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Biomedical subjects

F Y Lin

Publications and source records attributed to F Y Lin.

At least 109 records · Page 6Linked to original sources
PubMed1991

Surgical treatment of thoracoabdominal aortic aneurysm with graft inclusion technique.

Two male patients with huge thoracoabdominal aortic aneurysms were treated surgically at the National Taiwan University Hospital (NTUH) during the last 6 years. Case 1 was 70 years old with a case of malignant lymphoma. A huge thoracoabdominal aortic aneurysm was found which ruptured suddenly during the course of chemotherapy for malignant lymphoma. An emergency operation was performed because the patient suffered from profound shock. Case 2 was 34 years old and was referred to our hospital with a huge pulsating mass over his abdomen and progressive dysphagia. Both had atherosclerosis, thought to be the underlying etiology. The surgical technique we employed was the graft inclusion technique with major branch vessel reattachment to the side holes of the graft. Postoperative surgical results were excellent. Neither spinal cord complications nor visceral organ failure was found in either case. Case 1 unfortunately died 3 months after surgery because of advanced lymphoma with many organs being involved and upper GI bleeding. Case 2 is doing well and being followed up at our OPD at present.

Adult↗
PubMed1990

Reappraisals of atrioventricular node reentrant tachycardia: lessons learned from surgical treatment.

The exact site of reentrant circuit involved in the atrioventricular node reentrant tachycardia was questioned. Seven patients (6 females and 1 male), aged 21 to 64 years (mean = 40 +/- 17 years), with refractory nodal reentry, underwent surgical treatment. The associated cardiac diseases included rheumatic valvar disease in two and an atrial septal defect. Electrophysiologic studies before surgery showed dual nodal pathways in 4 patients. Right atrial endocardial mapping was performed and the earliest retrograde atrial activation during tachycardia was mapped to the apex of the triangle of Koch in 6 patients and near the orifice of coronary sinus in one. Perinodal dissection was performed according to the location of earliest retrograde atrial activity. Care was taken to preserve as much of the atrioventricular node and its arterial supply as was possible. Immediately after surgery, conduction in an antegrade direction recovered and the tachycardia could no longer be reproduced. There was no surgical mortality or morbidity. At 10 to 26 months of follow-up, all patients remain free of tachycardia without antiarrhythmic drugs. Four patients underwent repeated electrophysiologic studies at 2 weeks to 6 months after surgery. Dual nodal pathways were no longer demonstrated. It is concluded that the perinodal atrial tissue plays a part in the atrioventricular nodal reentry, and that surgical dissection is a simple and effective treatment for patients with refractory atrioventricular node reentrant tachycardia.

Adult↗
PubMed1990

A rural outbreak of Legionnaires' disease linked to visiting a retail store.

Between May 7 and June 7, 1986, 27 residents of a rural county in Maryland developed legionellosis, and two died. Legionella pneumophila serogroup 1 was cultured from the sputum of two patients and identified in lung tissue of a third patient by direct fluorescent antibody staining. An additional 11 patients had four-fold rises in antibody titer to L. pneumophila, and 13 had single titers greater than or equal to 1:256. To determine risk factors for disease, we performed a case-control study. Twelve of 16 case-patients reported visiting store A in the two weeks before onset of illness compared with four of 28 control-patients. A serologic survey of employees showed that employees of store A were 3.63 times more likely than control employees to have titers of antibody to L. pneumophila greater than or equal to 1:256 (95% confidence intervals 0.8, 16.7). Cultures of soil specimens, samples of water from the hot water system of store A and from stagnant ponds near store A collected five weeks after the end of the outbreak were negative for Legionella species. Store A was adjacent to a site of excavation and construction during May 1986, when the community was experiencing an extended drought. This investigation suggests that exposure to excavation and construction activity may be a risk factor for legionellosis.

Adult↗
PubMed1990

The use of TDMAC-heparin-impregnated shunt for managing aneurysm of the descending thoracic aorta.

From April 1981 to December 1988, a total of 23 patients were operated upon for the repair of an aneurysm of the descending thoracic aorta with a tridodecylmethylammonium chloride (TDMAC)-heparin-impregnated shunt. There were 20 men and 3 women. The ages ranged from 29 to 72 years with a mean of 52.3 years. The major pathological change of the aortic wall was medial cystic necrosis in 19 patients and atherosclerosis in 4. Among them, only 6 patients underwent elective surgery, while 17 patients underwent emergency operations with the surgical indication being shock in 4, oliguria in 3, persistence of chest pain in 2, massive hemoptysis in 1, rapid size progression of the aneurysm in 3, and impending rupture of the aneurysm in 4. During surgery, the aortic cross-clamping time ranged from 40 to 76 minutes with a mean of 54 minutes. Hospital death was limited to 2 patients with a mortality rate of 8.7%. Postoperative complications were noted in 5 patients, cerebrovascular accidents in 4 and transient paraparesis in 1. However, the clinical conditions recovered before those patients were discharged. The follow-up period ranged from 4 to 84 months with a mean of 32.3 months. Except for 1 patient who died of anaphylactic shock due to drug allergy, the other 20 survivors had an apparent improvement of their clinical status and life quality.

Adult↗
PubMed1990

The value of body surface potential maps in assessment of experimental myocardial infarction.

Body surface potential maps (BSPMs) and the pathology of 32 dogs with coronary artery ligations were analyzed to research the application of BSPMs to acute myocardial infarction (AMI). The group consisted of 18 dogs with left anterior descending coronary artery (LAD) ligations, 8 with right coronary artery (RCA) ligations and 6 with left circumflex coronary artery (LCX) ligations. The abnormal distribution of negative potential and minimal potential were observed in all of the dogs. In dogs with RCA ligations, the abnormal negative potential displayed on the right-superior, right-inferior or right portion of the anterior thorax. In those with LAD ligations, the abnormal potential appeared on the left-superior, left-inferior, middle-superior or middle portion of the anterior thorax. In those with LCX ligations, the abnormal potential showed on the left-superior or left-middle portion of the thorax. A good correlation was observed between the area of myocardial lesion and the extent of abnormal negative potential distribution (r = 0.82, p less than 0.001). A close correlation was also found between the area of myocardial lesion and the duration of abnormal negative potential (r = 0.61, p less than 0.05). This study suggests that BSPMs are useful in the assessment of AMI in terms of diagnosis, location and extent of myocardial infarct.

Animals↗
PubMed1990

Emergency surgery of patients with ruptured great vessels and profound shock.

From October 1986 to March 1989, a total of 7 patients who had preoperative profound shock underwent surgical treatment at the National Taiwan University Hospital for a ruptured aorta or vena cava. All 7 patients were men. Their age ranged from 21 to 70 years with a mean of 45 years. Emergency operations were performed due to a ruptured abdominal aortic aneurysm in 2, a ruptured dissecting thoracic aneurysm in 1, a penetrating injury which transected the intrahepatic vena cava in 2, and blunt chest injury which resulted in acute traumatic aortic transection in 2. One of these 7 patients died of acute tubular necrosis, anoxic encephalopathy and secondary sepsis, in spite of successful restoration of circulation. Two patients had postoperative complications. One had a transient paraparesis after an aortic cross-clamp, and the other had a transient impairment of the hepatic function due to the penetrating hepatic injury and the hypoxic hepatic damage. All 6 survivors were restored to an excellent state of health and had minimal post-resuscitation sequelae. We emphasize the importance of aggressive surgical treatment for those patients with the threat of impending death due to massive hemorrhage from a ruptured great vessel.

Adult↗
PubMed1990

Chronic intravascular hemolysis after valvular surgery.

The Phenomenon of intravascular hemolysis following cardiac valvular surgery was studied among 156 randomly selected patients. There were 76 men and 80 women, varying in ages between 15 and 71 years, with a mean age of 48.3 years. The time interval between the study and the operations ranged from 2 to 163 months with a mean of 41.1 months. The prosthetic valve was used in 129 patients; the xenograft tissue valve in 26 and the mechanical valve in 103. Subclinical hemolysis occurred in 68.9% of the 129 patients who had one or more prosthetic valve implants and in 14.8% of the 27 patients who underwent plastic repair of the mitral valve. Compared among the groups with different valve prosthesis, hemolysis could be detected in 81.6% of the patients with a mechanical prosthetic valve and in 23.1% of those with a bioprosthetic tissue valve (p less than 0.05). Twelve patients who had a valve prosthesis were documented to have symptomatic gallstones with an incidence of 9.3%. Among them, only 2 patients had biliary colic and required cholecystectomy to relieve the associated symptom. Anemia, secondary to the hemolysis, occurred in 3.8% of those with a xenograft tissue valve and 8.8% of those with a mechanical valve (p less than 0.05). None of them needed a blood transfusion. None had related renal impairment. In conclusion, the mechanical valve prosthesis has a higher incidence of hemolysis than the xenograft valve. Though the mechanical valve prosthesis has its own merits, the xenograft tissue prosthesis is superior in this respect.

Adolescent↗
PubMed1990

[Cavernous hemangioma of the heart: report of a case].

Cavernous hemangioma of the heart is a very rare disease. A 57-year-old male patient was admitted due to frequent onset of dull chest pain, which had been occurring for about 1 year. The pain was not related to exercise and was not relieved with nitroglycerin. On echocardiographic examination, a tumor was shown in the outflow tract of the right ventricle and was confirmed with computer tomography. He underwent open heart surgery for resection of the tumor. After a median sternotomy and opening of the pericardial cavity, a reddish-brown-colored tumor, 3 cm in diameter, was found protruding from the epicardial layer of the right ventricular outflow tract. The tumor involved all layers of the ventricle and could be resected only with the help of the cardiopulmonary bypass technique. The defect in the right ventricle was repaired with a woven dacron patch. The patient recovered without incident after the operation, and experienced no chest pain during 7 months of follow-up. Histology showed it to be a cavernous hemangioma.

Heart Neoplasms↗
PubMed1990

Aortomesenteric bypass using autogenous saphenous vein graft for superior mensenteric artery aneurysm: report of a case.

We report a 62-year-old man who had symptoms of abdominal angina and was diagnosed preoperatively with a superior mesenteric artery (SMA) aneurysm. The findings of the CT scan and angiography revealed a 3 X 4 cm saccular aneurysm at the proximal site of the SMA. During abdominal exploration, a weak pulsation of the SMA branches distal to the aneurysm was felt. The aneurysmal cavity was full of old thrombi. Brisk retrograde bleeding from the orifices of the connecting collaterals was seen after removal of the thrombi. Our operative procedures included endoaneurysmorrhaphy, proximal ligation, and distal interruption of the aneurysm. Vascular reconstruction by an aortomesenteric bypass using a segment of autogenous saphenous vein graft was also done. After creating the vein graft bypass, the weak pulsation of the distal SMA branches became normalized. The patient enjoyed an uneventful postoperative course and did not complain of abdominal pain on clinical follow up. Four months later, he received an evaluation including angiography and CT scan, which confirmed that the vein graft was patent and without deformity.

Aneurysm↗
PubMed1989

Automaticity of the SN and A-V junctional tissue before and after chemical denervation in the dog.

Automaticity of SN and A-V junctional tissue was studied in 40 dogs in which a stable junctional rhythm was obtained following thermal ablation of the SN and sulcus terminalis. Atrial overdrive pacing studies were performed both before and after chemical denervation of the heart. Control sinus cycle and junctional CL were 438 +/- 13 ms and 751 +/- 23 ms, respectively. Chemical denervation resulted in significant prolongation of both junctional CL and maximal corrected junctional recovery time; junctional rate was down to 46 percent of the sinus rate observed before suppression of SN activity. Neither sinus CL nor maximal corrected SN recovery time changed significantly after administration of drugs. The basal autonomic nervous system has a relatively greater influence on the junctional pacemaker than on the normal SN in the dog and, when SN was suppressed, chemical denervation prolonged the junctional CL by 23 percent and junctional recovery time by 63 percent.

Animals↗
PubMed1989

Adverse events following DTP immunization in Maryland, 1987.

Between January 1, 1987 and December 31, 1987, a total of 184 adverse events were reported to have occurred within 28 days following diphtheria, tetanus, pertussis (DTP) immunization in Maryland. More than half the reports (54 percent) were of serious or major vaccine reactions. Screaming episodes were the most frequently reported serious reaction, having occurred in 64 (35 percent) of the reports.

Child↗
PubMed1989

Mitral valve reconstruction with Carpentier ring for mitral regurgitation: experience with Chinese patients.

Between December 1985 and June 1987, 38 consecutive patients with mitral regurgitation underwent mitral valve reconstruction (MVP) with Carpentier rings. There were 16 men and 22 women, ranging in age from 16 to 63 years (mean 36.4 +/- 14.4). The underlying causes were rheumatic heart disease (55%), degenerative valvular disease (42%), and congenital heart disease (3%). Thirty patients were categorized in the New York Heart Association's functional classification III or IV preoperatively. The concomitant procedures included aortic valve replacement (AVR) in 6 patients, tricuspid valve repair (TVP) in 9, and closure of atrial septal defect in one. Hospital death happened to one patient (3%). All but one patient were followed up at 31 months postoperatively (rate 98.6%). There was one late death due to myocardial failure not related to the valves. The actuarial survival rate at 31 months was 96.8%. The thromboembolic rate was 1.44% per patient-year. No reoperation or endocarditis was encountered. All 36 survivors were in functional classes I and II. Twenty-one patients underwent Doppler echocardiography 3 to 12 months after surgery and 17 (81%) showed no or mild mitral regurgitation and 4 (19%) had moderate regurgitation. We conclude that MVP with Carpentier rings is a satisfactory method with low mortality and complication rates in Chinese patients.

Adolescent↗
PubMed1989

Time course of the ventricular arrhythmias following coronary reperfusion in dogs.

The time course of ventricular arrhythmia following reperfusion was investigated in 12 dogs undergoing a 2-hour coronary artery occlusion followed by reperfusion. At days 1, 3 and 7 following coronary reperfusion, the cardiac rhythm was monitored with a 24-hour Holter electrocardiographic recorder. Six dogs with sham operations were also studied with Holter monitoring at the same time periods as a control group. This showed that, following coronary reperfusion, all 12 dogs (group A) developed frequent premature ventricular complexes (PVCs) at day 1, with a total count (beats per hour, bph) of 1,806 +/- 390 (mean +/- SD). The PVC count decreased to 298 +/- 96 at day 3 (p less than 0.001) and 0.4 +/- 0.1 at day 7 (p less than 0.001). The incidence of spontaneous sustained ventricular tachycardia (VT) at day 1 was 100%; 1 of them deteriorated to ventricular fibrillation (VF). At day 3, 9 of the remaining 11 dogs (82%) had recurrent VTs (p greater than 0.05 vs day 1) which were of shorter duration and a slower rate. One of the 11 dogs died at day 5 and the remaining 10 dogs survived to day 7, with all the VTs subsiding (p less than 0.001 vs day 1 or 3). In the control group, only isolated PVCs were observed at day 1 (7 +/- 3 bph, p less than 0.001 vs group A) and no spontaneous VT or VF was noted. We conclude that spontaneous ventricular arrhythmias were observed in all dogs with coronary reperfusion following a 2-hour coronary artery occlusion and the arrhythmias could subside in 1 week of those survived. Only rarely did VT deteriorate to VF.

Animals↗
PubMed1988

Investigation of an outbreak of Salmonella enteritidis gastroenteritis associated with consumption of eggs in a restaurant chain in Maryland.

Salmonella enteritidis ser. enteritidis was isolated from patrons and employees of three restaurants in a restaurant chain in Maryland during August and September 1985. Isolates from all three restaurants had identical plasmid profiles; this profile was present in 13 of 40 randomly selected S. enteritidis isolates received by the Maryland state health department laboratory during a comparable time period. The outbreak in one restaurant resulted in at least 71 illnesses, with 17 persons known to have been hospitalized. Scrambled eggs served on a "breakfast bar" were implicated as the vehicle of transmission in this restaurant, with eggs a possible vehicle in another of the three restaurants. The data point out the risks associated with improper handling of eggs in food service establishments, provide further evidence for the observed association between S. enteritidis and eggs in the northeastern United States, and demonstrate the utility of plasmid analysis in investigation of outbreaks involving common Salmonella serotypes.

Adolescent↗
PubMed1988

Restaurant-associated outbreak of typhoid fever in Maryland: identification of carrier facilitated by measurement of serum Vi antibodies.

Ten cases of typhoid fever occurred between 24 August and 1 September 1986 in the vicinity of Silver Spring, Md. Shrimp salad served in a fast-food restaurant was implicated as the source of infection. Stool cultures were obtained from 104 employees, and serum Vi antibodies were assayed in 97 of the employees. Salmonella typhi was isolated from stool cultures of an 18-year-old asymptomatic female employee, who was a food handler. A high level of Vi antibodies (79.0 micrograms/ml), measured by radioimmunoassay, was found in her serum. She had emigrated from an endemic area at the age of 14 years and had visited that endemic area 2 years previously. The causal relation between the carrier and the 10 cases of typhoid fever was confirmed by a common bacteriophage type, denoted "degraded Vi resembling O," in the S. typhi isolates. This phage type is rare in the western hemisphere but common in the endemic area from which the carrier had emigrated. The high level of Vi antibody in the asymptomatic carrier, in contrast to the lower levels in the convalescent- and postimmunization-phase sera, facilitated the identification of the source infection in this outbreak. This radioimmunoassay offers a rapid and standardized method for identifying carriers of S. typhi.

Adult↗