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Biomedical subjects

C J Wang

Publications and source records attributed to C J Wang.

At least 55 records · Page 3Linked to original sources
PubMed2001

Treatment of nonunions of long bone fractures with shock waves.

A prospective clinical study investigated the effectiveness of shock waves in the treatment of 72 patients with 72 nonunions of long bone fractures (41 femurs, 19 tibias, seven humeri, one radius, three ulnas and one metatarsal). The doses of shock waves were 6,000 impulses at 28 kV for the femur and tibia, 3,000 impulses at 28 kV for the humerus, 2,000 impulses at 24 kV for the radius and ulna, and 1,000 impulses at 20 kV for the metatarsal. The results of treatment were assessed clinically, and fracture healing was assessed with plain radiographs and tomography. The rate of bony union was 40% at 3 months, 60.9% at 6 months, and 80% at 12 months followup. Shock wave treatment was most successful in hypertrophic nonunions and nonunions with a defect and was least effective in atrophic nonunions. There were no systemic complications or device-related problems. Local complications included petechiae and hematoma formation that resolved spontaneously. In the authors' experience, the results of shock wave treatment were similar to the results of surgical treatment for chronic nonunions with no surgical risks. Shock wave treatment is a safe and effective alternative method in the treatment of chronic nonunions of long bones.

Adolescent↗
PubMed2001

Effect of shock wave therapy on acute fractures of the tibia: a study in a dog model.

The effect of shock wave therapy on acute fractures of the tibia was studied in eight adult dogs. A fracture with a 3-mm gap was created in both tibias and the fractures were fixed internally with a small metallic plate and screws. Each of the right limbs received 2,000 impulses of shock waves at 14 kV whereas the left limbs were used as controls. The evaluations included the callus formations based on serial radiographic examinations at 1, 4, 8, and 12 weeks and histologic examinations at 12 weeks for tissue distribution including bone tissues. Based on radiographic findings, there was no statistically significant difference in the amount of callus formation between the treated and the control groups at 8 weeks or less. However, the radiographic findings at 12 weeks statistically showed more callus formations in the treated group. In histologic examinations, there was significantly more cortical bone formation in the treated group at 12 weeks and the bone tissues were thicker, denser, and heavier. Shock wave therapy enhanced callus formation and induced cortical bone formation in acute fractures in dogs at 12 weeks. The effect of shock wave therapy seemed to be time-dependent at 3 months.

Animals↗
PubMed2001

Attenuation of radiation dose by the skull base bone in patients with nasopharyngeal carcinoma: clinical importance.

PURPOSE: To measure the degree of attenuation of radiation dose by the skull base bone in patients with nasopharyngeal carcinoma (NPC) and to study its clinical importance. MATERIALS AND METHODS: Isodose distribution in 11 patients with NPC who received bilaterally opposed large-field irradiation (1.8 Gy per fraction) was studied with a three-dimensional treatment planning system with tissue inhomogeneity correction. Also studied were the sites of local tumor recurrence in 37 patients with NPC and skull base destruction (>/=0.5 cm) or intracranial invasion treated with radiation therapy from January 1989 to December 1992. Regression analyses were performed. RESULTS: In the dosimetric study, the low-dose areas (<1.65 Gy) were located at the level of the skull base in all 11 patients. A significantly positive correlation between the maximum width of the skull base bone and the low-dose volume (<1.65 Gy) was demonstrated (P =.003, linear regression). In the clinical study, local tumor recurrence was noted in 18 patients (49%). The sites of local recurrence included skull base in 16 patients (43%) and nasopharynx in six patients (16%). Wider skull base bone was a significant predictor of skull base recurrence after radiation therapy (P =.03, logistic regression). CONCLUSION: Herein demonstrated is the inadequacy of the radiation dose over the skull base due to attenuation by the skull base bone. The relationship between width of skull base bone and skull base tumor recurrence also is established.

Adult↗
PubMed2001

Clinical characteristics of outpatients at a psycho-oncology clinic in a radiation oncology department.

BACKGROUND: Psychosocial care in cancer medicine has become increasingly important. The first psychiatric consultation-liaison (C-L) outpatient clinic in Taiwan was established in a department of radiation oncology in a medical center in Oct. 1998. METHODS: From October 1998 through January 2000, 121 patients were referred for psychosocial evaluation. Six referred patients were excluded because of cerebral complications of malignant disease or coincidental psychiatric disorder. The remaining 115 patients were referred because of psychological problems related to their malignant disease. These patients were divided into 'depression related disorder' and 'anxiety related disorder' groups according to psychiatric standard diagnoses. The records of these referred patients were retrospectively analyzed based on the psychiatric diagnoses. RESULTS: The outpatient utilization rate for psychiatric consultation escalated from 0% to 5.92% after the C-L clinic was established. Patients with nasopharynx, breast, and head and neck cancer had higher referral, rates (over 10%) than patients with other types of cancer. There were significant differences in major subjective psychiatric problems and psychological reactions between patients with psychiatric diagnosis and those without psychiatric diagnosis. Cancer patients who were diagnosed with 'depression related disorder' visited this clinic more times than those with 'anxiety related disorder'. The former received antidepressant drugs more frequently than the latter. There were also more multiple visits in the former group than the latter group. CONCLUSION: Locating a C-L clinic in a radiation oncology department improves access to psychiatric evaluation, early detection and continuous intervention can then be offered to cancer patients with anxiety or depression, especially those with 'depression related disorder'.

Adult↗
PubMed2001

Diagnosis and results of treatment with radiation therapy in gliomatosis cerebri patient: case report.

Gliomatosis cerebri (GC) is a rare disease loosely defined as a diffusely infiltrating glioma involving extensive areas of the brain. The prognosis is poor and no definite treatment has proven effective for GC. Little information exists regarding the role of radiation therapy (RT) for GC, but some researchers have suggested that it is a good choice of treatment from their limited experience. In this report, we present a case with imaging and histological diagnosis of GC and demonstrate the treatment results of RT. The patient was a 39-year-old woman with progressive symptoms of dizziness, unsteady gait, headache, vomiting, and consciousness disturbance for 6 months. She received a series of radiographic examinations and surgical interventions for diagnosis. The definite diagnosis of GC was made by a combination of magnetic resonance imaging (MRI) findings and histological examinations. Forty Gray (Gy) of whole brain irradiation followed by 14 Gy reduced-field boosts were given to her. The MRI, following treatment, showed regressive changes, and clinical symptoms were slightly improved. The patient survived 19 months after the diagnosis, which is longer than the average survival time of patients without treatment.

Adult↗
PubMed2001

Intraoperative stroke under epidural anesthesia for bipolar hemiarthroplasty in a patient with multiple myeloma: a case report.

A 56-yr-old, 58-kg woman with right femoral neck fracture underwent right bipolar hemiarthroplasty. Her medical problems included diabetes mellitus and multiple myeloma. Epidural anesthesia was performed uneventfully. No other drug except for local anesthetic (2% lidocaine) was administered during the procedure. Unfortunately, we "witnessed" the dramatically hemodynamic change of an intraoperative stroke, which was preceded by a hypotensive episode and followed by sustained hypertension. The stroke was presented with decreased level of consciousness initially and confirmed by the brain CT, which revealed acute infarction at the right middle cerebral artery territory, four days after the procedure. Multiple mechanisms such as intraoperative hypotensive episode and vascular atherosclerotic change due to poor controlled diabetes mellitus might be involved in the event. In the meanwhile, hyperviscosity (3.7 centipoise units of the patient v.s. 1.4-1.8 centipoise units of normal range) caused by multiple myeloma might also have contributed to the intraoperative stroke. Clinical presentation of this case will be discussed.

Anesthesia, Epidural↗
PubMed2001

Microlaparoscopically assisted vaginal hysterectomy. A preliminary report.

OBJECTIVE: To evaluate the clinical possibility of using a microlaparoscope in laparoscopically assisted vaginal hysterectomy. STUDY DESIGN: Twenty-five women with different indications for hysterectomy and a uterine size < 14 weeks' gestation underwent laparoscopically assisted vaginal hysterectomy using a microlaparoscope and 2-mm instruments. RESULTS: Microlaparoscopic procedures included coagulation and separation of infundibulopelvic or uteroovarian round ligaments, vesico-uterine-visceral peritoneal fold dissection, and anterior and posterior colpotomy. The mean operative time, blood loss and length of hospital stay were 84.40 +/- 16.85 minutes, 262.00 +/- 112.99 mL and 3.08 +/- 0.64 days, respectively. No patients developed serious complications, but there were two minor ones. CONCLUSION: Microlaparoscopy appears to be an efficacious alternative treatment option in well-selected patients undergoing laparoscopically assisted vaginal hysterectomy.

Adult↗
PubMed2001

Arthroscopy in avulsion fracture of posterior cruciate ligament.

BACKGROUND: Surgical reduction of PCL avulsion fracture was performed from posterior approach and arthroscopic treatment was not routinely performed. However, associated intraarticular lesions of meniscus, cartilage, of any other pathologies were very common in PCL injuries. If the treatments of associated intraarticular lesions would improve the results was not known. Under this prospective study, we want to know if arthroscope is valuable in PCL avulsion fractures. METHODS: From January 1995 to December 1997, there were 29 cases of PCL avulsion fractures. They were grouped according to chart numbers. Group I was even number group and group II was odd number group. Arthroscopic examination was performed in even number group, but not in odd number group. Group I had 13 cases and group II had 16 cases. All the PCL avulsion fractures were repaired from posterior approach and fixed with cancellous screws. RESULTS: The range of motion, arthrometric data, and Lysholm score were similar in both group after more than 2 years of follow-up. The residual pain was less in arthroscopic group. Arthroscopic examination showed hemarthrosis in all cases of group I; meniscal lesion in 7 cases (54%), osteochondral or chondral lesions in 3 cases (23%), hard medial plica in 3 cases (23%), patellofemoral lesion in 1 case (7.7%), ACL tear in 1 case (7.7%), popliteal lesion in 2 cases (15.4%), lateral opening greater than 1 cm in 5 cases (38.5%). Though the functional results were similar in both groups, the arthroscopic findings in PCL avulsion fracture were negative in only 2 cases. CONCLUSION: Arthroscopic examination in PCL avulsion fracture can provide valuable information.

Adolescent↗
PubMed2001

Laparoscopic diagnosis and management of Fitz-Hugh-Curtis syndrome: report of three cases.

Perihepatic adhesions between the liver capsule and the diaphragm or the anterior peritoneal surface characterizes Fitz-Hugh-Curtis syndrome (FHCS). FHCS is an extrapelvic manifestation of pelvic inflammatory disease and usually refractory to medical treatment and surgical intervention. With the increased incidence of pelvic inflammatory disease, chronic pelvic pain and sequalae of the process are becoming more common. Herein, we report 3 patients with pelvic inflammatory disease in whom medical treatment failed initially and FHCS was diagnosed via laparoscopy. Laparoscopic lysis of pelvic and perihepatic adhesions, irrigation of the abdomino-pelvic cavity, and antibiotics treatment after surgery successfully relieved these patients' symptoms. FHCS is not a new syndrome but most gynecologists might neglect this condition. Laparoscopy is a less invasive procedure than exploratory laparotomy. We recommend laparoscopy in patients with lower abdominal and right upper quadrant discomfort when other organic disease has been ruled out and medical treatment has failed to relieve symptoms.

Adult↗
PubMed2001

Three-dimensional ultrasonic images of normal fetus.

BACKGROUND: The purpose of this study was to assess the usefulness and feasibility of 3-dimensional (3D) ultrasound for routine fetal observation. METHODS: Eighty-five normal pregnancies with gestational ages of 20-36 weeks were studied. A conventional ultrasound scanner with a specially designed operation unit, frame memory, and 3D probe was the apparatus used in this study. The unit has a circuit board consisting of digital integrated circuit chips designed to make calculations of volume ray tracings for volume rendering in real time. For each fetus, scanning was performed with different levels of opacity in the equation for volume rendering. In areas where there was an inadequate amniotic fluid pocket to perform an adequate examination, the pregnant woman was asked to push the fetus to the opposite side by gently pressing on her abdomen. RESULTS: Face, limbs, and fingers which are difficult to visualize on conventional ultrasonography could be seen clearly. Extremely satisfactory images were obtained at between 24 and 34 weeks of gestation that produced sonographic pictures easily recognized even by laypersons. Beyond 34 weeks of gestation due to the relative decrease in the size of amniotic fluid pockets, and before 24 weeks of gestation due to frequent fetal movement, the soft tissue of fetuses is thin and its acoustic impedance is virtually the same as that of water, so surface-rendered images are less satisfactory. In addition, the anterior wall placenta, multiple pregnancies, and oligohydramnios made viewing even more difficult. CONCLUSION: Between 24 and 34 weeks of gestation, 3D ultrasound is a feasible and useful procedure for routine antenatal examination.

Female↗
PubMed2001

Management of patellofemoral arthrosis in middle-aged patients.

Patellofemoral arthrosis is one of the most common causes of knee pain in middle-aged patients, and is often associated with patellofemoral malalignment. A correct diagnosis is established by history taking and physical and radiographic examinations of the knee. The initial treatment of choice is conservative treatment, which includes anti-inflammatory drugs, use of a knee brace, quadriceps-strengthening exercises, physical therapy, and modification of activity. Surgery is indicated when patients fail to improve after at least 6 months of conservative treatment and are functionally disabled. Lateral retinacular release and proximal realignment are performed only in selected cases. Distal realignment by anteromedial transfer of the tibial tubercle is the most effective method for treating patients with patellofemoral arthrosis. The magnitude of anteromedial transfer of the tibial tubercle must be individualized, and rigid internal fixation enables immediate postoperative rehabilitation. In knees with patellofemoral arthrosis with no malalignment, a 20-mm anterior displacement without medial transfer of the tibial tubercle is suggested. A 15-mm anterior displacement plus 5 to 10 mm of medial transfer of the tibial tubercle is recommended in knees with patellofemoral arthrosis and mild to moderate malalignment. In knees with severe malalignment, 15 mm of medial transfer and 10 mm of anterior displacement are recommended. A triple osteotomy is considered in knees with patellofemoral osteoarthrosis and patella baja. Patellofemoral resurfacing arthroplasty is only done in carefully selected patients. A patellectomy should be avoided if at all possible. Total knee arthroplasty is indicated in knees with bi- or tricompartmental osteoarthritis.

Biomechanical Phenomena↗
PubMed2001

Traumatic lumbar spinal subdural hematoma--a case report.

A 74-year-old woman suffered from lower legs weakness after a motor vehicle accident. Magnetic resonance imaging (MRI) on the seventh posttraumatic day, revealed a lumbar spinal subdural hematoma at the level of L4-5. After surgical intervention to remove the subdural hematoma, the patient made a complete recovery.

Aged↗
PubMed2001

Trigeminal neuralgia caused by nasopharyngeal carcinoma with skull base invasion--a case report.

We report a case of nasopharyngeal carcinoma with skull invasion, whose chief complaint was left-sided facial pain, which mimicked trigeminal neuralgia, and in whom there was no palpable neck mass. The magnetic resonance imaging (MRI) revealed an infiltrated lesion with abnormal signal intensity in the left nasopharynx, involving the left retro- and parapharyngeal space. The lesion was pathology-proven through biopsy of the nasopharynx to be a non-keratinizing carcioma. The patient received 6000 rad radiotherapy combined with 5-Fluorouracil(5-FU) and Cisplatin, and has been well after 2 years' follow-up.

Female↗
PubMed2001

[Gene cloning and expression of CTLA-4 in E. coli].

OBJECTIVE: To express hsCTLA-4 in E. coli. METHODS: The hsCTLA-4 gene was obtained by PCR amplification from pE plasmid which contains CTLA-4 gene and was inserted into the expression vector pGEX-2T. The recombination strain was induced by IPTG with different concentrations and time. RESULTS: The sequence of PCR amplified DNA fragments was identical with the reported CTLA-4 gene. SDS-PAGE and Western blot showed that 0.10 mmol/L IPTG can induce higher production of the fusion protein with molecular weight 40,000 after addition of IPTG 4 hours and GST-CTLA4 had immunological activity. CONCLUSIONS: hsCTLA-4 can be expressed in soluble form high efficiency.

Antigens, CD↗
PubMed2001

[Research on the synthesis and spectroscopy of 2-(2-phenyl propenyl) benzoxazoles].

In this paper the synthetic methods and the substituent effects on yields were discussed. It was found that the yields were not high, and the compounds with electron-drawing groups had higher yields. Some compounds with electron-giving groups such as t-Bu couldn't be synthesized by wittig-horner method. The compounds were characterized by IR, 1H NMR, MS, UV and FL. The experimental results indicated that there was not quantitative substituent effect on IR, the electron-drawing groups had great effect on the chemical shifts of propenyl hydrogen and methyl hydrogen, the strong double-electron fragments existed in MS. Some experimental phenomena of UV and FL were also studied.

Benzoxazoles↗
PubMed2000

Suppressive effect of penta-acetyl geniposide on the development of gamma-glutamyl transpeptidase foci-induced by aflatoxin B(1) in rats.

The suppressive effects of penta-acetyl geniposide, (Ac)(5)-GP, on the hepatotoxic lesions-induced by aflatoxin B(1) (AFB(1)) were investigated in male Wistar rats. Rats were divided into six groups: groups I and II served as normal and solvent control, respectively; group III was given AFB(1) (2 mg/kg body weight) alone; group IV was given (Ac)(5)-GP (2 mg/kg) alone; and groups V and VI received both AFB(1) (2 mg/kg body weight) and (Ac)(5)-GP (1 mg and 2 mg/kg body weight, respectively). Rats received treatments for 8 weeks, then were maintained on basal diet for 32 weeks. At the end of the experiment (week 40), the liver lesions (e.g. fatty change, eosinophilic and bile duct dilation) and preneoplastic changes in rats of groups V and VI were reduced when they were compared with group III. There were no liver lesions and preneoplastic changes in rats treated with (Ac)(5)-GP alone. Although no differences in the total number of gamma-glutamyl transpeptidase (GGT)-positive foci was observed between the groups treated with AFB(1) along with or without (Ac)(5)-GP, the treatment of (Ac)(5)-GP significantly reduced the number of AFB(1)-induced GGT positive foci (with diameter larger than 0.3 mm). These results indicated that the protective effect of (Ac)(5)-GP on early hepatocarcinogenesis-induced by AFB(1) was associated with the inhibition of GGT foci development.

Aflatoxin B1↗