND: Controversy surrounds the treatment of traumatic central cord syndrome (TCCS), as there are strong advocates for nonsurgical treatment for most patients. However, conservative treatment has been shown to yield a longer period of discomfort from pain and weakness in certain cases. METHODS: In a retrospective review of 114 patients presenting with acute or chronic TCCS from 1988-94, four different age groups were separately observed under different treatments. Motor and sensory recovery were assessed. RESULTS: Better results were achieved in younger patients, with or without radiographic abnormalities, and in patients with clinically correlated encroaching cord lesions who received early surgical decompression. CONCLUSIONS: Surgical intervention for TCCS must be addressed with careful clinical and radiographic survey. Removal of offending lesions in the subacute period results in significant motor and sensory improvement in short-term and long-term follow-up.

Acute Disease↗
PubMed1997

Early seizures after severe closed head injury.

BACKGROUND: We studied the incidence and clinical significance of early post-traumatic seizures after severe closed head injury. METHODS: This prospective study is based on clinical observation of 3340 adult patients with severe closed head injuries, each of them having a Glasgow Coma Scale (GCS) 3 to 8 after trauma. Anticonvulsant agents were not given to these patients unless there was evidence of seizure. RESULTS: One hundred and twenty-one patients (3.6%) experienced seizures within 1 week after head injury; 42 of these (1.26% of the series) had seizures within 24 hours after trauma. The incidence of intracerebral parenchymal damage was found to be higher among those patients who developed seizures in the first week (66.1%) than in those who did not (62.7%). However this result did not reach statistical significance. The patients with early seizures had a lower mortality rate (p < 0.01). In patients who survived from the initial injury, the occurrence of early post-traumatic seizures did not appear to influence the neurological recovery at 6 months after injury. CONCLUSION: Presence of intracerebral parenchymal damage on CT scan after severe closed head injury does not increase the risk of early post-traumatic seizures. With proper treatment, patients presenting with early seizures may have a lower mortality rate. However, the occurrence of early seizures does not influence the neurological recovery in patients who survive the initial severe closed head injury.

Adolescent↗
PubMed1996

C1-C2 fracture-dislocations in children and adolescents.

OBJECTIVE: C1-C2 is the predominant level of cervical spine injuries in children and adolescents. Either a fracture of the dens or atlantoaxial dislocation (AAD) without fracture of the dens can occur. We present a number of cases to compare their clinical presentations and discuss the preferred method of treatment. MATERIAL AND METHODS: There were 12 cases of type II odontoid fracture and 10 cases of AAD without fracture over a 13-year period. There was a male predominance and traffic collisions were the major cause of injury. Two thirds of the dens fractures were in children over 13 years of age and seven out of ten dislocations without fracture were under 13 years of age. Eight patients with fractured dens suffered from spinal cord injuries but six of those with dislocations were neurologically intact. Two patients of fractured dens and one with AAD presented with chronic myelopathies because of undetected injuries. RESULTS: Three patients expired because of irreversible respiratory failure. Most of the fractured dens achieved bony union after 3 months of halo-vest immobilization but those patients with AAD without fracture usually needed a fusion procedure. Transoral decompression was performed in two cases of dens fracture malunion. All of the survivors of the dens fracture returned to normal or independent daily living. Six of the AAD patients returned to normal, one had a mild neural deficit, and one had persistent spastic quadriparesis. CONCLUSIONS: There is a higher incidence of atlantoaxial dislocation without fracture in children under 13 years of age and a higher incidence of dens fractures in those over 13 years of age. Those with fractures of the dens are more likely to present with evidence of neural injury while those with AAD are more likely to be neurologically intact; however, a correct diagnosis and proper management are mandatory to prevent chronic myelopathy. Halo-vest immobilization is sufficient for most fractures of the dens in children, with AAD usually requiring a fusion.

Adolescent↗
PubMed1996

Postoperative ambulation of patients with intraspinal neurilemomas and meningiomas.

Factors affecting the postoperative ambulatory state of patients with intraspinal neurilemomas and meningiomas were evaluated in 92 patients who underwent surgery at the Chang Gung Memoriam Hospital. The patients' records were reviewed retrospectively and leg power grading was noted (Medical Research Council of Great Britain grading system, zero to five). Of the 89 patients with a preoperative leg power of 1 or better, 87 could walk with or without aids shortly after surgery. The remaining three patients, with a preoperative leg power of zero, were all wheelchair-bound postoperatively. The presence of sensory deficits and sphincter incontinence did not correlates with a poor postoperative ambulatory state, provided the preoperative leg power was above zero. The average period between the onset of the earliest symptoms and the establishment of the diagnosis was 68 weeks for patients with intraspinal neurilemomas and 71 weeks for those with meningiomas. Surgical for patients with neurilemomas were as good as those with meningiomas. Patients with multiple spinal neurilemomas did not fare any worse after surgery.

Chi-Square Distribution↗
PubMed1995

Early seizures after moderate closed head injury.

The incidence and clinical significance was studied in 2574 closed head injury patients, each of them having a Glasgow Coma Scale (GCS) 9 to 12 after trauma. All patients underwent computerized tomography (CT) after being admitted to the emergency service. One hundred and six patients (4.1%) experienced seizures within 1 week after head injury; 46 of these (1.8% of the series) had seizures within 24 hours after trauma. There was no statistically significant difference between the early seizure and seizure free group of patients in gender, age and GCS with the exception of cause of injury (p < 0.01). The incidence of intracerebral parenchymal damage was found to be higher with seizures developing between day 2 and day 7 (80%) than those with seizures developing within 24 hours (54.3%). Analysing the data revealed that early posttraumatic seizures were not related to the presence of intracerebral parenchymal damage on CT scan. The occurrence of early seizures did not affect the mortality and outcome of moderate closed head injury patients.

Adult↗
PubMed1995

Relative risk of deterioration after mild closed head injury.

In this prospective study, a series of 1812 consecutive mild head injured adult patients who visited the hospital emergency department were assessed. Twenty-eight patients (1.5%) deteriorated after head injury; 23 of these (1.3% of the series) required surgical intervention. Five patients (0.3%) deteriorated due to non-surgical causes [post-traumatic seizure 2, syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 3]. Most of the deterioration occurred within the first 24 hours (57%). Post-traumatic headache was found in 280 patients (15.5%) and 84 patients (4.6%) suffered post-traumatic vomiting. The relative risk is calculated. Age over 60, presence of drowsiness, focal motor weakness, post-traumatic headache and vomiting has increased risk of deterioration (p < 0.001). This study suggests that post-traumatic headache and vomiting deserve more clinical attention rather than being considered as post-traumatic syndrome only.

Adolescent↗
PubMed1993

Features of spinal cord injury in Taiwan (1977-1989).

In order to establish an etiological and statistical base for spinal cord injuries, 1,617 spinal cord injured patients admitted to the Chang Gung Memorial Hospital in Taiwan during the period of 1977 to 1989 were reviewed. The most common causes of injury were pedestrian (29.31%) and motorcycle (28.88%) accidents. The greatest incidence of injury was in the 26-35 year age group. The complete tetraplegic patients had the highest mortality rate (26.5%). Additional features studied were the time of occurrence and pattern of injury. Information gathered from this study suggest the need to establish a Spinal Cord Injury Prevention Program, to develop a Prehospital Care System and set up comprehensive Spinal Cord Injury Units in Taiwan. We expect this study to be adaptable to other similar developing countries.

Adolescent↗
PubMed1990

Facial bone fracture associated with carotid-cavernous sinus fistula.

Out of 989 cases of facial bone fracture, ten patients had carotid-cavernous sinus fistulas (1.01%). Their ages ranged from 25 to 48 years. Seven were male and three female. Two of the ten patients had lower third, three patients had middle third, three patients had upper third, and two patients had combined middle and lower third facial bone fractures. The signs and symptoms of a fistula appeared from the first postinjury day up to 50 days after the injury (mean, 21 days). Four patients had symptoms after operation for facial bone fracture. Most fistulae were identified by arteriography before treatment. Followup ranged from 1 year, 8 months, to 5 years, 9 months (mean, 2 years, 9 months). One patient had a malocclusion. Nine patients had complete resolution of their bruits. Complications included unilateral complete visual loss (two), CSF rhinorrhea (two), and stroke in one of the two CSF rhinorrhea patients. One patient expired due to a severe head injury, and there was one death from an unrelated cause.

Adult↗
PubMed1988

Blood compatibility of surfaces modified by plasma polymerization.

Tubular blood-contacting polymeric materials were modified by plasma polymerization and evaluated in the baboon with respect to their capacity to induce both acute and chronic arterial thrombosis. Polymer surface composition was determined by electron spectroscopy for chemical analysis. Steady-state arterial thromboembolism was initiated by introducing tubular segments into chronic arteriovenous shunts. Rates of platelet destruction induced by the test materials were calculated from 111In-platelet survival measurements. Nine plasma polymers based on tetrafluoroethylene, hexafluoroethane, hexafluoroethane/H2, and methane, when deposited on silicone rubber, consumed platelets at rates ranging from 1.1-5.6 x 10(8) platelets/cm2-day. Since these values were near the lower detection limit for this test system, the plasma polymers were considered relatively nonthrombogenic. Acute thrombus formation was initiated by inserting expanded Teflon (Gore-Tex PTFE) vascular grafts into the shunt system. 111In-platelet deposition was measured by scintillation camera imaging over a 1-h exposure period. Standard PTFE grafts (10 cm x 4 mm i.d.) accumulated approximately 1 x 10(10) platelets over this interval. While modification of PTFE grafts with a plasma polymer based on hexafluoroethane/H2 did not alter graft surface morphology, platelet deposition was reduced by 87% as compared to the controls (p less than 0.001). We conclude that both the surface chemistry and texture of prosthetic materials influence thrombogenesis. The method of plasma polymerization may be useful for assessing the importance of these variables independently and, perhaps, for minimizing certain adverse blood-material interactions.

Animals↗
PubMed1988

Pseudomelanosis duodeni. Case report and review of literature.

Pseudomelanosis duodeni is an extremely rare disease that has been only recently recognized. We present what we take to be the first Oriental case with typical endoscopic and histological manifestations. With detailed studies of histochemistry and electron microscopy, we have confirmed that the pigment is composed of iron and lipofuscin. A detailed review of the literature may be found here.

China↗
PubMed1982

Histopathological changes and experimental chemotherapy of TT-1 cell-induced tumor in nude mice.

TT-1 cells, a cell line derived from pancreatic carcinoma in 1962, were tested in nude mice (BALB/c nu/nu) for their tumorigenicity and histopathological features following cell injection. Moreover, an experimental chemotherapy of TT-1-cell-induced tumors in nude mice and attempts of extracting TT-1 tumor-associated antigens were made. The tumorigenicity was measured by subcutaneous inoculation of TT-1 cells in the back of nude mice. The 50% tumor-producing dose (TPD50) for 3-wk and 5-wk old nude mice were 4.7 X 10(4) and 2.4 X 10(5) cells respectively. When 5 TPD50 of TT-1 cells were inoculated subcutaneously into 3-wk old mice, initially cells were found in the subcutaneous space of the inoculated site, then gradually growing into colonies which could be clearly demonstrated microscopically 6 days after inoculation, though by that time tumor was not perceivable nor palpable. Mitomycin-C and fluoro-uracil were administered 2 days after TT-1 cell inoculation. It was found that 5 doses of 8 microgram mitomycin-C and 0.25 mg fluoro-uracil administered intravenously were effective to prevent the nude mice inoculated with 5 TPD50 from tumor formation. However, if these two drugs were injected 3 weeks later, tumor growth was suppressed only by the first 4 doses of drugs but not thereafter. Immune sera were prepared by immunizing rabbits and mice with 3 M KCl extract of nude mouse-grown tumors. Nude mouse serum and subcutaneous tissue antigens were present in the tumor extract and showed strong antigenicity.

Animals↗
PubMed1981

Theoretical error in radionuclide ejection fraction study due to photon attenuation.

The ejection fractions measured with the radionuclide method are usually lower than those measured with the X-ray contrast method in our hospitals. One of the reasons for this may be that the photon attenuation by the cardiac blood pool and soft tissue is greater for the larger end-diastolic ventricle than that for the end-systolic ventricle. Mathematically, the error due to photon attenuation in radionuclide ejection fraction study is calculated to be about 5 percentage points. Clinically, if 5 percentage points are added to the ejection fractions measured by the radionuclide method, the results would correlate better with the studies by the X-ray contrast method. The correction factors for photon attenuation may also be applied in calculation of the residual urinary bladder volume.

Cardiac Output↗
PubMed1980

A case of malignant lymphoma, undifferentiated, Burkitt's type with high antibodies to Epstein-Barr virus.

A 5-year-4-month-old girl was admitted to Taipei Municipal Jen-Ai Hospital because of a rapidly enlarging right submandibular tumor. The diagnosis of malignant lymphoma, undifferentiated, Burkitt's type was made by distinctive histopathological features. Positive serological findings related to Epstein-Barr virus infection were disclosed. Complete remission has been achieved since the treatment with high-dose cyclophosphamide was given, and no signs of relapse have been found yet.

Antibodies, Viral↗
PubMed1977

Infection of Taiwan monkey T and B cells with Epstein-Barr virus.

In order to establish Taiwan monkey lymphoblastoid cell lines, attempts were made to raise the susceptibility of monkey lymphocytes to Epstein-Barr virus (EBV) by chemical and enzymatic treatments. EBV infectivity to monkey T and B cells were tested by detection of EBV early antigens in infected cells with the indirect immunofluorescent antibody technique. Treatments of monkey unfractionated lymphocytes with DEAE-Dextran (160 microgram/ml) for 1 hr, ethylenediamine tetra-acetic acid (EDTA, 0.5%) for 10 min, 5-bromodeoxyuridine (BUdR, 12.5 microgram/ml) for 23 hr and 5-iodo-2'-deoxyuridine (IUdR, 12.5 microgram/ml) for 20 hr raised the susceptibility of the cells to EBV. However, trypsin treatment (0.05, 0.1 and 0.2%) at 37 degrees C for 5 min did not affect cell susceptibility to EBV. Unfractionated lymphocytes, T cells which were purified by rosette formation with sheep red blood cells, and a B cell-rich population obtained by the treatment of lymphocytes with antithymoycte serum were treated with the chemicals described above. The results showed that although the possibility of T cell susceptibility to EBV could not be ruled out because of 1 to 2.5% of B cell contamination in purified T cells, the main target cells in Taiwan monkey leukocytes for EBV infection were B cells.

Animals↗