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Biomedical subjects

B L Chang

Publications and source records attributed to B L Chang.

At least 37 records · Page 2Linked to original sources
PubMed1999

The effect of mitomycin-C on the healing process in rabbit extraocular muscle surgery.

BACKGROUND AND OBJECTIVE: One of the most serious complications following extraocular muscle surgery is formation of postoperative adhesions that may result in restrictive ocular motility dysfunction. The effect of mitomycin-C (MMC) on postoperative wound healing in extraocular muscle surgery was investigated. MATERIALS AND METHODS: Sixteen albino rabbits (24 eyes) were used and anesthetized with ketamine and xylazine. These rabbits were divided into 3 groups; (1) control group (balanced salt solution (BSS) exposure for 5 minutes), (2) Group 1 (0.5 mg/ml MMC exposure for 1 minute) and (3) Group 2 (0.5 mg/ml MMC exposure for 5 minutes). After 3 mm recession of superior rectus muscle, MMC or BSS was applied using Weck-Cel sponge (Solan, Jacksonville, FL). The reduction of fibroblast and collagen fiber proliferation were evaluated histopathologically with light microscope at 1, 2, 4 and 8 weeks after operation. We also evaluated the amount of basic fibroblast growth factor (bFGF) by immunohistochemical study at the same time. RESULTS: Histopathologically, there was a more significant reduction of fibroblast and collagen fiber proliferation in Group 1 and 2 than the control group. Immunohistochemically, Group 1 and 2 showed lesser expression of bFGF than the control group. But, there was no difference between Group 1 and 2. CONCLUSIONS: Topical intraoperative application of mitomycin C in extraocular muscle surgery may reduce postoperative adhesions.

Animals↗
PubMed1999

Nursing care of the elderly as a vulnerable population.

Older Americans are a rapidly growing segment of our population and present unique health problems. Although life expectancy is increasing and disability is currently decreasing in the elder population as a whole, socioeconomic and environmental resources are lacking for many elders. This lack of resources added to physiologic decline places elders at increased risk for health problems. Nurses need to expand their traditional, individualistic view of health care and incorporate a broader, social perspective in order to provide adequate health care for the vulnerable population.

Aged↗
PubMed1999

Education of health professionals using a proposed telehealth system.

The movement of health care from hospitals to the community has demanded a major shift in the way in which health care professionals are being taught. This paper describes the collaboration of the Schools of Nursing and Medicine in the use of telehealth technology for the education of health care professionals. The specific aims of the project were to use the technology for the verification of the students' assessment and physical examinations, for the conduct of multi-professional patient rounds, and provision of consultations to professionals at remote sites. Capitalizing on the Schools' previous experience for observing students via computer technology at remote sites, we employed PC-based workstations, specialized peripherals, and Internet connecting protocols to implement a telehealth project for professional clinical education. Initial student, faculty and staff reactions were generally positive. The formal evaluation plan focuses on students, faculty, and staff. Structured questionnaires are used and a comparison of learning by telehealth technology will be made with alternative (more conventional) methods in evaluating knowledge and quality of verification of physical examination findings, and satisfaction with the learning process.

California↗
PubMed1999

Does what nurses do affect clinical outcomes for hospitalized patients? A review of the literature.

OBJECTIVE: Through a review of the literature, to identify and describe (1) empirical studies of inpatient nursing care quality that evaluate links between nursing care processes and health-related patient outcomes, (2) nursing care processes for which process-outcome links have been established, and (3) important nursing care processes that have not yet been evaluated. DATA SOURCES/STUDY SETTING: Published empirical studies of inpatient nursing care quality that evaluated links between processes of nursing care and health-related patient outcomes. STUDY DESIGN/DATA COLLECTION/EXTRACTION METHODS: This literature review used a five-step article search and review method. PRINCIPAL FINDINGS: Of 257 data-based studies of nursing care quality identified, 135 investigated a process-outcome link but only 17 met study inclusion criteria. The literature provides evidence that the quality of nursing care processes affects health-related patient outcomes during and after hospitalization. Gaps in the literature that evaluates nursing quality are identified. CONCLUSIONS: Although some nursing care processes affect health-related patient outcomes, the full extent of nursing process-outcome links is relatively understudied. Further evaluation of the interrelationships between nursing care processes and outcomes is critical.

Humans↗
PubMed1997

Novel patterns of p53 abnormality in breast cancer from Taiwan: experience from a low-incidence area.

Among 114 breast cancers in Taiwan, the prevalence of p53 mutation (22.8%) and p53 accumulation (38.3%) was similar to that in high-incidence areas. However, novel patterns of p53 abnormalities, including unique sites or types of mutation (i.e. an excessive proportion of G:C to A:T transition at CpG site), and accumulation of wild-type p53 either within nuclear or cytoplasmic compartments were noted. These may have relevance to breast cancer in Taiwan, a low-incidence area.

Breast Neoplasms↗
PubMed1997

Persistent hyperplastic primary vitreous in male twins.

Persistent hyperplastic primary vitreous (PHPV) occurs sporadically and few familial occurrences have been reported. The authors report PHPV unassociated with other congenital anomalies in male twins. One underwent a lensectomy for the management of angle-closure glaucoma and the other was treated for amblyopia. These cases provide further evidence to suggest autosomal recessive inheritance, though the possibility of developmental error cannot be excluded.

Amblyopia↗
PubMed1997

Delayed reattachment of extraocular muscles in rabbits using thin polytetrafluoroethylene.

BACKGROUND AND OBJECTIVE: The authors attempted to find a way to perform reliable delayed suture adjustment so that surgeons can investigate whether delayed adjustment actually gives more reliable and stable results. To prevent the formation of postoperative adhesions and delay the time of adjustment, the authors used polytetrafluoroethylene (PTFE) as a mechanical barrier. MATERIALS AND METHODS: PTFE was placed between the free muscle end and the sclera as a physical barrier in 16 rabbits. RESULTS: PTFE could delay the adjustment for up to 4 weeks after surgery in 4 of 10 eyes in each group. After removal of PTFE, adjustment was possible up to 12 weeks because there was no adhesion between the muscle and the PTFE. CONCLUSION: Adjustment could be delayed up to 4 weeks in 40% of the experimental eyes using PTFE as a physical barrier.

Animals↗
PubMed1996

Molecular epidemiology of cytomegalovirus infection in kindergarten children.

This study was conducted to determine the source of cytomegalovirus (CMV) excretion in children who had persistent viruria. A total of 287 children, ages 3-5 years, enrolled in two kindergartens were followed for 9 months, and 28.8% of 139 CMV-infected children were found to have shed virus persistently in urine for > or = 3 months. A polymerase chain reaction (PCR)-based method provided direct evidence to demonstrate differences in CMV strains shed by 32 persistent shedders selected at random. The glycoprotein B (gB) nucleotide regions of CMV were amplified and analyzed by restriction enzyme digestion. The CMV strains shed by most of these children showed different restriction profiles compared with strains from their playmates. It is considered that persistent reactivation of endogenous CMV is the most plausible explanation.

Antibodies, Viral↗
PubMed1996

Use of physical barriers for delayed adjustable strabismus surgery: the effect of interceed and polyglactin 910 mesh.

AIMS/BACKGROUND: In the course of adjustable strabismus surgery there is only a limited period after surgery before the formation of firm adhesions prevents successful adjustment. To determine if this period could be increased by the interposition of suitable physical barriers, the use of Interceed and polyglactin 910 mesh was investigated in an animal model. METHODS: A total of 39 rabbit eyes were divided into three groups. After recession of the superior rectus muscle (SRM), balanced salt solution was applied to the control group between the free muscle end and the sclera; in each of the two experimental groups, Interceed and polyglactin 910 mesh were applied. Delayed adjustment was performed once on each SRM at 1, 2, or 3 weeks postoperatively. The length and force of the adjustment, the degree of adhesions, and the degree of fibrous proliferation were recorded. RESULTS: Adjustment was not possible in any of the eyes in the control group. At 1 week postoperatively, adjustment was possible in four out of five eyes with Interceed and in three out of five eyes with polyglactin 910 mesh as a physical barrier. CONCLUSIONS: Interceed may be clinically useful in delaying the timing of adjustment up to 1 week. Further study of the use of other materials could be carried out to see if it was possible to delay the timing of adjustment for more than 1 week.

Animals↗
PubMed1996

The validity of a nursing assessment and monitoring of signs and symptoms scale in ICU and non-ICU patients.

PURPOSE: This study examined the validity of medical-record-based nursing assessment and monitoring of signs and symptoms (nursing surveillance) in predicting patients who were admitted to ICUs and those admitted to non-ICUs. The association of this assessment and monitoring with differences in an intermediate patient outcome, instability at discharge, was also explored. Patients admitted to either setting with a diagnosis of acute myocardial infarction, cerebrovascular accident, congestive heart failure, or pneumonia, were included in the study. METHOD: A secondary analysis was carried out using a subset of data originally collected for a quality-of-care study. Data from the medical records of 11,246 patients (52% female, 48% male) with a mean age of 76.4 years were used in the present study. RESULTS: ICU patients (n = 3969) were found to have a longer length of stay and to be sicker on admission than non-ICU patients (n = 7277). Overall, patients in the ICU received significantly higher nursing assessment and monitoring of signs and symptoms scores than non-ICU patients. Nursing assessment and monitoring of signs and symptoms scores were lower for patients discharged with greater instability for three of the four diseases (cerebrovascular accidents, congestive heart failure, and pneumonia).

Aged↗
PubMed1995

Nursing diagnoses and construct validity of pain, self-care deficit and impaired mobility.

Construct validity of the concepts of pain, self-care deficit and impaired mobility was examined in a study of 120 medical-surgical patients. Factors derived from a factor analysis of the empirical signs and symptoms were: pain-factor and self-care deficit/impaired mobility-factor. The pain-factor clearly showed discriminant validity by differentiating between those with and without Clinical Nurse Specialist (CNS)-identified diagnosis of pain. An overlap between the defining characteristics of the diagnoses of self-care deficit and impaired mobility has been suggested in the present sample of patients. Limitations of the study and recommendations for further research are described.

Activities of Daily Living↗
PubMed1995

Effects of mitomycin C on delayed adjustment in experimental strabismus surgery.

In adjustable strabismus surgery, a satisfactory final result would be achieved with delayed adjustment. However, the postoperative adhesions following strabismus surgery make delayed adjustment impossible. We evaluated the efficacy of mitomycin C in reducing the severity of postoperative adhesions following strabismus surgery and in delaying the time adjustment after surgery. Experimental rabbits underwent a hang-back recession procedure in the superior rectus muscle. A topical application of mitomycin C was made between the conjunctiva and the sclera for 5 minutes during the operation. We then studied the possible time of delayed adjustment and estimated the minimal forces required for the adjustment. The topical application of 0.1 mg/ml mitomycin C between the conjunctiva and sclera allowed for a 2-week delayed adjustment after surgery, and 0.2 mg/ml mitomycin C prevented the adhesions between these tissues and the muscle 5 weeks after surgery. These results suggest that topical mitomycin C may enhance the success rate of strabismus surgery with delayed adjustment and reduce postoperative adhesions.

Administration, Topical↗
PubMed1995

Allergy as a risk factor for nursing care problems in the elderly cancer patient.

The purpose of this secondary analysis was to determine (a) the nursing diagnoses in elderly patients with cancer and (b) whether elderly cancer patients with a current or past history of allergy were at risk for selected nursing problems. A retrospective clinical data base from 59 patients (32 male, 27 female) with a diagnosis of cancer and an age range of 55-85 years with a mean age of 65.6 years was examined. The most frequently occurring priority nursing diagnoses identified by Clinical Nurse Specialists (CNS) were Pain, Risk for Infection, and Impairment of Skin Integrity. When examining the comprehensive list of priority and nonpriority nursing diagnoses, identified for these patients with cancer, it was found that those with a history of allergy were significantly more likely to have a high risk for infection than those without a history of allergy. Two other diagnoses (knowledge deficit and potential fluid volume deficit) occurred in a significant number in the allergy group, but there was no occurrence of these two diagnoses in the nonallergy group. The limitations of assessing immunologic status as a part of regular nursing assessments were discussed. Recommendations were provided for future research in the area of immunology, aging, and nursing diagnoses.

Aged↗
PubMed1994

Validity of concepts for selected nursing diagnoses.

The purpose of this study was to determine the extent to which defining characteristics found in selected patients cluster to form a nursing diagnostic response/label or define a concept, and to determine the construct validity of the defining characteristics for Self-Care Deficit, Impaired Mobility, and Pain. The sample included 309 medical-surgical patients who were found to have the diagnostic responses of interest. The signs and symptoms of the 309 patients were submitted to cluster analysis. Scores on the clusters were examined for their ability to differentiate between two known groups of patients: those identified by clinical nurse specialists (CNS) as having, or not having, selected diagnostic responses/labels. The cluster score Self-Care Deficit differentiated between patients with and without the CNS-diagnostic response of Self-Care Deficit and Pain. Patients with CNS-diagnosis of Self-Care Deficit and Impaired Mobility scored high in the Impaired Mobility Cluster score. Limitations of the study, clinical relevance, and recommendations for future research are discussed.

Cluster Analysis↗
PubMed1994

Pathologic changes after inferior oblique marginal myotomy in rabbits.

To evaluate the histopathologic changes after an inferior oblique marginal myotomy with local injection of triamcinolone, an inferior oblique marginal myotomy was performed in 14 white rabbits and they were divided into 2 groups, one group with a local injection of triamcinolone and the other group without triamcinolone injection after a myotomy. At the postoperative one month, an edema of the muscle fibers and an infiltration of the inflammatory cells were observed and at postoperative three months, a fibrous tissue ingrowth around the muscle fibers and an atrophy of the muscle fibers were found and those changes were less prominant in the group with triamcinolone injection. The local injection of triamcinolone after the inferior oblique marginal myotomy would help in decreasing the fibrous tissue ingrowth and the formation of the scar tissue, thus it could be used in augmenting the effect of the inferior oblique marginal myotomy.

Animals↗