Biomedical subjects

F Y Chang

Publications and source records attributed to F Y Chang.

302 records · Page 17Linked to original sources

PubMedDate not supplied

The risk factors for gallstone disease among senior citizens: an Oriental study.

BACKGROUND/AIMS: Few Occidental studies have addressed the risk factors for gallstone disease (GSD), among aged people. It is unknown whether these factors also present in the Orientals. Therefore, we studied the prevalence and risk factors for GSD among aged people in Taiwan. METHODOLOGY: 1441 aged subjects (> or = 60 years) who received a paid physical checkup at this hospital were investigated. Their demographic characteristics and biochemical parameters were recorded and compared. Ultrasonographic diagnosis revealed a normal gallbladder in 1092 subjects, gallbladder stones in 171, cholecystectomy for gallstones in 65, gallbladder polyps in 83, mixed gallbladder stones/polyps in 10, and miscellaneous results in 20. We enrolled 236 subjects showing either gallbladder stones or cholecystectomy for gallstones as the GSD group. RESULTS: Excluding those subjects with mixed gallbladder stones/polyps, the overall prevalence of GSD in our series was 16.6%. Using multivariate analysis, the encountered factors manifesting risk for the development of GSD were old age (p<0.001), lower serum high-density lipoprotein level (p<0.01), diabetes mellitus (adjusted odds ratio: 2.127; p<0.001) and glucose intolerance (adjusted odds ratio: 1.954; p<0.001), whereas past history of alcohol consumption (adjusted odds ratio: 0.335; p<0.01) exhibited a protective effect against the development of GSD. Other demographic characteristics and biochemical parameters, such as body mass index, ABO blood type, cigarette smoking, blood pressure, serum cholesterol level, hepatitis B virus carrier, liver function, and parity, did not have any correlation to GSD. CONCLUSIONS: Among the aged senior citizens in Taiwan, individuals with old age, lower serum high-density lipoprotein level, diabetes and glucose intolerance are at high risk for developing GSD.

Aged↗

PubMedDate not supplied

Gastric inhibitory polypeptide appears less important in mediating acid secretion.

BACKGROUND/AIMS: Gastric inhibitory polypeptide is recognized as an acid inhibitor, while its relationship with Helicobacter pylori colonization is unknown. The present study measured serum gastric inhibitory polypeptide levels in patients after various types of gastric resection and the influence of demographic characteristics including Helicobacter pylori on serum gastric inhibitory polypeptide levels. METHODOLOGY: The study included twenty patients who underwent distal gastrectomy for duodenal ulcer, 33 patients who underwent radical subtotal gastrectomy for gastric carcinoma and 7 patients who underwent total gastrectomy. Another 58 healthy subjects served as controls. Their demographic characteristics were recorded, while serum gastric inhibitory polypeptide levels were measured using a homemade radioimmunoassay kit. RESULTS: The serum gastric inhibitory polypeptide levels in the three patient groups and the controls were 246.2+/-38.7 pg/ml, 201.7+/-30.9 pg/ml, 183.5+/-34.5 pg/ml and 202.6+/-14.0 pg/ml, respectively. The difference among the four groups was not significant. Neither age, gender, body mass index, smoking, Helicobacter pylori colonization nor type of gastrectomy had an influence on serum gastric inhibitory polypeptide levels in the controls and the three patient groups. However, elapsed time since operation in patients following total gastrectomy exhibited a significant positive correlation with their gastric inhibitory polypeptide levels (r=0.89, p<0.05). CONCLUSIONS: Serum gastric inhibitory polypeptide levels remain unchanged in patients undergoing various types of gastrectomy. Colonization of Helicobacter pylori does not influence its level. This peptide is probably less important in mediating gastric acid secretion.

Aged↗

PubMedDate not supplied

The influence of intravenous omeprazole on intragastric pH and outcomes in patients with peptic ulcer bleeding after successful endoscopic therapy--a prospective randomized comparative trial.

BACKGROUND/AIMS: The role of omeprazole in preventing rebleeding in patients with peptic ulcer bleeding after successful endoscopic therapy has been controversial. In this study, we used 3 different formulas of intravenous omeprazole in the above patients. We wished to compare the intragastric pH and outcomes among them. METHODOLOGY: Between July 1996 and May 1997, after having obtained initial hemostasis with endoscopic therapy, a total of 20 patients with peptic ulcer bleeding (spurting/oozing/non-bleeding visible vessel: 6/4/10) received intravenous bolus of omeprazole 20 mg every 3 hours; 20 patients (3/5/12) received intravenous bolus of omeprazole 40 mg every 6 hours; and, 20 patients (5/4/11) received intravenous bolus of omeprazole 80 mg every 12 hours for 3 days. One intragastric pH meter (Gastrograph Mark III, Medical Instruments Corp. Switzerland) was used to record 24-hour intragastic pH. RESULTS: The intragastric pH in the patients receiving omeprazole 20 mg every 3 hours was 6.1, 6.0-6.2 (mean: 95% CI); in patients receiving omeprazole 40 mg every 6 hours it was 6.4, 6.2-6.5; and, in patients receiving omeprazole 80 mg every 12 hours it was 5.8, 5.7-5.9. The duration of intragastric pH > 6.0 in omeprazole 20 mg every 3 hours was 70.9%, 57.3%-84.4% (mean: 95% CI); in omeprazole 40 mg every 6 hours it was 83.1%, 73.1%-93.1%; and, in omeprazole 80 mg every 12 hours it was 66%, 51.5%-80.4%. Patients with peptic ulcers receiving omeprazole 40 mg intravenous bolus every 6 hours had the highest intragastric pH as compared with the other 2 groups (p < 0.0001). There were no significant differences concerning rebleeding rates, volume of blood transfusion, hospital stay, numbers of operation and mortality among the 3 groups. CONCLUSIONS: After initial hemostasis had been obtained, patients with peptic ulcer bleeding receiving 40 mg intravenous bolus every 6 hours had the highest intragastric pH. However, they had similar outcomes with the other 2 groups.

Adult↗

PubMedDate not supplied

The experience of endoscopic tissue glue injection in the treatment of hepatic sarcoidosis related gastric variceal bleeding: report of a case.

A case of hepatic sarcoidosis complicated with portal hypertension and gastric variceal bleeding is described. A 53 year-old male suffered from persistent fever and massive hematemesis. Acute gastric variceal bleeding was diagnosed. Endoscopic tissue glue injection stopped this acute episode and ablated the varices after another two sessions of endoscopic tissue glue injection treatment. Subsequent administration of corticosteroids improved the symptoms and liver function. This was probably the first case of hepatic sarcoidosis associated with gastric variceal bleeding which was successfully treated by endoscopic tissue glue injection to be reported.

Acute Disease↗

PubMedDate not supplied

The efficacy of the third pump inhibitor--pantoprazole--in the short-term treatment of Chinese patients with duodenal ulcer.

BACKGROUND/AIMS: To study the efficacy and tolerability of pantoprazole 40 mg once daily before breakfast compared with ranitidine 300 mg once daily at bedtime in Chinese patients with duodenal ulcer, and to evaluate the relationship between Helicobacter pylori (H. pylori) clearance and ulcer healing rate. METHODOLOGY: A total of 160 patients (80 in each group) with endoscopically diagnosed, active duodenal ulcers were studied in this randomized double-blind trial. Endoscopy was performed after 2 weeks of treatment. If unhealed, then the patients were re-endoscoped after an additional 2 weeks of similar treatment. RESULTS: The healing rates after 2 and 4 weeks were 61.3% and 97.3%, respectively in the pantoprazole group, and 50.7% and 76.9% in the ranitidine group. The difference between the two groups was significant at 4 weeks (p < 0.01, per protocol analysis). The rate of pain free ulcer was higher in the pantoprazole group than in the ranitidine group at 2 weeks (84.2% vs. 59.6%, p < 0.01). Higher clearance of H. pylori was also observed in the pantoprazole group compared with the ranitidine group at 4 weeks (20% vs. 0%, p = 0.05). The healing rate tended to be higher in patients who were H. pylori-cleared at 2 weeks (p = 0.07) in the pantoprazole group. Both medications were well tolerated without any serious adverse effects. CONCLUSIONS: Pantoprazole 40 mg daily is superior to ranitidine 300 mg daily in the short-term treatment of acute duodenal ulcer in Chinese patients, in terms of ulcer healing and pain relief, and appears to be well-tolerated.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMedDate not supplied

Preserved esophagogastric manometric motility in patients after distal gastrectomy.

BACKGROUND/AIMS: A prospective study resolved whether commonly employed distal gastrectomies could influence the esophagogastric manometric measurements and the role of vasoactive intestinal polypeptide in mediating motility after surgery. METHODOLOGY: Studied groups consisted of 20 patients following radical subtotal gastrectomy for gastric cancer, 20 patients after subtotal gastrectomy for duodenal ulcer and 20 controls. Fasting blood was obtained to measure serum vasoactive intestinal polypeptide levels. A pneumohydraulic infusion system measured esophagogastric motility parameters. RESULTS: Measured lower esophageal sphincter pressures in subjects of gastric cancer surgery, duodenal ulcer surgery and controls were 15.3 +/- 4.7, 13.1 +/- 5.3 and 12.6 +/- 5.0 mmHg, respectively (NS), while the sphincter lengths were 3.15 +/- 0.81, 3.22 +/- 0.79 and 2.86 +/- 0.85 cm, respectively (NS). In addition, other parameters including lower esophageal body remained unchanged. The serum vasoactive intestinal polypeptide levels of three groups were 24.1 +/- 10.8, 22.5 +/- 9.5 and 21.3 +/- 7.8 pg/ml, respectively (NS). CONCLUSIONS: Neither gastric cancer nor duodenal ulcer in distal stomach removal can alter the lower esophageal body and LES manometric motilities. Unchanged serum VIP levels after gastric surgery are likely one of the mechanisms preserving esophagogastric integrity.

Aged↗

PubMedDate not supplied

Abdominal aortic aneurysm compression is probably responsible for the recurrent episodes of acute pancreatitis: case report.

An aged male with a known history of abdominal aortic aneurysm suffered from epigastralgia, vomiting and cold sweating for one day. According to the physical examination, serum amylase level and computed tomographic examination, acute pancreatitis was diagnosed. Surgical intervention for the abdominal aortic aneurysm was not performed because of his age, and finally this patient died after three recurrent episodes. Acute pancreatitis co-existing with an intact abdominal aortic aneurysm has never been reported before. The possible pathogenesis of this recurrent acute pancreatitis was discussed.

Acute Disease↗

PubMedDate not supplied

What is the essential role in the normalized rat intestinal transit? Calcium or calcitonin.

BACKGROUND/AIMS: Both calcium and calcitonin have been involved in mediating gastrointestinal motility. Using a thyroidectomized rat model the present study tried to determine which one of them was essential for normal small intestinal transit. METHODOLOGY: Adult Sprague-Dawley male rats simultaneously received thyroidectomy or a sham operation plus a laparotomy for duodenal tubing. After two-week housing, a small intestinal transit study was conducted via geometric center computation of radioactivities of the intestinal segments counted from intraduodenal feeding of radiochromium. Before feeding, these rats were i.p. injected with saline or human calcitonin in the doses of 0.1, 1 and 10 microM/kg, respectively. Another group of Tx rats received i.v. infusion of saline or CaCl2 for 30 min before motility study. RESULTS: Thyroidectomization effectively delayed transit compared to the sham-operated controls (3.59 +/- 0.15 vs. 2.98 +/- 0.32, P < 0.05). High doses of calcitonin treatment in thyroidectomized rats further inhibited transit (P < 0.01), whereas calcitonin did not restore the suppressed calcium level. Delayed transit in thyroidectomized rats was restored after calcium infusion (2.95 +/- 0.22 vs. 3.78 +/- 0.42, P < 0.05) while their hypocalcemia was already corrected. CONCLUSIONS: Thyroidectomization disturbs small intestinal transit, while peripheral calcitonin replacement further inhibits transit. Since calcium replacement enables to restore small intestinal transit, it is apparent that calcium rather than calcitonin is essential for normal small intestinal transit.

Animals↗

PubMedDate not supplied

Long-term outcome of kidney transplantation in patients with hepatitis C virus infection.

BACKGROUND/AIMS: The impact of HCV (hepatitis C virus) infection on the long-term outcome of kidney transplant patients is controversial. METHODOLOGY: Eighty-four renal allograft recipients who were seronegative for hepatitis B surface antigen and had been screened for antibody to hepatitis C virus (anti-HCV) were included. The outcome and survival were compared between anti-HCV-positive (n = 30, group 1) and anti-HCV-negative (n = 54, group 2) kidney transplant patients. Group 1 patients were further compared to 52 anti-HCV-positive end-stage renal disease patients (group 3) who were on chronic dialysis. RESULTS: Group 1 patients had a higher prevalence of chronic hepatitis than group 2 and group 3 patients did (67% vs. 2% and 31%). Liver-related complications and deaths between group 1 and group 2, and group 1 and group 3 patients were not significantly different. The comparisons of the long-term survival between these groups showed no significant differences, despite group 3 patients had a higher overall mortality rate. Cox regression analysis confirmed that age more than 45 years was the only independent factor that affected survival in anti-HCV-positive end-stage renal disease patients with or without kidney transplantation. CONCLUSIONS: HCV infection is not a contraindication to kidney transplantation. For anti-HCV-positive end stage renal disease patients, survival is better in younger patients, and is not influenced by kidney transplantation or continuing dialysis.

Adolescent↗

PubMedDate not supplied

Duodenal lesions following severe acute pancreatitis: review of 10 years' clinical experience.

BACKGROUND/AIMS: Acute pancreatitis may result in many local and contiguous organ complications; though the pancreas is in close proximity to the duodenum anatomically, acute pancreatitis causing duodenal lesions is rarely encountered. Our aim is to retrospectively evaluate the clinical features of the duodenal lesions in patients with severe acute pancreatitis. METHODOLOGY: During the past 10 years, 1,637 consecutive patients with acute pancreatitis were admitted to Taipei Veterans General Hospital. Total parenteral nutrition was employed in 251 patients with acute pancreatitis, defined as 'severe acute pancreatitis'. They had all received computed tomography during the hospitalization period, and the computed tomography reports were reviewed to find patients with duodenal involvement induced from pancreatitis. We defined those patients having duodenal wall thickening, extrinsic compression of the duodenum, or other obstructive lesions seen on the computed tomography scan as evident duodenal lesion or duodenal involvement. RESULTS: Nine cases of evident duodenal lesions following severe acute pancreatitis have been documented over a 10-year period in 1 teaching medical center. The lesions were found by image study or during operation. The most frequently involved site was the second portion of the duodenum. Clinically, 1 unique case developed severe duodenal obstruction requiring surgical correction, and 7 cases recovered after supportive therapy. Of the 9, only 1 case died of multiple organ failure. CONCLUSIONS: In contrast to the colonic lesions caused by acute pancreatitis with a high morbidity and mortality, total parenteral nutrition yields a good prognosis in patients with evident duodenal lesions following severe acute pancreatitis.

Adult↗

PubMedDate not supplied

A 3-day anti-Helicobacter pylori therapy is a good alternative for bleeding peptic ulcer patients with Helicobacter pylori infection.

BACKGROUND/AIMS: One-week triple therapy has been recommended as a standard regimen for eradicating Helicobacter pylori infection. The emergence of antibiotic-resistant strains, adverse drug effects, poor compliance and high cost of therapy add problems to the management of these patients. In this study, we assessed whether a 3-day triple therapy could be effective in eradicating Helicobacter pylori infection in bleeding peptic ulcer patients. METHODOLOGY: Peptic ulcer patients with Helicobacter pylori infection were enrolled in this study. Patients enrolled at the outpatient department (group A) received a 7-day oral regimen: bismuth subcitrate colloid 300 mg + amoxicillin 500 mg + metronidazole 250 mg four times per day. Patients who were admitted to the wards due to peptic ulcer bleeding (group B) received a 3-day regimen including omeprazole 40 mg intravenously every 6 hours, amoxicillin 500 mg + metronidazole 250 mg orally four times daily after hemostasis had been achieved. Patients of both groups received omeprazole 20 mg once per day or cimetidine 400 mg twice daily per os for at least-one month after anti-Helicobacter pylori therapy. We followed every patient endoscopically two months after anti-Helicobacter pylori therapy. RESULTS: From June 1997 to April 1999, a total of 57 patients (30 in group A and 27 in group B) with gastric or duodenal ulcer and Helicobacter pylori infection completed anti-Helicobacter pylori therapy. Two months after anti-Helicobacter pylori therapy, peptic ulcer was found to be healed with a scar in 26 (86.7%) of group A and 23 (85.2%) of group B (P > 0.1). The eradication rates of Helicobacter pylori in the two groups were not significantly different in an intention-to-treat analysis [group A: 78.8% (26/33), 95% CI: 64.9-92.7%; group B: 80% (24/30), 95% CI: 65.7-94.3%, P > 0.1] and in a per protocol analysis [group A: 86.7% (26/30), 95% CI: 74.5-98.9%, group B: 88.9% (24/27), 95% CI: 77.1-100.7%, P > 0.1]. Fewer side effects occurred in group B (3/30) than those in group A (7/33) (P > 0.1). CONCLUSIONS: In patients with peptic ulcer bleeding a 3-day anti-Helicobacter pylori therapy is a good alternative for eradicating Helicobacter pylori infection.

Adult↗

PubMedDate not supplied

Is submucosal epinephrine injection necessary before polypectomy? A prospective, comparative study.

BACKGROUND/AIMS: Polyps of the gastrointestinal tract are usually removed due to their link to bleeding, obstruction and malignancy. However, complications may occur following polypectomy. The aim of this study was to assess whether submucosal epinephrine injection before polypectomy could reduce the incidence of bleeding and perforation. METHODOLOGY: Between June 1997 and November 1999, patients with sessile polyps of the gastrointestinal tract found in our endoscopic unit were randomized to receive submucosal epinephrine injection (epinephrine group) or no injection (control group) before polypectomy. In the epinephrine group, epinephrine (1:10,000) was injected surrounding the stalk of the polyp until the mucosa was blanched and bulged. The patients were observed for complications in the following month. RESULTS: A total of 120 patients with 151 sessile polyps were enrolled in this study. In the epinephrine group, 75 polyps (n = 68) were randomized to receive epinephrine injection before polypectomy. In the control group, 76 polyps (n = 61) underwent polypectomy without epinephrine injection. In both groups, there was no significant difference in clinical features including the sizes of the polyps and their stalks, the location of polyps and the pathological diagnosis. There were a total of nine episodes of post-polypectomy hemorrhage, two in the epinephrine group and seven in the control group (2/75 vs. 7/76) (P = 0.07). One case in the epinephrine group experienced delayed bleeding (4 days later). Immediate hemorrhage occurred less in the epinephrine group than that in the control group (1/75 vs. 7/76, P = 0.03). There was one case of perforation in each group. CONCLUSIONS: Epinephrine injection prior to polypectomy is effective in preventing immediate bleeding.

Adult↗

PubMedDate not supplied

Alteration of distal esophageal motor functions on different body positions.

BACKGROUND/AIMS: This study tried to resolve whether changed body position influences esophageal manometric parameters. MATERIAL AND METHODS: A pneumohydraulic infusion system was employed to measure esophageal parameters for 32 healthy volunteers. They underwent two consecutive manometries on both supine and sitting positions in a random order. These motility measurements included lower esophageal sphincter pressure, dry/wet swallow induced contractile amplitude and interval of distal esophageal body, and its peristaltic speed. RESULTS: Sitting position evoked a higher lower esophageal sphincter pressure than the supine measurement (Mean +/- SD: 14.6 +/- 4.0 mmHg vs. 11.9 +/- 4.2 mmHg, p < 0.01). At the distal esophagus, a swallow led to a stronger contractile amplitude and longer interval on supine measurement. CONCLUSIONS: Recorded peristaltic speeds in various esophageal segments resulted in a difference while this result was mainly due to the different recorded body positions (p < 0.01). Partial esophageal manometric parameters recorded on sitting position are different from the supine measurement. Hence altered body position may modulate some distal esophageal motor functions.

Adult↗

PubMedDate not supplied

The incidentally found leiomyoma that was in a resected stomach and its follow-up.

BACKGROUND/AIMS: A prospective study measured the occurrence of leiomyoma in patients receiving various gastric surgeries and the probable characteristics of patients presenting an incidental leiomyoma. METHODOLOGY: Twenty-eight (3.5%) patients with gastric leiomyoma were encountered among 796 resected stomach specimens within the past two years. Of these patients, 11 exhibiting a submucosal tumor were preoperatively diagnosed with endoscopy, whereas 17 showing leiomyoma were incidentally found during a thorough survey of the resected stomach specimens. Their demographic characteristics were compared. RESULTS: Occurrence of incidental leiomyoma tended to be more common in patients with gastric cancer than in other lesions (3.2% vs 0.9%, p = 0.0513). Comparing the characteristics of patients showing incidental leiomyoma and pre-operatively diagnosed submucosal tumor, their differences in age, gender, tumor location or number were not significant. However, the former usually exhibited tiny lesions without an overlying necrotic ulcer. Recent endoscopic follow-up did not find any evidence of recurrence. CONCLUSIONS: Incidental leiomyoma is not rare in resected specimens. Most lesions are tiny without overlying ulcer and gross recurrence looks impossible. Pre-operative diagnosis of this lesion remains difficult since a warning sign of leiomyoma never exists.

Aged↗