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Biomedical subjects

H H Hu

Publications and source records attributed to H H Hu.

36 records · Page 2Linked to original sources
PubMed1994

Frequency and characteristics of early seizures in Chinese acute stroke.

We retrospectively studied 1200 hospitalized acute strokes of all etiologies between July 1990 and August 1992. Ninety-six % of all strokes underwent computed tomography of the head. Fifty-eight percent of the 1200 strokes were brain infarction, 32% brain hemorrhage, 6% subarachnoid hemorrhage and 4% were other stroke subtypes. Thirty (2.5%) of all strokes suffered from early seizures. The incidences of early seizures were 2.8% in brain hemorrhage, 2.3% in brain infarction, 2.7% in subarachnoid hemorrhage and 2% in other stroke subtypes. Early seizures were documented in 6% of the patients with carotid territory cortical infarctions and 12% of the patients with lobar hemorrhage, whereas only 0.6% of the patients without carotid territory cortical infarctions and 0.6% of the patients without lobar hemorrhage were affected. Sixty-six percent of 30 early seizures were partial seizures, 24% generalized and status epilepticus were seen only in 10%. In conclusion, we found the early seizure incidence was 2.5% in Chinese patients hospitalized with acute strokes. There was no correlation between seizure occurrence and stroke subtypes. Early seizure developed significantly higher in acute stroke patients with lesions of the cortex than those patients without cortical involvement. The partial seizures were the most frequent type occurring in 66% of all acute stroke patients with early seizures.

Acute Disease↗
PubMed1994

Further analysis of a pilot study for planning an extensive clinical trial in traditional medicine--with an example of acupuncture treatment for stroke.

Statistical methods for evaluating the effects of treatments and prognostic factors in clinical trials are discussed. Exploratory data analysis, nonparametric methods, regression modeling, and regression diagnostics of influential cases are applied to the analysis of a pilot 'randomized' controlled trial on the treatment of acute stroke with acupuncture. The utility of this analysis for modifying patient eligibility criteria, determining required sample size and utilizing stratified randomization in a future extensive stroke trial is discussed.

Acupuncture Therapy↗
PubMed1994

Stroke associated with methamphetamine inhalation.

Seven patients (all men, mean age 32 years, range 17-47) with stroke following methamphetamine inhalation were collected during the last 2 years. Like oral or intravenous abusers, our patients had more hemorrhagic (n = 5) than ischemic strokes (n = 2). Cases of intracerebral hemorrhage (ICH) were lobar (n = 3), caudate (n = 1) or putaminal (n = 1), whereas the infarctions were both in the middle cerebral artery region. Each stroke event occurred within 3 days after drug use. Three patients had hypertension on admission. Though young in age, most patients had multiple stroke risk factors. In 3 patients with ICH, we also found small, low attenuated lesions on the brain computed tomography, however, without clinical correlations. Except for arteriovenous malformation in 1 patient, all angiograms failed to show vasculopathy or vasospasm. Contrary to what one might surmise from previously published reports, methamphetamine inhalation is at least as likely to produce ICH as it is to produce brain infarction.

Administration, Inhalation↗
PubMed1994

[Ischemic stroke in Taiwan].

An extensive survey of stroke in Taiwan was carried out by members of the Neurological Society, R.O.C. (Taiwan). Of a total 7,355 acute stroke patients who were admitted to 26 teaching hospitals in Taiwan (January 1 through December 31, 1985), there were 3,949 (53.7%) patients of cerebral infarction (CI). There was little seasonal variation in CI occurrence. In 90.5% of CI patients, the age of onset was above 50 years. The male to female ratio was 1.51:1. Hypertension was noted in 2,648 patients (67.1%), diabetes in 1,030 (22.9%), and heart disease in 953 (17.4%). A previous history of one or more strokes was obtained in 24.6% of the CI patients, and transient ischemic attacks (TIAs) in 6.4%. The stroke onset during the ordinary activities was noted in 41.1% of the CI patients, during sleep in 12.8% and at rest in 9.9%. CI occurred most frequently in the morning hours (24.0%). The majority of patients (85.9%) underwent computed tomography which provided valuable information in making distinction between cerebral infarction and cerebral hemorrhage. Angiography was performed in 3.3% of the patients for visualizing the stenosis and/or occlusion of the intracranial and the extracranial vessels. The mortality rate for CI was 8.4%, and 49.4% of fatal cases died within the first week after onset. At the time of discharge, the stroke survivors were rated "recovered" in 10.8% of CI patients, "minimally disabled" in 26.3%, "moderately disabled" in 38.0% and "severely disabled" in 16.9%.

Cerebral Infarction↗
PubMed1993

A randomized controlled trial on the treatment for acute partial ischemic stroke with acupuncture.

The effectiveness of acupuncture in acute stroke remains largely untested and unproved. A randomized, controlled trial was carried out to study the feasibility of acupuncture in combination with conventional supportive treatment for acute stroke patients. A total of 30 patients, aged 46-74, with the onset of symptoms within 36 h were enrolled into the study after appropriate screening. All patients gave informed consent. Basing on the same supportive treatment, patients were randomly assigned to a treatment with or without acupuncture. The procedure and acupoint selection were discussed and decided through several meetings of a group of senior acupuncture doctors in Taiwan. Acupuncture was applied 3 times/week for 4 weeks. During the study period, there were no problems in conducting this trial in terms of patient availability and acceptance, and physician cooperation. A significantly better neurologic outcome was observed in the acupuncture group on day 28 and day 90. The improvement in neurologic status was greatest in patients with a poor neurologic score at baseline. There were no important side effects except for one episode of dizziness related to acupuncture treatment. The data and results of this study will be used as a guideline for planning a full-scale clinical trial, e.g. sample size calculation, method of randomization with stratification of prognostic factors, choosing acupuncture points and technique of acupuncture.

Acupuncture Points↗
PubMed1993

Color Doppler imaging of orbital arteries for detection of carotid occlusive disease.

BACKGROUND AND PURPOSE: Distal to a hemodynamically significant stenosis, the Doppler effect becomes dampened. Thus, measuring the flow profile in the ophthalmic artery and the central retinal artery with color Doppler imaging may provide hemodynamic information about the carotid circulation. METHODS: To validate the flow profile measurement with color Doppler imaging in the ophthalmic and central retinal arteries and to determine the sensitivity and specificity of this examination in the detection of hemodynamically significant carotid stenosis, we compared color Doppler imaging examinations with ocular pneumoplethysmography and ophthalmodynamometry examinations in 66 patients with atherothrombotic ischemic cerebrovascular disease. The degree of carotid stenosis in these patients was determined by a duplex scan with color Doppler imaging, and 57 patients underwent angiography to verify the stenosis. RESULTS: The flow velocities (systolic peak velocity and end-diastolic velocity) and pulsatility indices (A/B ratio and resistance index) in the ophthalmic and central retinal arteries decreased as the degree of carotid stenosis increased. There is a statistically significant difference in the mean of systolic peak velocity and the mean of end-diastolic velocity of the ophthalmic and central retinal arteries among groups with various degrees of carotid stenosis (P < .02). Using the flow velocities of the ophthalmic and central retinal arteries to diagnose carotid stenosis (> or = 75% stenosis and occlusion), 8 cm/s for systolic peak velocity in the central retinal artery and 29 cm/s for systolic peak velocity plus flow direction reversal in the ophthalmic artery gave the maximum accuracy (sensitivities, 84% and 85.7% and specificities, 89.6% and 81.7%, respectively). The systolic peak velocity in the central retinal artery varied directly with the systolic pressure of the ophthalmic and central retinal arteries. CONCLUSIONS: The flow velocity and pulsatility in orbital arteries examined by color Doppler imaging provide further hemodynamic information; this test can be used to complement current sonographic examination of carotid disease.

Aged↗
PubMed1992

Incidence of stroke in Taiwan.

BACKGROUND AND PURPOSE: Few epidemiological studies concerning the incidence of stroke have been conducted in Taiwan. In an attempt to investigate this common disease, we studied the incidence of stroke in Taiwan in a prospective incidence study. METHODS: A cohort of 8,562 stroke-free people were followed up for 4 years to observe new stroke occurrence. The methods of sampling the study population have been reported elsewhere. In addition to the help of local doctors, who reported the new stroke cases, we also sent public nurses to visit the study population annually to screen the new cases of stroke. RESULTS: There were 104 (61 men and 43 women) first-ever stroke cases identified by a neurologist in a period between October 1, 1986 and December 31, 1990. The average annual incidence rate of first-ever stroke for people aged 36 years or older in this study was 330 per 100,000. Incidence rate was higher in eastern Taiwan and in rural communities. Percentages of the major types of stroke were as follows: cerebral infarction, 71%; cerebral hemorrhage, 22%; subarachnoid hemorrhage, 1%; and unclassified, 6%. The significant risk factors for stroke were hypertension and intake of food with a high sodium content. CONCLUSIONS: The age-specific incidence rates in this study are higher than those reported from the United Kingdom and the United States. The rates are close to those in a report from Japan and a report from a city in mainland China at the same latitude. Cerebral hemorrhages are more common among people in Taiwan than among Occidental people.

Adult↗
PubMed1991

Percutaneous reposition of dislodged coils in the treatment of a vertebral arteriovenous fistula--with CT follow-up.

We report a case of vertebral arteriovenous fistula in which embolization was complicated by migration of two coils and a partially inflated balloon. In order to relieve compression to the spinal cord, the displaced balloon was punctured percutaneously. For both relieving compression to the spinal cord and obliterating the residual fistula, the dislodged coils in the partially thrombosed epidural venous sinus were removed percutaneously and placed in the fistula, and more coils were implanted in the fistula percutaneously through the needle. CT follow-up half a year later showed complete resolution of compression of the spinal cord and complete recovery from myelopathy was clinically apparent.

Adult↗
PubMed1990

Secondary prevention of ischemic stroke with low dose acetylsalicylic acid.

In order to evaluate the efficacy of low dose acetylsalicylic acid (ASA) for the secondary prevention of ischemic stroke, this cooperative multicenter clinical trial was conducted on a non-blind basis. Patients having a first transient ischemic attack (TIA), reversible ischemic neurological deficit (RIND) or completed ischemic stroke were eligible for this trial. A total of 590 patients including 47 cases of TIA, 23 cases of RIND and 520 cases of completed stroke entered this study. These patients were allocated by the time of admission to one of the following 5 trial regimens: (1) vasodilators having no known inhibitory effect on platelet function (control group), (2) dipyridamole (DP) 50 mg 3 times a day (DP group), (3) ASA 300 mg once a day (ASA 300 mg group), (4) ASA 300 mg once in combination with DP 50 mg 3 times a day (ASADP group), and (5) ASA 100 mg once a day (ASA1 group). No difference in effect between the control and DP groups was observed, nor between the ASA 300 mg and ASADP groups. Therefore, we combined the control and DP groups to make a non-ASA group, and joined the ASA 300 mg and ASADP groups to make an ASA3 group. The differences in the cumulative event-free rate appeared to be significant between the non-ASA group and the ASA3 group and also between the non-ASA group and the ASA1 group. But the frequency distribution of age, territory of stroke, diabetes mellitus, cardiac disease, hematological disease and hyperuricemia were significantly different among these 3 study groups. We thus included these covariates in the Cox's proportional hazard model to control their possible confounding effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Common carotid artery dissection diagnosed by ultrasonic image: report of a case.

Carotid artery dissection is not uncommon and usually starts at the internal carotid artery. It rarely begins in the common carotid artery. It may cause symptoms of cerebral vascular insufficiency such as stroke and transient ischemic attacks. The case reported here is a 38-year-old man with an acute onset of left hemiparesis 2 hours after drinking three bottles of beer. Computed tomographic scan showed cerebral infarction in the territory of the right middle and anterior cerebral arteries. Ultrasonic imagings showed an intimal flap, starting at the bifurcation of the right common carotid artery, indicative of arterial dissection. Angiography confirmed the diagnosis and the arterial dissection appeared to extend into and terminate at the internal carotid artery.

Adult↗
PubMed1989

The serial hemostasis-related changes in patients with cerebral infarction: comparison between progressing and non-progressing stroke.

Serial determinations of beta-thromboglobulin (BTG), platelet factor 4 (PF4), fibrinopeptide A (FPA), antithrombin III (ATIII), protein C (PC), fibrin (ogen) degradation product (FDP), FDP D-dimer, activated partial thromboplastin time (APTT), prothrombin time (PT), and euglobulin lysis time (ELT) were performed in 18 patients with non-progressing stroke and 14 patients with progressing stroke in order to predict the development of progressing stroke. Increasing levels of BTG, PF4 and FDP with frequent fluctuation were noted in both kinds of stroke. Fluctuation of FPA levels was also noted but was less pronounced. PC levels were found to be slightly decreased with fluctuation but the mean was still in the lower normal limit. BTG, PF4 and PC all elevated at the time of deterioration of physical condition in patients with progressing stroke, whereas FPA had no definite change at that time. From our study, we conclude that both platelet activation and coagulation process do occur in both kinds of stroke. But the latter plays a minor role in the formation of thrombosis. The hemostasis change, especially concerning the thrombosis formation, probably plays a role in the development of progressing stroke, but we cannot predict their development even by the detections of the newly known molecular substances appearing in various steps of the hemostatic mechanism. Development of new tests for understanding the whole dynamic change of the thrombosis process is necessary for accurate prediction of the progressing stroke in the future.

Aged↗
PubMed1989

Prevalence of stroke in Taiwan.

We investigated the prevalence of stroke in Taiwan in an epidemiologic study of stroke, diabetes, and cardiovascular disease that used a two-phase survey design. The study population was drawn by cluster sampling and consisted of both urban and rural communities from four regions of Taiwan. There were 8,705 people 36 years of age or older interviewed during the period of October 1 to December 31, 1986, and 143 cases of completed stroke were later identified by a neurologist. The point prevalence rate for people aged 36 or older in our study was 1,642/100,000 population (95% confidence interval 1,389-1,942/100,000). Prevalence rates differed significantly among the four study regions and between urban and rural communities; prevalence was greater in northern Taiwan and in urban communities. Percentages of the major types of stroke in 143 stroke survivors were as follows: cerebral infarction 67.1% (96 cases), cerebral hemorrhage 14.0% (20 cases), subarachnoid hemorrhage 4.2% (six cases), and unclassified 14.7% (21 cases). Of the stroke survivors, 67.1% were independent in activities of daily living, and 75.5% were independent in ambulation. Hypertension, heart disease, diabetes mellitus, and a family history of stroke were significantly more common in stroke survivors than in strokefree individuals.

Adult↗
PubMed1988

Ocular bruits in ischemic cerebrovascular disease.

A total of 72 ocular bruits in 50 patients with symptoms of atherothrombotic ischemic cerebrovascular disease were studied with continuous-wave Doppler ultrasonography with spectrum analysis (Dopscan). Fourteen patients also had conventional angiography, and 14 had digital subtraction angiography. Ocular bruits by augmentation flow due to occlusion (seven bruits, 9.7%) or tight stenosis (17 bruits, 23.6%) of the contralateral internal carotid artery accounted for only 24 ocular bruits (33.3%). In contrast, siphon stenosis ipsilateral to the ocular bruit was a very common finding. All 14 patients studied with conventional angiography had variable degrees of siphon stenosis ipsilateral to the ocular bruits; there was one angiography failure. We conclude that siphon stenosis can cause ocular bruit alone or can act in combination with augmentation flow by contralateral carotid occlusion or tight stenosis. The difference in their relative occurrence in our patients compared with previous reports probably reflects racial differences in the distribution of stenotic or occluded lesions of the carotid artery between our patients and Caucasian patients. The ocular bruit was the only auscultatory finding in more than a quarter of our patients (14 of 50, 28%).

Aged↗
PubMed1986

Brain SPECT imaging with 99Tcm-hexamethylpropyleneamine oxime in the early detection of cerebral infarction: comparison with transmission computed tomography.

A new cerebral blood flow agent, 99Tcm-hexamethylpropyleneamine oxime (HM-PAO), was evaluated for early detection of acute cerebral infarction in conjunction with the transmission computed tomographic (CT) studies. The data from 22 cases were analysed. Results reveal that 99Tcm-HM-PAO enables the early detection of acute cerebral infarction prior to CT with rather proper depiction of the extent of physiological abnormality in the majority of patients. This promising result together with the lack of logistical problems will make 99Tcm-HM-PAO a useful and practical agent worldwide for diagnosing and managing acute cerebral infarction.

Brain↗
PubMedDate not supplied

MR perfusion studies of brain for patients with unilateral carotid stenosis or occlusion: evaluation of maps of "time to peak" and "percentage of baseline at peak".

Maps of "time to peak" (TTP) and "percentage of baseline at peak" (PBP) were compared with maps of conventional brain perfusion parameters, namely, mean transit time (MTT) and relative cerebral blood volume (rCBV). We performed MR perfusion studies in 11 patients. All of them had occlusion or high-grade stenosis of the unilateral carotid artery. Three areas of old infarct, 4 areas of new infarct, and 10 areas of brain without infarct were evaluated specifically. In all these cases, the TTP maps appeared similar to the MTT maps. They showed increases, normal values, or decreases at the same time in all areas evaluated. Most areas of abnormally decreased CBV had increased signal in PBP maps. In conclusion, the TTP map provided the same qualitative information as MTT. PBP seemed correlated inversely to CBV and was less sensitive in demonstrating abnormality.

Aged↗
PubMedDate not supplied

Trends in mortality from cerebrovascular disease in Taiwan.

The rate of decline in the age-adjusted death rate from cerebrovascular disease (CVD) in Taiwan is not as rapid as in the United States and Japan, and the trends of CVD mortalities have not decreased steadily during the period 1972-1983. A low record of hypertension regulation (5.0%-12.7%), a high proportion (47.1%) of stroke due to cerebral hemorrhage (by clinical assessment), and a high fatality rate (40.1%) for cerebral hemorrhage may account partially for the slower declining rate. A geographic difference in the downward trend of CVD death rate was observed in this period. Districts remote from the major cities have had the lowest decline in CVD death rate.

Age Factors↗