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Biomedical subjects

I N Lien

Publications and source records attributed to I N Lien.

At least 37 records · Page 2Linked to original sources

Locomotor strategies before independent walking: prospective study of 50 mentally retarded children.

To investigate the association between pre-walking locomotor strategies and psychomotor developments in children with mental retardation (MR), 50 children with non-specific MR were included in this study. There were 29 boys and 21 girls, 96% of whom had moderate to severe MR. They were followed from 4-53 months to 25-99 months of age, and their follow-up periods ranged from 10 to 48 months (mean 30 months). According to the pre-walking locomotor strategies, these children were categorized into three groups: the crawling group (n = 34) who used crawling or creeping as their main locomotion pattern before independent walking; the shuffling group (n = 9) who used shuffling prior to independent walking; and the direct-walking group (n = 7) who did not have any other locomotor strategies except rolling. In almost all motor developmental milestones, children in the direct-walking group developed earlier than those in the crawling and shuffling groups. Children in the crawling group had more advanced developments than those in the shuffling group. The difference in the mean ratio developmental quotients of the Bayley Mental Scale among the three groups was not significant. The present study showed that crawling may not be a necessary prerequisite for early ambulation or better cognitive function in MR children.

Child Development↗

Electroejaculation in spinal cord injured males.

Electroejaculation is a newly developed method to retrieve sperm in anejaculatory spinal cord injured (SCI) males. We studied 25 completely traumatic SCI males from August 1990 to May 1991. The patients' ages ranged from 18.7 to 43.3 years, and the interval since injury ranged from four months to 14.1 years. The level of injury varied from C5 to T12. Bi-directional emission was found in 12 patients, antegrade in nine, retrograde in one and failure in three. Electroejaculatory stimulation parameters were 434 +/- 54 mA for mean maximum current, 21.7 +/- 2.7 volts for mean maximum voltage and 35.9 +/- 3.1 degrees C for mean maximum probe temperature. The antegrade semen obtained showed wide variations in sperm quality and quantity between subjects. The total sperm count was 478 +/- 809 x 10(6) in the antegrade portion, and the sperm motility was below 5% in most cases. The retrograde portion was usually worse. There was no correlation between sperm quality and quantity with patient age, injury level or injury period. Bladder management had no effect on the results of electrical stimulation. Epididymitis had a negative impact on the success of retrieval. Low-level injury victims needed analgesia or anesthesia to complete the stimulation. The major side effects were minimal autonomic dysreflexia and mild rectal mucosal change. Repeated stimulation may improve sperm counts, but semen quality deteriorates if the procedure is performed once a week. As a whole, electroejaculation is a safe, effective and simple procedure to retrieve sperm in anejaculatory persons, especially SCI patients.

Adolescent↗

Estimate of motor conduction in human spinal cord: slowed conduction in spinal cord injury.

By using motor evoked potential (MEP) created by transcranial electric stimulation over the motor cortex and F-wave measurement from the peripheral nerve stimulation, it is possible to estimate the spinal cord motor conduction velocity (SCMCV) in the diseased state. Twenty-four patients with spinal cord injury (SCI) between T1 and T11 neurological levels participated in this study. MEP in leg muscle was absent in all neurologically complete paraplegics. In 16 patients with neurologically incomplete SCI, MEP was obtained in 13 patients. The SCMCV estimated from C7 to T12 spinal levels was 32.1 (SD = 9.4) m/s. This was significantly slower than 63.3 (SD = 8.6) m/s in 40 normal controls. This noninvasive, indirect method is measurable, and can provide valuable electrophysiological data in the assessment of motor function in patients with SCI.

Adult↗

Comparison of sensory nerve conduction in the palmar cutaneous branch and first digital branch of the median nerve: a new diagnostic method for carpal tunnel syndrome.

Comparison of sensory nerve conductions in palmar cutaneous branch (PCB) and digit I nerves was applied in 50 patients suspected of having carpal tunnel syndrome (CTS) and 40 healthy persons. The abnormalities were defined as the differences in latencies and sensory nerve conduction velocities (SNCVs) of more than mean plus 2.5 SD of controls. Comparing these 2 sensory nerves, statistical differences were seen in 83.7% (36 of 43 patients) of their sensory latencies and 76.7% (33 of 43 patients) of their SNCVs. This excluded 7 patients who had unobtainable sensory nerve action potentials in digit I nerves. This method may serve as an adjunctive technique in the diagnosis of CTS. Its diagnostic sensitivity was high in comparison with other testing methods.

Adult↗

Respiratory function in patients with spinal cord injuries: effects of posture.

The purpose of this study was to evaluate the respiratory function of spinal cord injuries (SCI) during different postures. Measurements were performed with a Fukuda PM 80 spirometer on 31 chronic stable SCI and 22 normal controls. Among the SCI patients, there were 12 quadriplegics and 19 paraplegics. The respiratory parameters, including forced vital capacity (FVC) and forced expiratory volume during first second (FEV1.0) were collected in each subject during supine, sitting and standing postures. The results revealed that SCI patient had impaired FVCs (p less than 0.05), the degree of impairment depending upon the level of cord injury (r = 0.81). The FEV1.0/FVC ratio of SCI was normal. For quadriplegics, the FVC during sitting and standing fell on 30 to 50% of normal values. The FVCs of paraplegics during all postures were around 80% of the predicted values. The FVC in the control group was reduced by 5 to 7% when changing postures from erect to supine. This study concludes that respiratory impairment does occur in SCI. The results obtained display a typical pattern of restrictive pulmonary impairment. The severity of the impairment is affected by the level of cord damage and is posturally dependent.

Adult↗

Spinal nerve stimulation in the diagnosis of lumbosacral radiculopathy.

Direct spinal nerve stimulation was compared with needle electromyography (EMG) in 40 patients who were suspected of having an L5 or S1 radiculopathy. For spinal nerve stimulation, we adapted a monopolar needle electrode inserted deep into the paraspinal muscle. The minimal latency, amplitude, and negative phase area of compound muscle action potential from myotomal muscles were recorded with computer assistance. Abnormality was considered to be significant when the value fell outside of 2 SD of control mean values. Among 17 patients with clinical evidence of radiculopathy, needle EMG was abnormal in 10 patients (58.8%), whereas in the nerve stimulation test the abnormalities were shown in 16 patients (94.1%); in amplitude difference and the abnormal area, differences were shown in 12 patients (70.6%). Among 23 patients with only subjective symptoms of radiculopathy, needle EMG was abnormal in nine patients (39.1%), whereas the abnormal amplitude differences were shown in 18 patients (78.3%) and 15 patients (65.2%) with abnormal area difference by spinal nerve stimulation, respectively. Direct spinal nerve stimulation is recognized as an objective and sensitive test in the diagnosis of lumbosacral radiculopathy.

Action Potentials↗

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↗

Isokinetic study of muscle strength in osteoarthritic knees of females.

The present investigation was aimed at assessing the difference in peak torque between normal and osteoarthritic (OA) knees in females. Fifty-five female osteoarthritic patients with 85 osteoarthritic knees were studied. Thirty-three normal females of similar age were also collected as a control group. The muscle torque of the knee flexor and extensor was assessed by a Cybex II dynamometer. The speed of isokinetic contraction was set at 30 RPM, 5 RPM, and 0 RPM. The muscle torque of the affected knee in patients with unilateral osteoarthritis was found to be significantly greater than that of those with bilateral osteoarthritis (p less than 0.05). The peak torque of OA patients at the faster speed (30 RPM) showed significant deterioration with age. Compared with the value for controls, the deficit of peak torque in geriatric patients was significant (p less than 0.05), especially at the faster speed (30 RPM). The decrease in extensor torque in OA knees tended to be greater than that of flexor torque, especially in patients less than 51 years of age at 5 RPM and 0 RPM. Age, duration of illness and the grading of X-ray change accounted for isokinetic torque differences in osteoarthritic knees.

Adult↗

Inhibitory effect of acetylsalicylic acid on platelet function in patients with completed stroke or reversible ischemic neurologic deficit.

The purpose of our study was to investigate the effects of different doses of acetylsalicylic acid on platelet aggregation. Among inpatients of the National Taiwan University Hospital, 236 cases of completed stroke and seven cases of reversible ischemic neurologic deficit that were diagnosed by computed tomography of the brain and that had not ingested acetylsalicylic acid or acetylsalicylic acidlike drugs for greater than 2 weeks before admission were selected for this study. Thromboxane B2 and 6-keto-PGF1 alpha were measured by radioimmunoassay, threshold concentration of adenosine diphosphate was measured by Born's method, and circulating platelet aggregates were measured by the method of Wu and Hoak. Various single doses of acetylsalicylic acid (75, 300, or 600 mg) or 300 mg acetylsalicylic acid every 6 hours for four doses or one dose of 300 mg acetylsalicylic acid with 75 mg dipyridamole significantly suppressed the mean plasma thromboxane B2 concentrations and elevated the mean adenosine diphosphate threshold concentrations. Abnormal plasma thromboxane B2 concentrations, adenosine diphosphate threshold concentrations, or circulating platelet aggregate ratios were significantly normalized after administration of these regimens. The effects were not significantly different among treatment groups. Forty milligrams of acetylsalicylic acid seemed to have less platelet-inhibitory effect. A single dose of 75 mg acetylsalicylic acid significantly inhibited platelet hyperfunction and effectively corrected the abnormal plasma thromboxane B2 concentrations, adenosine diphosphate threshold concentrations, and circulating platelet aggregate ratios. Higher doses did not enhance the inhibitory effect. In addition, this single dose of acetylsalicylic acid did not significantly suppress plasma 6-keto-PGF1 alpha. We conclude that 75 mg acetylsalicylic acid per day is adequate to inhibit platelet hyperfunction.

Adenosine Diphosphate↗